There has been a steep rise in overdoses and mortality among people who use opioids or who inject drugs (PWUD), including in North America, the United Kingdom, and parts of Eastern Europe, with some of the sharpest increases amassing in rural communities. Currently, the literature lacks a comparative focus on the views and experiences of rural PWUD and professionals who regularly work and interface with them, in terms of their understandings of the rural drug use initiation/relapse trajectory. Considering a renewed sociology of emotions and empathy and the constructs of direct experience (e.g., of personal drug use) versus role-playing (e.g., envisioning oneself in another's position), we used a modified constant comparison method to analyze interviews conducted with PWUD and professional stakeholders in rural southern Illinois, an opioid overdose hotspot. Findings suggest that rural opioid use is adopted in service of an intricate interplay of sensory, relational, somatic, and psychosocial benefits, with a sharp divergence between PWUD, who express considerable agency in their drug use behaviors, and professionals, who fail to successful role-play in emphasizing PWUD's limited willpower and “deviant” sociocultural predilection. These dynamics illuminate challenges to advancing nuanced, culturally humble programming to advance public health goals related to the opioid and drug injection epidemic.

中文翻译：

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同理心和共同理解的社会学：将人们为何使用阿片类药物的信念和态度情境化

在北美、英国和东欧部分地区，阿片类药物或注射吸毒者 (PWUD) 的过量用药和死亡率急剧上升，其中一些增幅最大的是农村社区。目前，就农村吸毒开始/复发轨迹的理解而言，文献缺乏比较关注农村 PWUD 和经常与他们工作和接触的专业人员的观点和经验。考虑新的情感和同理心社会学以及直接体验（例如个人吸毒）与角色扮演的构造（例如，设想自己处于他人的位置），我们使用改进的持续比较方法来分析在伊利诺伊州南部农村地区（阿片类药物过量热点）对 PWUD 和专业利益相关者进行的访谈。研究结果表明，农村阿片类药物的使用被用于服务于感官、关系、躯体和心理社会益处的错综复杂的相互作用，在 PWUD 之间存在巨大差异，他们在吸毒行为中表现出相当大的代理权，而专业人士未能成功发挥作用- 强调 PWUD 有限的意志力和“离经叛道”的社会文化偏好。这些动态说明了推进细致入微、文化谦逊的规划以推进与阿片类药物和药物注射流行相关的公共卫生目标的挑战。