Defining the Opioid Epidemic: Congress, Pressure Groups, and Problem Definition

Abstract

The passage of the Comprehensive Addiction and Recovery Act of 2016 evidences a shift in federal legislative support from criminal justice oriented legislative alternatives to more health oriented legislative alternatives to addressing the ongoing Opioid Epidemic. Such a shift was preceded by a redefinition of problem drug use in the policy discourse from an issue of deviancy to a health issue. However, the redefinition of problem drug use as a health issue, has been dominated by policy narratives and causal stories that do not define problem drug use in a manner that aligns with a multi-modal public health oriented legislative solution, a solution type that has been shown to be successful in other developed nations across the world. In order to adopt such an approach in the U.S., pressure groups, including organized interest groups and administrative agencies, will need to utilize narrative techniques to strategically craft a narrative that defines problem drug use as a health issue affected by the social determinants of health. The purpose of this manuscript is to equip legal scholars, researchers, and all concerned citizens with a greater understanding of the legislative problem definition process and the role that pressure groups play in such a process. Through the utilization of examples from drug policy history, this manuscript demonstrates how pressure groups strategically used problem definitions to shape legislative discourse and pressure Congress into supporting policy solutions that aligned with their problem definitions—attributing addiction to disease at times and to deviancy at other times. By example, this manuscript outlines strategies that can be used by legal scholars, researchers, and concerned citizens to define problem drug use as a health issue caused by multiple sociological, psychological, economical and biological factors.

Keywords: drug policy, opioid, narratives, policy, causal stories, drugs, addiction, drug use, legislation, public health