The Social Construction of ‘Good’ and ‘Bad’ Addicts: How Relabelling Addiction Shaped the Opioid Epidemic
摘要
This chapter focuses on the social construction of the medicinal pro-opioid narrative which has contributed to the normalisation of strong opioid pain killers, resulting in the opioid crisis and a massive increase of drug-related deaths. Here I highlight one critical aspect of this narrative: the redefinition of addiction in order to remove the stigma of opioid drug use. My research, which consists of an analysis of academic articles in medical journals, is the first to explore these publications in a critical, historical and systematic way. It shows that with this redefinition a differentiation was constructed between dependency and addiction and between ‘good’ and ‘bad’ addicts. Pain specialists argued that those patients who showed symptoms of physical dependence and tolerance and stuck to the medical guidelines were not addicted, they were ‘good’ patients (and ‘good addicts’). They also stated that less than one percent of these patients would become addicted, for which they used the concept ‘psychological dependence’. According to this narrative ‘bad addicts’ were patients who showed signs of aberrant behaviour. These ‘bad’ patients (and ‘bad addicts’) became addicted because they did not follow the medical guidelines. The core theme of the narrative was that the pill was not the problem; the user was the problem. This chapter shows that many articles were not based on rigorous research and were published with one aim: to normalise opioid analgesics.