Shared Technology, Competing Logics: Use of Prescription Drug Monitoring Programs in Healthcare and Law Enforcement

• In Event: 4111 - Innovation, Technology, in Studies of Crime and Social Control

Abstract

A growing sociological literature examines how new technological tools help to reshape professional work. From police body cameras to big data analytics in law enforcement and electronic medical records in healthcare, technological advances have transformed various workers’ daily routines. However, most research on technological innovation focuses on changes within a single field. This leaves unanswered questions about how technologies that are shared across fields impact work in each field and relationships between fields.
This research focuses on the contemporary U.S. opioid crisis, a social problem shared across the fields of healthcare and criminal justice, to examine how state-level Prescription Drug Monitoring Programs (PDMPs) shape frontline work and interprofessional relationships. I focus on pharmacists, underexamined healthcare professionals who exert significant discretion over opioid provision. Drawing on field theory and frontline work theory, I ask: 1) How does the PDMP transform pharmacy practice? 2) How does the PDMP affect pharmacy’s relationship to adjacent fields of medicine and criminal justice? 3) Under what circumstances do workers resist field change wrought by PDMP use?
Data for this study consist of 38 semi-structured interviews with pharmacists and enforcement agents in California conducted between 2013 and 2016 including follow-up interviews with pharmacists interviewed in 2009. Findings demonstrate that PDMP use reshapes pharmacists’ roles, routines, and relationships. When afforded access to PDMPs, pharmacists embrace rather than eschew enforcement roles. They also interact differently with physicians and enforcement agents. They are more likely to resist entrenched interprofessional power dynamics that subordinate them to physicians when they have evidence of patients’ drug seeking and are more likely to consider enforcement agents allies than threats. This paper concludes by discussing the implications of new surveillance technology for relationships within and between professional fields and the potential consequences of intense monitoring for patients’ access to care and exposure to criminal justice.

Author

• Elizabeth Chiarello, Saint Louis University