Re-thinking ‘outbreak’ in ‘long-view’: The case of opioid overdose

Author: Tim Rhodes, Kari Lancaster

Theme: Social Science & Policy Research Year: 2023


Early warning efforts to detect and anticipate outbreaks promise preparedness and rapid response. The Covid-19 pandemic has re-energised attention on the methods and technologies of early warning. In this paper, we offer a sociological analysis of outbreak applied to opioid overdose.


We engage critically with science narratives on early warning and outbreak. Focusing on opioid overdose in North America, we draw on ideas of ‘slow emergency’ and ‘big events’ to re-think outbreak in sociological ‘long-view’.


We first trace configurations of outbreak in relation to viruses and drugs. This accentuates outbreak as a rupturing event enabling a rapid reflex response of precautionary control, based largely on short-term and proximal indicators. We then look at opioid overdose outbreak. We draw specific attention to the promise and pitfalls of prediction as a form of anticipatory governance. Our analysis of outbreak in ‘long-view’ and as ‘slow emergency’ locates opioid overdose in long-term processes of deindustrialisation, pharmaceuticalisation and structural violence intersecting with a half-century ‘war on drugs’.


Early warning of drug outbreaks should not only focus on proximal and short-term predictions tailored to rapid reflex responses, but should open-up towards a ‘long’ and ‘ecological’ view. Outbreaks evolve in relation to big events and slow violent pasts. To ignore this perpetuates harm.

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