Annual William Form Lecture with Michelle Smirnova

In recent decades, journalists, policymakers, and families have lamented the so-called “opioid epidemic,” or the rise in opioid-related overdose in the US. In so doing, fingers of blame have been pointed in every direction: from the Sackler family to regulatory bodies like the FDA, unscrupulous doctors to drug cartels to the users or drugs themselves. But opioids are not a recent invention, neither are psychotropics or other prescription drugs whose nonmedical use has also increased precipitously in the last 20 years. What then accounts for this rise in the use and prosecution of prescription drugs? Based upon interviews with 80 incarcerated men and women, it becomes clear that increases in prescription drug use, overdose, and arrest reflect heightened pain experienced by those marginalized by society and the ways that medical and carceral institutions exacerbate—rather than remedy—that pain. In this talk, I explore (1) how certain groups are trapped in a nexus of too-little and too-much healthcare and policing, (2) how they seek to cope with structural harms, and (3) how their attempts are often punished, further intensifying pain and the likelihood of incarceration or overdose.