Needles in a Haystack: Perceptions of Deservingness on the Implementation of Harm Reduction Programs in the American Midwest

The association of opioid abuse with rural, white, working-class individuals ultimately generated sympathy, rather than hatred, in the general political zeitgeist. However, some cases deviated from this pattern by adhering to the common cycle and villainizing individuals with substance use disorder...

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Bibliographic Details
Main Author: David, Lauren A.
Other Authors: Campbell, Andrea
Format: Thesis
Published: Massachusetts Institute of Technology 2024
Online Access:https://hdl.handle.net/1721.1/153329
Description
Summary:The association of opioid abuse with rural, white, working-class individuals ultimately generated sympathy, rather than hatred, in the general political zeitgeist. However, some cases deviated from this pattern by adhering to the common cycle and villainizing individuals with substance use disorder involving opioids, and in no such state was this more prevalent than Indiana and the circumstances of the 2014 Scott County HIV Crisis. First-person interviews and comparative analysis between Ohio, Kentucky, and Indiana revealed that negative moral evaluations of individual behavior contribute to a reticence to implement harm reduction programs, often due to the influence of in-group isolation and the social phenomenon known as “not-in-my-backyard.” Indiana is found to be an outlier even among the Midwestern states in its negative response to opioid epidemic victims due to the continued legacy of three, Indiana-specific historical events and phenomena: the rise and legacy of the Temperance Movement; the development of the Indiana Klan – a subset of the KKK; and the lasting influence of moral evangelism, manifesting in the careers of politicians like Mike Pence. This thesis demonstrates that while Americans, in general, viewed victims of the opioid epidemic as more sympathetic than victims of previous substance use epidemics, in part due to the blame placed by pharmaceutical and medical sectors, citizens of Indiana displayed less sympathy, which helps to explain the slow and minimal response to the Scott County HIV Crisis.