“Overdose Has Many Faces”: The Politics of Care in Responding to Overdose at Sydney’s Medically Supervised Injecting Centre

Abstract

Drug consumption room literature often presents overdose as a stable phenomenon, which can be responded to in the same way from one context to the next. The literature is dominated by a clinical paradigm that implies that consumption rooms are effective because they provide sterile spaces and medical supervision, yet this is not the only way in which such services are delivered, nor is it the only component of the care provided at centers with a clinical focus. A growing body of critically oriented social science literature has highlighted the way different socio-material relations of care produce different capacities for service delivery. In order to expand the field’s understanding of care beyond an avowed a-political approach to clinical supervision, we conducted qualitative interviews with staff at Sydney Medically Supervised Injecting Centre (MSIC) about how they respond to overdose. Drawing on feminist notions of the politics of care we argue that overdoses are ontologically multiple phenomena, which are enacted at MSIC in ways that are explicitly differentiated from how they are understood and responded to in more traditional clinical settings. This illustrates how a desirable clinical intervention (saving lives) is made possible at MSIC through a set of constitutive relations (and politics) of care that are aimed at more than simply ensuring the client’s heart keeps beating.