Who Is responsible for the Opioid Crisis? A Discourse Analysis of Responsibility Claims in Medicine.

The opioid crisis has continued despite efforts to intervene on its identified causes. In this article, we analyse responsibility claims in pain and addiction medical journals concerning the opioid crisis. Selected journals represent the opioid crisis as a medical problem. Using the method of discourse analysis, we examine 32 sampled articles from 3 medical journals published over the past decade to understand how the cause of the opioid crisis is represented. Drawing upon the sociological concept of responsibilization, we observe and explain two patterns in the responsibility claims. Pain medicine specialty journals tended to responsibilize physicians for their part in the crisis, whereas the addiction journal directed responsibility toward users. Despite some differences in proposed solutions, statements in both journals tend to responsibilize individual behaviours as the cause of the crisis. Accordingly, each article suggested solutions that target these behaviours. We argue that by focusing on individual behaviours, other factors and social conditions related to the crisis are omitted, including pharmaceutical companies, regulators, and health system infrastructure. We advocate for the need to redefine the assumptions related to the cause of the opioid crisis in order to consider alternative solutions.