From deviance to disease: How Congress frames opioid use, 1994-2019
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Over the past thirty years, the use of opioids like heroin, fentanyl, oxycodone, and hydrocodone led to tens of thousands of deaths from overdoses and caused a public health crisis. Researchers have noted the roles of various social organizations and groups in creating a public discourse around this topic and have studied the changing public views of opioid use in light of new scientific research. And yet, there remains a gap in research on the role of the members of Congress in this public discourse. These legislators pass policies that directly affect people who live with or who know someone who uses opioids and fund the various agencies and programs that regulate and treat people who use opioids, yet their words remain unexamined. I draw upon the theories of deviance and medicalization to question how they speak about opioid use and whether their ways of speaking may have changed over time. In order to identify how the members of Congress speak about (or, frame) opioid use, I conducted a content analysis of the speeches they gave in the Senate and House of Representatives between 1994 and 2019. From a random sample of 105 speeches, I identified three frames of speaking about opioid use: as a deviant behavior, as a medical condition, and as both deviant and medical. In the beginning of the timeframe, the deviance frame is more prominent, but in the latter part of the timeframe, the medicalized frame and the both frame are more prominent. This change suggests the members of Congress have gradually spoken more of opioid use as a medical condition needing treatment rather than as a deviant behavior needing punishment. Though the members of Congress changed the ways they spoke about opioid use, they continue to engage in a moral crusade against it in their speeches and policies. This work will help stakeholders recognize how the members of Congress conceptualize and communicate about narcotic use and addiction and to adapt educational efforts to meet their needs.
