Doctor of Philosophy (Ph.D.)
Degree Granting Department
Sara Green, Ph.D.
Donileen Loseke, Ph.D.
Shawn Bingham, Ph.D.
Lori Roscoe, Ph.D.
chronic pain, culture, narrative, opioids, public policy
Since the late 1990s, the abuse of prescription opioid painkillers has been constructed as a major social problem in the United States, commonly referred to in the media as the “prescription painkiller epidemic.” Stories of addiction, overdose deaths, robberies, and other tragedies related to prescription opioids have been, and continue to be, commonly featured in the media. In response to public outcry regarding the “epidemic,” government and medical institutions have enforced strict regulations on the distribution of opioids, targeting most of these regulations at the treatment of chronic pain in particular. In this dissertation, I examine the experience of chronic pain management with opioids amid this cultural environment, using the personal, cultural, and institutional levels of narrative outlined by Loseke (2007) as an organizing theme. The dissertation is comprised of four distinct but interrelated chapters that explore the topic of chronic pain management with opioids in four different ways.
In the first substantive chapter, I share a personal narrative of my own experience as the daughter of a mother with chronic pain who relies on opioids, in order to provide context for the rest of the dissertation, disclose my own positionality, and show rather than tell how the stigma and regulations surrounding opioids are experienced in the lives of people with chronic pain and their families. In the following chapter, I shift away from the personal and use Loseke’s (2012) method for the empirical analysis of formula stories to examine cultural narratives about prescription opioids published in the New York Times between 2000 and 2013. I argue that the narratives contribute to an environment in which people with chronic pain who rely on opioids are made vulnerable to stigma and discrimination. I use Loseke’s method again in the third substantive chapter to examine institutional narratives about opioids told in an FDA public hearing. I argue that the narratives serve to construct moral boundaries between different types of pain patients and justify a label change that disproportionately burdens patients with chronic pain. In the final substantive chapter, I share personal narratives acquired through in-depth interviews with twelve people currently living with chronic pain. I find that the dominant cultural and institutional narratives surrounding prescription opioids translate into stigma and barriers experienced in the lives of people seeking chronic pain treatment, and serve to silence their personal narratives which are resistant and subversive. I conclude by urging for the removal of barriers to chronic pain treatment with opioids and for the wider dissemination of personal narratives of chronic pain patients at the cultural and institutional levels.
Scholar Commons Citation
Wilbers, Loren, "The Experience of Chronic Pain Management: A Multi-Voiced Narrative Analysis" (2015). Graduate Theses and Dissertations.