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How opioids became “safe”: pharmaceutical splitting and the racial politics of opioid safety

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Abstract

This article explores how opioid painkillers, known for over a century to be highly addictive, came to be considered a safe treatment for chronic pain. Based on a critical content analysis of industry-sponsored medical education, biomedical opioid research, and opioid marketing strategy it identifies the unacknowledged racialized category distinctions between ‘pain patients’ and ‘opioid abusers’ that have influenced medical opinion on opioid safety since the 1990s. It develops the concept of pharmaceutical splitting to understand how distinctions between ‘pain patients’ and ‘opioid abusers’ drew on racial and class-based imagery enabling prescribers to reconcile long-standing evidence of opioids’ addictive properties with the argument that they were a safe treatment for common chronic pain. Overall, this article contributes to understandings of the cultural and racial politics of pharmaceutical marketing and commercially-sponsored pharmacology.

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Notes

  1. Of this collective of 21 scientists, fourteen are now known to have received financial support from pharmaceutical companies, including six who received financial support specifically from Purdue, and eight who received financial support from other opioid manufacturers (New York Attorney General’s Office 2018).

  2. Though these guidelines are no longer publicly available on the websites of pharmaceutical companies, they can be found in the appendices of numerous court complaints (Ohio Attorney General’s Office 2017; Florida Attorney General’s Office 2018; Virginia Attorney General’s Office 2019; Massachusetts Attorney General’s Office 2019).

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Authors and Affiliations

  1. Presidential Fellow, Department of Social Anthropology, University of Manchester, Oxford Road, Manchester, M13 9PL, UK

    Caroline Mary Parker

  2. Anthropology and Psychiatry, New York University, 25 Waverly Pl, New York, NY, 10003, USA

    Helena Hansen

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Parker, C.M., Hansen, H. How opioids became “safe”: pharmaceutical splitting and the racial politics of opioid safety. BioSocieties 17, 577–600 (2022). https://doi.org/10.1057/s41292-021-00230-y

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