What is health?
Health: ‘individual and collective bodily self-determination’ that ‘positively animates freedom’
Loyd, 2012
Who are the victims of the opioid crisis?
Age - young mentally ill people with a ready supply (ie from a parent or personal prescription)
Geographically - minority communities prescribed the most, but have the lowest service provision (esp. New Hampshire) - $10,000 for 28 day retreat
Bag of OxyCotin costs $80 but heroin $10
Who are the Sackler family?
Sackler family own Perdue Pharma - worth $14 billion
Marketed in 1996, over 200,000 people died since
Made their fortune by marketing the drug
Glazek, 2017
What is the opioid crisis?
Hansen, 2012
- States with the highest prescription rates are the states which have seen the most economic decline
- Opioids are the largest selling class of drugs in the world, with the US consuming 80%
- From 1999-2011 opioid consumption increased by 500% (Kolodny et al, 2015)
- Addiction is defined as the continued use of a drug despite negative consequences (Angres, 2008)
What was the rise of the opioid crisis?
- First opioid prescribed in 1996 with claims only less than 1% risk of addiction (Van Zee, 2009)
- Several states reported increases in prescription abuse of 500% in the first 5 years opioids were released
- Patients with pre-existing drug habits found they could crush the pill and inject or snort the contents for a heroin-like rush
- Prescription opioid abuse was associated with the white middle class
- Pharmaceutical company who released the drug (Purdue Pharma) had to pay a fine of $600 million, despite earning $3 billion in profits in 2009 alone
How can the opioid crisis be historicised?
Crisis is history repeating - crisis in late C19 due to prescriptions, Chinese immigrants smoking it, soldiers using it for war wounds (Kolodny et al, 2015)
- From 1997-2011 there was 900% increase in people seeking treatment for addiction to OPRs
Why was there such a rise in opioid use?
Highly addictive
Pressure to relieve chronic pain (Dasgupta et al, 2018):
- people live longer, survive diseases (ie cancer), survive complex surgeries, and more obesity
- very accessible and cheap (Dasgupta et al, 2018)
Benefits of the crisis
Weiner et al, 2017
Increase in organ donors - 27% of donors in 2016 were opioid deaths
What is pain?
Wailoo, 2016
Hard to articulate, share, communicate - personal and subjective experience
- So many different types of pain, therefore hard to define and measure
- Pain raises questions of compassion for suffering, citizenship, belonging and social welfare (Rosenberg, 1962)
- When pain becomes highly politicized, the question of whose pain matters also takes on political meanings