Skip to main content
SpringerLink
Log in

The North American Opioid Epidemic

  • Chapter
  • First Online:
Book cover Life in Pain

  • 368 Accesses

Abstract

In this chapter I tell a story about the opioid epidemic in North America. The cultural neuromatrix framework implicates a wider set of actors in the propagation of the epidemic. Rather than just blame bad pharma and its compliant regulators, this chapter offers an alternative explanation for the epidemic. In this chapter it is the shapeshifting quality of pain as a commodity that enables a networked affective economy to thrive. Affective capitalism is at the heart of the oxycodone epidemic in North America. Although oxycodone was the reliever that was consumed, it actually only covaried with pain, the real commodity in this economy. When regulators began to reduce access to oxycodone, the third wave of the epidemic began with a range of other synthetic opiates. Once North America unleashed the pain tiger, it has been hard to put back in the box. Cannabis has been primed as the next substance in line to mitigate the pain epidemic that has swept North America. The problem is that the epidemic has been misdiagnosed. It is affective capitalism that is at the heart of pain.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ahmed, S. (2004a). Affective economies. Social Text, 79(22–2), 117–139.

    Article  Google Scholar 

  • Ahmed, S. (2004b). The cultural politics of emotion (1st ed.). New York: Routledge.

    Google Scholar 

  • Ahmed, S. (2013). The cultural politics of emotion (2nd ed.). New York: Routledge.

    Book  Google Scholar 

  • Bachhuber, M. A., Saloner, B., Cunningham, C. O., & Barry, C. L. (2014). Medicinal cannabis laws and opioid analgesic overdose mortality in the United States 1999–2010. JAMA Internal Medicine, 174(10), 1668–1673.

    Article  Google Scholar 

  • Bradford, A. C., Bradford, W. D., Abraham, A., & Adams, G. B. (2018). Association between the US state medical cannabis laws and opioid prescribing in the Medicare Part D Population. JAMA Internal Medicine, 178(5), 667–673.

    Article  Google Scholar 

  • Brena, S. (1978). Chronic pain: America’s hidden epidemic. New York: Antheneum.

    Google Scholar 

  • Brena, S. F., Chapman, S. L., & Decker, R. (1981). Chronic pain as a earned experience: Emory university pain control centre. NIDA Research Monographs, 36, 76–83.

    Google Scholar 

  • Chen, Q., Larochelle, M. R., Weaver, D. T., Lietz, A. P., Mueller, P. P., Mercaldo, S., et al. (2019). Prevention of prescription opioid misuse and projected overdose deaths in the United States. JAMA Network Open, 2(2), e187621.

    Article  Google Scholar 

  • Coleman, J. J. (2019). Whatever happened to the decade of pain control and research? In J. F. Peppin, J. J. Coleman, K. K. Dineen, & A. J. Ruggles (Eds.), Prescription drug diversion and pain: History, policy and treatment. Chapter 4 (pp. 78–109). New York: Oxford University Press.

    Google Scholar 

  • Commonwealth of Massachusetts. (2018). Healey vs. Purdue Pharma Inc. https://www.mass.gov/files/documents/2018/06/12/Purdue%20Complaint%20FILED.pdf.

  • De Knegt, N. C., Schuengel, C., Lobbezoo, F., Visscher, C. M., Evenhuis, H. M., Boel, J. A., et al. (2016). Comprehension of pictograms for pain quality and pain affect in adults with Down syndrome. Journal of Intellectual and Developmental Disability, 41(3), 222–232.

    Article  Google Scholar 

  • Department of Veterans Affairs. (2000). Pain as the 5th Vital Sign Toolkit. Washington: Veterans Health Administration.

    Google Scholar 

  • Derrida, J. (1981). Dissemination. London: Athlone Press.

    Google Scholar 

  • Deyo, R. A. (2014). Watch your back: How the back pain industry is costing us more and giving us less. And what you can do to inform and empower yourself in seeking treatment. Ithaca: Cornell University Press.

    Google Scholar 

  • Ehrenreich, B., & Hochschild, A. R. (2003). Global woman: Nannies, maids and sex workers in the new economy. New York: Henry Holt and Company.

    Google Scholar 

  • Evans, W. N., Lieber, E. M. J., & Power, P. (2019). How the reformulation of oxycontin ignited the heroin epidemic. The Review of Economics and Statistics, 101(1), 1–15.

    Article  Google Scholar 

  • Fitzgerald, J. L. (2015). Framing drug use: Bodies, space, economy and crime. Oxford: Palgrave McMillan.

    Book  Google Scholar 

  • Foucault, M. (1973). The birth of the clinic: An archeaology of medical perception. London: Tavsistock.

