Economic problems and other societal issues have led many people not only to lose hope of a better future but also hope in their relationships with their families and communities. This study will explore how people living under such conditions negotiate relationships of trust and to alter their sense of future, focusing on the role that opioid analgesics and addiction treatment programs play in these processes. Since the proliferation of prescription opioids began in the 1990s, opioid addiction and overdose rates in the United States have skyrocketed and those suffering from opioid addiction are overwhelmingly from deindustrialized, lower-income surroundings. This study will examine how these substances have affected people 's lives, social networks, and sense of the future. It will also investigate the effects of three therapeutic interventions: medication assisted treatment (MAT); Narcotics Anonymous; and faith-based programs. How might these modes of addressing addiction influence people 's sense of future possibility and perceived pathways to recovery? How do these programs contribute to or detract from people 's efforts to transform their relationships with those around them? Are religious and clinical therapeutics mutually exclusive?
University of Virginia anthropologists, China Scherz and Joshua Burraway, will investigate these questions by using qualitative methods to analyze the life trajectories of twenty current and former opioid addicts over the course of three years. The research will be conducted in Southwest Virginia because of the intersection of deindustrialization and rural poverty; higher than national overdose rates; and this region 's religious landscape. Results from this research will provide a model for addressing questions of hope and temporality in clinical and social scientific studies of addiction. This study will also provide the first ethnographic analysis of how spiritual transformations relate to opioid addiction and recovery in an Appalachian context, illuminating the way that religious practices intersect with the historical, economic, sociopolitical, and embodied trajectories of the current epidemic. Finally, through its potential to offer insights into other ways of conceptualizing addiction, this study will contribute to a growing body of literature that seeks to think beyond the increasingly dominant medical model of addiction as a chronic relapsing brain disease. Opioid abuse and addiction present a national crisis given the unprecedented toll on both public health and the economy. While Medication Assisted Treatment (MAT) remains a valuable and hard-won therapeutic avenue for those afflicted, recovery, like addiction itself, does not emerge in a social vacuum. Indeed, rebuilding meaningful social connections and a sense of trust in the future may be just as important an aspect of recovery as mediating physical withdrawal symptoms. This study aims to offer new insights into the mechanisms through which these social connections could be built and to lay groundwork for improved collaborations between addiction practitioners who may see their approaches as fundamentally at odds. The research team 's enduring connections with academics and policy-makers at leading national psychiatric and medical facilities in the United States and UK will facilitate broadcasting the results and translating the study 's findings into relevant and usable policy recommendations.
This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.
