Department of Anthropology, University of Michigan, Ann Arbor, Michigan, USA.
Med Anthropol. 2021 Apr;40(3):228-240. doi: 10.1080/01459740.2020.1811704. Epub 2020 Sep 4.
The opioid epidemic in the United States is often portrayed as leading to a "pendulum swing" from indiscriminate prescribing toward appropriate use. This portrayal imagines rational-ethical physicians trying to resist irrational-manipulative patients and pharmaceutical companies. Drawing on an ethnography of pain management in U.S. hospital and clinic settings, I suggest instead that chronic pain generates a constantly renewed "emergency affect," a mutual experience for providers and patients that polarizes decisions toward either medication escalation or patient abandonment. Understanding this "emergency affect" can help provide a path forward through the opioid epidemic to embrace the discomfort of pain management.
美国的阿片类药物泛滥问题常被描绘为从无差别处方转向合理使用的“钟摆式摆动”。这种说法设想了理性-伦理医生试图抵制非理性-操纵患者和制药公司。通过对美国医院和诊所疼痛管理的民族志研究，我认为慢性疼痛会产生一种不断更新的“紧急影响”，这是提供者和患者共同的体验，使决策要么是药物升级，要么是患者被抛弃。理解这种“紧急影响”可以帮助我们走出阿片类药物泛滥的困境，接受疼痛管理的不适。