    Google Scholar 

  • Friedman, J., Schneberk, T., Bourgois, P., Shin, M., Celious, A., & Schriger, D. L. (2019). Assessment of racial/ethnic and income disparities in the prescription of opioids and other controlled medications in California. JAMA International Medicine, 179(4), 469–476.

    Article  Google Scholar 

  • Gluck, A. R., Hall, A., & Curfman, G. (2018). Civil litigation and the opioid epidemic: The role of courts in a national health crisis. Journal of Law, Medicine and Ethics, 46(2), 351–366.

    Article  Google Scholar 

  • Gostin, L. O., Hodge, J. G., & Noe, S. A. (2017). Reframing the opioid epidemic as a national emergency. JAMA, 318(16), 1539–1540.

    Article  Google Scholar 

  • Green, M. S., & Chambers, R. A. (2015). Pseudoaddiction: Fact or fiction? An investigation of the medical literature. Current Addiction Reports, 2(4), 310–317.

    Article  Google Scholar 

  • Haefeli, M., & Elfering, A. (2006). Pain assessment. European Spine Journal, 15(Suppl 1), S17–S24.

    Article  Google Scholar 

  • Hill, D. (2019). The opioid epidemic: How it happened and what are the best alternatives for your patients. Presentation to the 2019 ROME Rocky Mountain conference, which was held February 7–10, 2019 in Keystone, Colorado. https://osteopathic.org/wp-content/uploads/rocky-mountain-2019-hill-slides.pdf.

  • Hochschild, A. R. (1983). The managed heart: Commercialization of human feeling. Berkeley: University of California Press.

    Google Scholar 

  • Jalal, H., Buchanich, J. M., Roberts, M. S., Balmert, L. C., Zhang, K., & Burke, D. S. (2018). Changing dynamics of the drug overdose epidemic in the United States from 1979 through 2016. Science, 361(6408), eaau1184.

    Article  Google Scholar 

  • Jensen, T. S., & Finnerup, N. B. (2014). Allodynia and hyperalgesia in neuropathic pain: Clinical manifestations and mechanisms. The Lancet Neurology, 13(9), 924–935.

    Article  Google Scholar 

  • Jung, E. K., Srivastava, K., Abouljoud, M., Keller, B. S. R., Okoroha, K., & Davis, J. (2018). Does hospital consumer assessment of healthcare providers and systems survey correlate with traditional metrics of patient satisfaction? The challenge of measuring patient pain control and satisfaction in total joint replacement. Arthroplasty Today, 4(4), 470–474.

    Article  Google Scholar 

  • Keefe, P. R. (2017). The family that built an empire of pain. The New Yorker, October 30. https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain.

  • Kiang, M. V., Basu, S., Chen, J., & Alexander, M. J. (2019). Assessment of changes in the geographical distribution of opioid-related mortality across the United States by opioid type, 1999–2016. JAMA Network Open, 2(2), e190040.

    Article  Google Scholar 

  • Kim, E. J., & Buschmann, M. T. (2006). Reliability and validity of the faces pain scale with older adults. International Journal of Nursing Studies, 43(4), 447–456.

    Article  Google Scholar 

  • Kirmayer, L. J., & Sartorius, N. (2007). Psychosomatic Medicine, 69, 832–840.

    Article  Google Scholar 

  • Kolodny, A., Courtwright, D. T., Hwang, C. S., Kreiner, P., Eadie, J. L., Clark, T. W., et al. (2015). The prescription opioid and heroin crisis: A public health approach to an epidemic of addiction. Annual Review of Public Health, 36, 559–574.

    Article  Google Scholar 

  • Kreuger, A. (2017). Where have all the workers gone? An inquiry into the decline of the U.S. Labor Force participation rate. Washington: Brookings Institute. https://www.brookings.edu/blog/brookings-now/2017/09/07/how-the-opioid-epidemic-has-affected-the-u-s-labor-force-county-by-county/.

  • Leung, P. T. M., Macdonald, E. M., Dhalla, I. A., & Juurlink, D. N. (2017). A 1980 Letter on the risk of opioid addiction. The New England Journal of Medicine, 376, 2194–2195.

    Article  Google Scholar 

  • Levy, N., Sturgess, J., & Mills, P. (2018). “Pain as the fifth vital sign” and dependence on the “numerical pain scale” is being abandoned in the US: Why? British Journal of Anaesthesia, 120(3), 435–438.

    Article  Google Scholar 

  • Lumley, M. A., & Schubiner, H. (2019). Psychological therapy for centralized pain: An integrative assessment and treatment model. Psychosomatic Medicine, 81(2), 114–124.

