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CHASING the DRAGON: the SOCIAL CONSTRUCTION of the U.S. OPIOID EPIDEMIC a Dissertation Submitted to the Graduate Faculty of Th

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CHASING the DRAGON: the SOCIAL CONSTRUCTION of the U.S. OPIOID EPIDEMIC a Dissertation Submitted to the Graduate Faculty of Th CHASING THE DRAGON: THE SOCIAL CONSTRUCTION OF THE U.S. OPIOID EPIDEMIC A Dissertation Submitted to the Graduate Faculty of the North Dakota State University of Agriculture and Applied Science By Jennafer Nicole Vondal In Partial Fulfillment of the Requirements for the Degree of DOCTOR OF PHILOSOPHY Major Program: Criminal Justice March 2019 Fargo, North Dakota North Dakota State University Graduate School Title CHASING THE DRAGON: THE SOCIAL CONSTRUCTION OF THE U.S. OPIOID EPIDEMIC By Jennafer Nicole Vondal The Supervisory Committee certifies that this disquisition complies with North Dakota State University’s regulations and meets the accepted standards for the degree of DOCTOR OF PHILOSOPHY SUPERVISORY COMMITTEE: Kevin Thompson, Ph.D. Chair Carol Archbold, Ph.D. Andrew Myer, Ph.D. Elizabeth Crawford, Ph.D. Approved: March 25, 2019 Jeffrey Bumgarner Date Department Chair ABSTRACT Utilizing a social construction perspective, this study uses a mixed method approach to examine the opioid epidemic. The study begins by identifying the numerous claims-making groups along with conducting a content analysis of the rhetoric and symbols used to legitimize the claims about the opioid epidemic. The data for the content analysis was obtained through a search of the websites, newsrooms, and pressrooms of claims-making groups. Additionally, the study examines and assesses the volume of money that is generated and allocated towards opioid research and prevention in an effort to determine who has more power to influence the policy initiatives. Findings show that the frequency of rhetoric and the number of claims-making groups releasing information about the opioid epidemic increased from 2010-2016. Most of the rhetoric consists of groups proposing resolution strategies and formulating new policies. Only a few claims-makers are making financial contributions towards opioid prevention initiatives and in most cases, it is a very small amount of money. iii ACKNOWLEDGMENTS I would like to gracefully acknowledge and thank the following people who have supported me, not only during the course of my dissertation, but throughout my doctoral journey. First, I would like to express my gratitude to my dissertation committee chair, Dr. Kevin. Thompson, for his unconditional support, tireless guidance, and meaningful feedback. I truly appreciate you meeting with me to answer all my questions and open my mind to look at my research from different perspectives. Second, I would like to thank Dr. Carol Archbold for serving on my committee and being an amazing mentor throughout my graduate career. Thank you for the words of encouragement, endless hours of support, and constructive feedback you have provided. Your door was always open to answer any of my questions or be just a voice of reason. Next, I would like to thank Dr. Andrew Myer for serving on my committee and providing valuable feedback along the way. I appreciate all the hours of time you spent mentoring me on research projects and offering me advice on ways to balance research and teaching. I would like to thank the numerous faculty, advisors, and graduate students at NDSU who have given me valuable support and guidance. Finally, I would like to express my heartfelt thanks to my husband Joel and my three daughters, Kenyah, Symone, and Aryah, for sacrificing their lives while I pursued my doctoral degree. There are no words to describe the inspiration, support, and patience you have given me along the way. Thank you to my friends and family who have helped me remained focused and committed to completing my doctoral degree which has been a largely rewarding and enriching journey. iv TABLE OF CONTENTS ABSTRACT ................................................................................................................................... iii ACKNOWLEDGMENTS ............................................................................................................. iv LIST OF TABLES ........................................................................................................................ vii LIST OF FIGURES ..................................................................................................................... viii CHAPTER 1. INTRODUCTION ................................................................................................... 1 CHAPTER 2. LITERATURE REVIEW ...................................................................................... 12 Historical Context of Heroin and Opioids ................................................................................ 12 First Era: 1880s through 1920s ............................................................................................. 12 Second Era: 1940s-1950s ...................................................................................................... 14 Third Era: 1960s-70s ............................................................................................................. 15 Fourth Era: 1980s-90s ........................................................................................................... 16 Fifth Era: 2000s-Today ......................................................................................................... 17 Current Research ....................................................................................................................... 19 Social Construction Theoretical Framework ............................................................................ 24 Drug Scares ............................................................................................................................... 34 Current Study ............................................................................................................................ 36 CHAPTER 3. METHODS ............................................................................................................ 38 Qualitative Data ........................................................................................................................ 38 Quantitative Data ...................................................................................................................... 44 Qualitative Analysis .................................................................................................................. 46 Quantitative Analysis ................................................................................................................ 48 CHAPTER 4. FINDINGS ............................................................................................................. 51 Sample Description ................................................................................................................... 51 Research Q1: Role of Claims-making Groups ......................................................................... 51 v Research Q2: Frequency of Social Construction Content ........................................................ 65 Allocated Resources ................................................................................................................. 80 Fiscal Budgets and Opioid Prevention .................................................................................. 80 Opioid Research and Awards ................................................................................................ 82 Lobbying Funds and Agencies .............................................................................................. 84 Lawsuits ................................................................................................................................ 85 Research Q3: Resolution Strategies .......................................................................................... 86 CHAPTER 5. DISCUSSION ...................................................................................................... 103 Discussion ............................................................................................................................... 103 REFERENCES ........................................................................................................................... 117 APPENDIX A. CODEBOOK ..................................................................................................... 132 APPENDIX B. ANNUAL BUDGET & DRUG EXPENSES BY GROUP & YEAR ............... 138 APPENDIX C. OPIOID RESEARCH FUNDING & AWARDS BY GROUP & YEAR ......... 141 APPENDIX D. LOBBYING FUNDS & NUMBER OF CLIENTS BY GROUP & YEAR ..... 145 vi LIST OF TABLES Table Page 1. List of Claims-making Groups............................................................................................. 40 2. Frequency of Content on Opioid Epidemic by Claims-making Group and Year ................ 68 vii LIST OF FIGURES Figure Page 1. Frequency of Content on Opioid Epidemic by Group and Year ......................................... 70 2. Governmental Agencies: Frequency of Content on Opioid Epidemic ................................ 71 3. Special Interest Groups: Frequency of Content on Opioid Epidemic .................................. 72 4. Professional Organizations: Frequency of Content on Opioid Epidemic ............................ 73 5. Frequency of Social Construction Themes on Opioid Epidemic......................................... 74 6. Frequency of Social Construction Themes on Opioid Epidemic by Year ........................... 78 7. Frequency of Social Construction Themes by Categorical Group and Year ....................... 79 viii CHAPTER 1. INTRODUCTION The
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