Moralizing the Opioid Shortage: Race, Pain, and Interpretations of Resource Scarcity in an Urban Hospital

• In Event: 3421 - Health Equity, Social Justice, and Social Movements

Abstract

This article examines the production of racial inequalities in the healthcare system through an ethnography of a safety-net hospital located on the South Side of Chicago. In Fall 2017, a major nationwide shortage of injectable opioid drugs, the result of a combination of natural disaster, manufacturing problems, federal policy, and market forces, radically altered care for patients with sickle cell disease. I argue that instead of experiencing the opioid shortage as a crisis, workers at this hospital interpreted it as a moral positive because the new practice of rationing opioids resonated with stereotypes about the immorality low-SES black patients, who were widely believed to be drug abusers. This caused physicians, pharmacists, and administrators to advocate for policies that would make restrictions on opioid prescriptions for sickle cell patients permanent even after the shortage was over. This study provides insight into how seemingly-neutral hospital protocols become embedded with racial biases that disadvantage black patients.

Author

• Alexandra E. Brewer, University of Chicago