Kelly Knight, PhD

Phone: 415-867-8405
kelly.knight@ucsf.edu

Research Interests

  • The social construction and experience of addiction
  • Opioids, chronic non-cancer pain, clinical uncertainty, and scientific evidence
  • Co-morbidity (HIV, substance abuse, mental illness), homelessness, and US urban health
  • Structural competency in medical education and clinical care
  • Post-traumatic stress disorder (PTSD), bi-polar disorder, and the US welfare state
  • Gender, reproduction, motherhood and citizenship
  • The production of knowledge in science, clinical medicine, and public health

Courses taught

ANTH211A: Introduction to Ethnographic Theory and Methods
ANTH205A: Introduction to Medical Anthropology Theory  (with Vincanne Adams)
ANTH 225: The Clinic, in theory and practice
ANTH 225: Disability and Dependence in the US Welfare State (with Aimee Medeiros)
PH290/ANTH 225: Structural Competency (with Seth Holmes)

Research Program

Opioids, chronic non-cancer pain and clinical uncertainty in the US healthcare safety net

I have been examining the US opioid crisis for several years, following multiple lines of anthropological inquiry.  Recently, I am have been thinking and writing about the public mediation of the opioid crisis in the production of racialized and classed narratives of structural vulnerability, social anxiety, and failed progression. This work centers on analytic questions raised in the movement between highly localized registers of mortality and morbidity and aggregate publics that seek to parse and categorize risk while simultaneously democratizing addiction vulnerability.

I completed an NIH-funded clinical and community ethnography of chronic non-cancer pain, Pain Management in the Clinic and Community (R01DA034625; 2013-2017). This study took place in safety-net clinics and community settings and led to the identification of “opioid pharmacovigilance” as a driver for the management of clinical uncertainty and the containment of opioid-associated risks. I am continuing to examine the consequential dynamics of reductions in US opioid prescribing for patients, their clinicians and community stake holders occupying a variety of social roles (e.g. affected kin, harm reductionists, substance use treatment professionals, health policy makers, DEA agents, clergy) in an ethnographic study also funded by the National Institute of Drugs Abuse (R01DA043631; 2017-2021).

Addiction, housing instability, and health in the US welfare state

I have several projects reflecting a body of work centered on the production of knowledge about addiction and mental health, urban landscapes of housing instability and adjudication, women’s health, and co-morbidity (HIV, mental illness, and substance abuse).  My book-length ethnography, addicted.pregnant.poor (Duke University Press, 2015), sought to answer the question “What forms of life are possible here?” by engaging with the social actors who are called upon to produce knowledge about addicted pregnancy, including addicted, pregnant women, an anthropologist, public health epidemiologists, advocates, social policy-makers, treatment professionals, bureaucrats, and scientists.  addicted.pregnant.poor was awarded the British Sociological Association’s Foundation for the Sociology of Health and Illness (FSHI) 2016 Book Award, was a finalist for the 2015 C. Wright Mills Award, and received an Honorable Mention for the Society of Medical Anthropology’s Eileen Basker 2016 Book Prize.

I am currently Principal Investigator, in collaboration with Margot Kushel, MD, of the Family Assisted Housing for Older Homeless Adults Study (R01AG050630; 2015-2020) that uses ethnographic theory and methods to examine the role of housing policy and family kinship networks in reducing homelessness.  My past research included two ethnographic studies funded by the California HIV/AIDS Research Program (Kelly Knight-PI), Policing, Arrest, HIV risk, and Women (2008-2011) and The HIV, Environment and Risk Study (2006-2008), and one ethnography funded by the UCSF Center for AIDS Prevention Studies (Kelly Knight-PI), The Care to Home Study: socio-structural barriers for HIV+ women who use illicit stimulants (2010-2011).  During this period, I also collaborated on two longitudinal, multi-methodological cohort studies of housing instability, substance use, gender, and victimization funded by the NIH-National Institute of Drug Abuse (R01DA015605; Elise Riley-PI) Shelter, Health care, And Drug use (2007-2012) and Drugs, gender and healthcare use among HIV+ homeless (2003-2007).

Structural competency and medical education

I have been involved with national and local efforts to develop and implement structural competency into to clinician education.  I play an active role in UCSF medical education, focused on the Bridges Curriculum and the Differences Matter Initiative. I served on the design content committee for the Foundations Sciences I: Health and the Individual (H&I) and Health and Society Elements. I teach two required lectures in H&I: “Understanding Addiction” and “Cultural and Structural Competency” to first year medical students, and lead the Foundational Sciences curriculum development for addiction, structural competency, and health disparities for the second year medical students.  I am an active member in the UCSF School of Medicine committee charged with optimizing the curriculum to ensure inclusive teaching and integration of issues of race, racism, exclusion, and health disparities-relevant competencies. I serve as one of the two UCSF faculty representatives on the UC system wide Opioid Curriculum Workgroup tasked with developing a shared and portable curriculum to address the national concerns about an opioid epidemic.   I also serve as a faculty mentor in the UCSF Department of Psychiatry and I am affiliated faculty with the Z-SFGH Center for Vulnerable Populations.  I am research mentor for medical and global health students and regularly lecture in medical student-designed electives and at the invitation of Internal Medicine, Global Health, Psychiatry, and Residency Diversity Committee residents.

Selected Publications                                                                                                                                 

Knight KR  addicted.pregnant.poor. Duke University Press, 2015.

Knight, KR. Women on the edge: opioids, benzodiazepines and the social anxieties surrounding women’s reproduction in the US opioid epidemic. Contemporary Drug Problems. 2017, Dec.

Knight KR, Kushel M, Chang JS, Zamora K, Ceasar R, Hurstak E, Miaskowski C. Opioid pharmacovigilance: A clinical-social history of the changes in opioid prescribing for patients with co-occurring chronic non-cancer pain and substance use. Soc Sci Med. 2017 Aug; 186:87-95.

Neff J, Knight KR, Satterwhite S, Nelson N, Matthews J, Holmes SM. Teaching Structure: A Qualitative Evaluation of a Structural Competency Training for Resident Physicians. J Gen Intern Med. 2016 Nov 28.

Knight KR, Lopez AM, Comfort M, Shumway M, Cohen J, Riley ED. Single room occupancy (SRO) hotels as mental health risk environments among impoverished women: the intersection of policy, drug use, trauma, and urban space. Int J Drug Policy. 2014 May; 25(3):556-61.

Knight, KR. (2012) The public life of sex work: risk, politics, and public health. Western Humanities Review, Fall, 2012: 55-76.

Riley, EB; Cohen, J; Knight, KR; Decker, A; Marson, K; Shumway, M. (2014) Recent Violence in a Community-Based Sample of Homeless and Unstably Housed Women With High Levels of Psychiatric Comorbidity.  American Journal of Public Health.

For a full list of publications: http://profiles.ucsf.edu/kelly.knight

 

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Last modified: November 28, 2017