    Article  Google Scholar 

  • Marx, K. (1976/1867). Capital: A critique of political economy (p. 252) (Ben Fowkes Harmondsworth, trans.). London, UK: Penguin.

    Google Scholar 

  • Massumi, B. (2015). The power at the end of the economy. Durham: Duke University Press.

    Book  Google Scholar 

  • Massumi, B. (2018). 99 Theses on the revaluation of value. A postcapitalist manifesto. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Morris, D. B. (1991). The culture of pain. Berkeley: University of California Press.

    Google Scholar 

  • Moseley, G. L. (2007). Painful yarns: Metaphors & stories to help understand the biology of pain. Canberra: Dancing Giraffe Press.

    Google Scholar 

  • National Center for Health Statistics. (2017). Wide-ranging online data for epidemiologic research (WONDER). Atlanta, GA: CDC, National Center for Health Statistics, 2017. Available at http://wonder.cdc.gov.

  • National Drug Intelligence Centre. (2001). Oxycontin diversion and abuse. http://www.justice.gov/archive/ndic/pubs/651/abuse.htm.

  • Partners Against Pain. (2008). Clinical issues in opioid prescribing: Considerations for the practitioner in the use of opioids in managing moderate to severe pain 2. Purdue Pharmaceuticals L.P.

    Google Scholar 

  • Portenoy, R. K., & Foley, K. M. (1986). Chronic use of opioid analgesics in non-malignant pain: Report of 38 cases. Pain, 25(2), 171–186.

    Article  Google Scholar 

  • Porter, J., & Jick, H. (1980). Addiction rare in patients treated with narcotics. New England Journal of Medicine, 302, 123.

    Google Scholar 

  • Price, T. E. (2017). Secretary price announces HHS strategy for fighting opioid crisis. National Rx drug abuse and heroin summit, April 19, 2017, Atlanta, Georgia. https://www.hhs.gov/about/leadership/secretary/speeches/2017-speeches/secretary-price-announces-hhs-strategy-for-fighting-opioid-crisis/index.html.

  • Read, J. (2016). The affective economy: Producing and consuming affects in Deleuze and Guattari. In: C. Meiborg & S. van Tuinen (Eds.), Deleuze and the passions. Chapter 5 (pp. 103–124). Goleta, CA: Punctum Books.

    Google Scholar 

  • Rosenthal, E. (1993). Patients in pain find relief, not addiction, in narcotics. New York Times. p1. https://www.nytimes.com/1993/03/28/us/patients-in-pain-find-relief-not-addiction-in-narcotics.html.

  • Rudd, R. A., Aleshire, N., Zibbell, J. E., & Gladden, R. M. (2016). Increases in drug and opioid overdose deaths—United States, 2000–2014. Morb Mortal Weekly Report (MMWR), 64(50), 1378–1382.

    Article  Google Scholar 

  • Scholl, L., Seth, P., Kariisa, M., Wilson, N., & Baldwin, G. (2018). Drug and opioid-involved overdose deaths—United States, 2013–2017. Morb Mortal Weekly Report (MMWR), 67(5152), 1419–1427.

    Google Scholar 

  • State of Colorado. (2018). State of Colorado vs. Purdue Pharmaceuticvals L.P. and Purdue Pharma Inc. Denver Colorado. https://coloradosun.com/wp-content/uploads/sites/15/2019/02/Purdue-Pharma-opioids-lawsuit.pdf.

  • State of Florida. (2018). Bondi vs. manufacturers and distributors. Pasco Country, Florida. http://myfloridalegal.com/webfiles.nsf/WF/GWRY-B6KV32/$file/Amended+Complaint+(Filed).pdf.

  • State of Georgia. (2019). Carr vs. manufacturers and distributors. Gwinnett County Georgia. https://law.georgia.gov/sites/law.georgia.gov/files/related_files/press_release/Opioid%2520Lawsuit_Carr%2520v.%2520Manufacturers%2520and%2520Distributors.pdf+&cd=8&hl=en&ct=clnk&gl=au&client=firefox-b-d.

  • State of Illinois and Cook County. (2017). The People of the state of Illinois and Cook County Illinois vs. Purdue Pharma L.P. Cook County, Illinois. https://news.wttw.com/sites/default/files/article/file-attachments/FS%20Complaint%20at%20Law.pdf.

  • State of North Carolina. (2018). North Carolina vs. Purdue Pharmaceuticals L.P. https://www.ncdoj.gov/getattachment/2ddcd2de-4bc4-460f-9623-c5bed10f371a/NC-Complaint-against-Purdue-Pharma.pdf.aspx.

  • Stewart, K. (2010). Worlding Refrains. In M. Gregg & G. Seigworth (Eds.), The affect theory reader (pp. 339–353). London: Duke University Press.

