Moral or Medical Disease? Pressure Group Redefinition of Problem Drug Use

• In Event: The Politics of Public Health: Frames, Federalism, and Opioids in the US

Abstract

Criminal justice, or punitive, legislation has historically been the hallmark of U.S. drug policy. With the Comprehensive Addiction Recovery Act of 2016, there has been a shift from a punitive approach to a more health-oriented approach, emphasizing patient education, prescription monitoring programs, and expansion of access to treatment, including medication assisted treatment. Such a legislative shift was preceded by a redefinition of the policy problem of addiction from one of moral failing to a health issue or disease of the brain.

Pressure groups, which I define as organized interest groups and administrative agencies, have historically played a significant role in defining problem drug use in the U.S. This paper explores how pressure group mobilization around the issue of problem drug use has changed in the last 15 years by analyzing changes in causal story use by pressure groups. In this paper, I analyze congressional hearing testimony, press releases and the Lobbying Disclosure Act disclosure reports to identify changes in the types of groups lobbying on problem drug use. I also analyze changes causal narratives that they use to identify the source of the problem.

My initial findings show that in the last 15 years there has been an increase in lobbying the by the healthcare industry and a decrease in lobbying activity by conservative parents’ groups and religious organizations. There has also been a rise in citizens groups comprised of recovering addicts and their families, which is noteworthy since comparative drug policy analysis has shown that countries with more progressive drug policy have stronger coalitions of drug users that lobby on drug policy, a phenomenon that has historically been absent from U.S. drug policy. Lastly, my initial findings reveal that under the Obama administration, recovery groups had key allies in high ranking executive officials that supported the definition of addiction as a disease.

Since complete problem redefinition of an issue is rare, the redefinition of addiction from a criminal justice problem to a health problem offers a unique opportunity to contribute to the problem definition and narrative literature by analyzing the narrative contributions that organized interest groups and administrative officials make during the redefinition of a policy problem.

Author

• Taleed El-Sabawi, The Ohio state university