"There's nothing here": Deindustrialization as risk environment for overdose.

Area of Science:

• Public Health
• Sociology
• Criminology

Background:

• Deindustrialization in Pennsylvania's Monongahela Valley created a
• risk environment
• contributing to increased drug overdose deaths.
• Study focuses on McKeesport, a deteriorating mill city, contrasting with media attention on suburban overdoses.

Purpose of the Study:

• To explore contextual factors contributing to drug overdose in a deindustrialized region.
• To understand the lived experiences of individuals affected by overdose in McKeesport.
• To identify potential remedies for the local overdose epidemic from the perspective of affected individuals.

Main Methods:

• In-depth interviews with 18 clients of a drug treatment facility in McKeesport.
• Participants described personal or witnessed overdose events.
• Participants speculated on the causes and solutions for the local overdose epidemic.

Main Results:

• Participants described a micro-level risk environment characterized by unprepared "assistants" and hidden settings.
• Hopelessness and lack of opportunity in the deindustrialized area were identified as drivers of heroin use.
• Participants explicitly called for jobs and community reinvestment to reduce overdose fatalities.

Conclusions:

• Current state and county efforts focus on naloxone accessibility.
• Study findings suggest a need for interventions addressing poverty and social isolation among opiate users.
• Addressing the socio-economic conditions of the post-industrial periphery is crucial for reducing overdose mortality.