    Google Scholar 

  • Thompson, C. A. (2017). HCAHPS survey to measure pain communication, not management. American Journal of Health-System Pharmacy, 74(23), 1924–1926.

    Article  Google Scholar 

  • Tompkins, D. A., Hobelmann, J. G., & Compton, P. (2017). Providing chronic pain management in the fifth vital sign era: Historical and treatment perspectives on a modern day dilemma. Drug and Alcohol Dependence, 173(suppl 1), S11–S21.

    Article  Google Scholar 

  • Toye, F., Seers, K., Allcock, N., Briggs, M., Carr, E., Andrews, J., & Barker, K. (2013). A meta-ethnography of patients’ experience of chronic non-malignant musculoskeletal pain. Health Services and Delivery Research, 1(12).

    Google Scholar 

  • Unick, G., Rosenblum, D., Mars, S., & Ciccarone, D. (2013). Intertwined epidemics: National demographic trends in hospitalizations for heroin-and opioid-related overdoses, 1993–2009. PloS One, 8(2), e54496. https://doi.org/10.1371/journal.pone.0054496.

    Article  Google Scholar 

  • United States Department of Justice, Middle District of Florida. (2015). United States reaches $22 million settlement agreement With CVS For unlawful distribution of controlled substances. https://www.justice.gov/usao-mdfl/pr/united-states-reaches-22-million-settlement-agreement-cvs-unlawful-distribution.

  • United States Department of Justice (DOJ). (2017a). Justice news: McKesson agrees to pay record $150 million settlement for failure to report suspicious orders of pharmaceutical drugs. https://www.justice.gov/opa/pr/mckesson-agrees-pay-record-150-million-settlement-failure-report-suspicious-orders.

  • United States Department of Justice (DOJ). (2017b). Civil penalty settlement agreement. https://www.justice.gov/opa/press-release/file/928471/download.

  • United States Senate Homeland Security and Governmental Affairs Committee (HSGAC). (2018). Fuelling an epidemic: Exposing the financial ties between opioid manufacturers and third party advocacy groups. Washington: Senate Homeland Security and Governmental Affairs Committee. https://www.hsgac.senate.gov/…/fueling-an-epidemic-exposing-the-financial-ties-betw….

  • US Department of Justice. (2007). Press release: The purdue frederick company, Inc. and top executives plead guilty to misbranding oxyContin; will pay over $600 million. http://www.prnewswire.com/news-releases/the-purdue-frederick-company-inc-and-top-executives-plead-guilty-to-misbranding-oxycontin-will-pay-over-600-million-58092727.html.

  • Van Zee, A. (2009). The promotion and marketing of oxycontin: Commercial triumph, public health tragedy. American Journal of Public Health, 99(2), 221–227.

    Article  Google Scholar 

  • Vuille, M., Foerster, M., Foucault, E., & Hugli, O. (2018). Pain assessment by emergency nurses at triage in the emergency department: A qualitative study. Journal of Clinical Nursing, 27(3–4), 669–676.

    Article  Google Scholar 

  • Wailoo, K. (2014). Pain: A political history. Maryland: John Hopkins University Press.

    Google Scholar 

  • Weissman, D. E., & Haddox, J. D. (1989). Opioid pseudoaddiction—An iatrogenic syndrome. Pain, 36(3), 363–366.

    Article  Google Scholar 

  • Wen, H., & Hockenberry, J. M. (2018). Association of medical and adult use marijuana laws with opioid prescribing for Medicaid enrollees. JAMA Internal Medicine, 178(5), 673–679.

    Article  Google Scholar 

  • Whaley, D., & Wong, D. L. (1995). Nursing care of infants and children (5th ed., p. 1085). St Louis, MO: Mosby.

    Google Scholar 

  • White, W. (2004). Oxycontin addiction, a new drug but an old problem. In M. D. Seppala, M. J. Meyers, J. Gardin, W. White, & S. Brown (Eds.), When painkillers become dangerous. What everyone needs to know about Oxycontin and other prescription drugs (pp. 99–138). Centre City MN: Hazelden.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Social and Political Sciences, University of Melbourne, Parkville, VIC, Australia

    John L. Fitzgerald

Authors
  1. John L. Fitzgerald
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John L. Fitzgerald .

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Fitzgerald, J.L. (2020). The North American Opioid Epidemic. In: Life in Pain. Springer, Singapore. https://doi.org/10.1007/978-981-10-5640-6_3

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-5640-6_3

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-5639-0

  • Online ISBN: 978-981-10-5640-6

  • eBook Packages: Social SciencesSocial Sciences (R0)

Publish with us

Policies and ethics

Search

Navigation