CAREER: The Influence of Social Problems on Healthcare and Legal Institutions

Saint Louis University, Saint Louis MO

Investigators

Abstract

The United States is facing an unprecedented opioid crisis. Opioids are addictive pain relievers that are profitable in illicit markets and pose challenges for healthcare providers who are responsible for treating pain and for enforcement agents who are tasked with ensuring proper drug provision. Several states have responded by adopting prescription drug monitoring programs (PDMPs), surveillance technologies designed for healthcare and criminal justice use. However, researchers and policymakers have not fully considered how this technology will impact professional fields. This project will examine how current efforts to curb the opioid crisis affect healthcare and criminal justice workers. This project asks: how does policing patients affect healthcare practice? And, how does targeting healthcare providers affect law enforcement? Addressing these questions is important because requiring workers to venture beyond their traditional scopes of practice could undermine their professional commitments and negatively impact professional community members. This research contributes to policy by including both health care and enforcement workers, aiming to develop policy solutions amenable to both fields. It advances education by enlisting the help of undergraduate research assistants. Findings will inform policymakers and clinicians about ways to address the opioid crisis while avoiding unintended consequences. This project examines the opioid epidemic as a case for understanding how social problems transform social fields. The primary goal is to extend sociological and socio-legal theory by developing a micro-level theory of field change. This project uses a mixed-methods, comparative design across three states, California, Florida, and Missouri, that will culminate in four original qualitative and quantitative data sets. These data will be analyzed with the assistance of an undergraduate research team using grounded theory techniques. This research contributes by addressing intersections between law and medicine and by using nested maximum variation samples to capture field-level heterogeneity and change. Although most research on opioid abuse is heavily siloed, focusing either on healthcare or law enforcement, this research brings together insights from both fields. Findings will inform policy makers and healthcare leaders about how using technology to combat opioid abuse affects practice. Technology is often considered a panacea for addressing social problems, but this research brings a critical lens to technology, addressing the kinds of unintended consequences that might result from its use. This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.