Department of Sociology and Anthropology, Elon University.
Department of Medicine, Brown University.
Med Anthropol Q. 2021 Jun;35(2):141-158. doi: 10.1111/maq.12618. Epub 2020 Nov 5.
Public narratives often attribute the opioid overdose epidemic in the United States to liberal prescribing practices by health care providers. Consequently, new monitoring guidelines for the management of opioid prescriptions in patients with chronic pain have become recognized as key strategies for slowing this tide of overdose deaths. This article examines the social and ontological terrain of opioid-based pain management in an HIV clinic in the context of today's opioid overdose epidemic. We engage with anthropological analyses of contemporary drug policy and the nonverbal/performative ways patients and clinicians communicate to theorize the social context of the opioid overdose epidemic as a "situation," arguing that the establishment of new monitoring strategies (essentially biomedical audit strategies) trouble patient subjectivity in the HIV clinic-a place where that subjectivity has historically been protected and prioritized in the establishment of care.
公共叙述常常将美国的阿片类药物过量流行归因于医疗保健提供者的宽松处方做法。因此，新的监测指南用于管理慢性疼痛患者的阿片类药物处方已被认为是减缓这一过量死亡浪潮的关键策略。本文在当今阿片类药物过量流行的背景下，考察了艾滋病毒诊所中基于阿片类药物的疼痛管理的社会和本体论领域。我们参与了对当代毒品政策的人类学分析以及患者和临床医生进行非言语/表现性沟通的方式，以将阿片类药物过量流行的社会背景理论化为一种“情况”，认为新的监测策略的建立（本质上是生物医学审计策略）扰乱了艾滋病毒诊所中患者的主体性 - 在那里，这种主体性在护理的建立中一直受到保护和优先考虑。
