Biopolitics and the Development and Implementation of Medication-Assisted Treatment for Opioid Use Disorder

Abstract

COVID-19 is worsening the overdose crisis; of the 93,000 fatal overdoses in 2020, 70% were opioid-involved. In response, FDA regulatory policies related to the medications used to treat opioid use disorder [OUD] have been loosened to expand access to medication-assisted treatment [MAT]. However, MAT remains stigmatized, and its uneven implementation has an ongoing, harmful impact on access to pharmacotherapy amongst marginalized groups. In this paper, I conduct an interpretive content analysis wherein I examine eleven federal policy and clinical guideline documents and situate how the depoliticization of harm reduction influences the acceptance of pharmacotherapy for OUD to answer the following research questions: What is MAT, and who are the key actors, institutions, and stakeholders in its development? Why is MAT considered best practices while remaining controversial and under-implemented? To what extent and in what ways does MAT represent a novel approach for treating OUD? My findings suggest that contradictions at the interface of policy and practice, stigma in the medical and public sphere, an absence of institutional pathways that guarantee or streamline the cooperation of clinical jurisdictions, insufficient attention to factors mitigating access to treatment, and the persistence of ideologies which frame addiction medicine as a specialty, hinder the implementation of MAT. Therefore, I contend that MAT constitutes a biopolitical paradigm rather than a discrete treatment modality. The contradictions mentioned above, taken alongside federal policy shifts and the prominence of synthetics in the drug supply, signal a new wave of the opioid epidemic.

Presenters

Kaylee Allyssa Roberts Larson
Student, PhD, University of California, Santa Cruz, California, United States

Details

Presentation Type

Paper Presentation in a Themed Session

Theme

Social and Community Studies

KEYWORDS

Opioid crisis, Medication-assisted treatment, Opioid use disorder, Biopolitics