The Impact of Pharmaceutical Industry Messaging on the Opioid Crisis among U.S. Military Veterans

制药行业信息对美国退伍军人阿片类药物危机的影响

• 批准号: 10640028
• 负责人: Luther Elliott
• 金额: $ 67.2万
• 依托单位: NDRI-USA, INC.
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-01 至 2028-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10640028
• 关键词: Addendum; Advocacy; Anxiety Disorders; Archives; Area; Attitude; Automobile Driving; Back; Benzodiazepines; Black race; Caring; Case Study; Cessation of life; Circulation; Clinical; Cognitive; County; Data; Data Set; Development; Disadvantaged; Disparity; Documentation; Dose; Drug Controls; Drug Industry; Ethnic Origin; Formulation; Fostering; HIV/HCV; Health; Healthcare Systems; Hepatitis C; Heroin; Hospitals; Industry; Injections; Injury; Intervention; Interview; Journals; Label; Leadership; Legal; Literature; Litigation; Low income; Manufacturer; Marketing; Medical; Methodology; Methods; Military Personnel; Minority; Morbidity - disease rate; Natural History; Newspapers; Opioid; Opioid Analgesics; Outcome; Overdose; Pain; Pain management; Patients; Perception; Periodicals; Pharmaceutical Preparations; Pharmacologic Substance; Phase; Policies; Policy Maker; Population; Prevalence; Process; Public Health; Publications; Publishing; Race; Recording of previous events; Research; Research Methodology; Research Personnel; Resources; Risk; Role; Scholarship; Scientist; Shapes; Sleep Disorders; Technology; Tobacco; Tobacco Industry; Translating; Translational Research; United States Department of Veterans Affairs; Veterans; Veterans Health Administration; Withdrawal; analytical method; chronic pain; chronic pain management; chronic pain patient; data mining; expectation; experience; future epidemic; heroin use; high risk population; hospital care; injured; innovation; insight; large datasets; member; military veteran; mortality; non-opioid analgesic; online resource; opioid epidemic; opioid mortality; opioid therapy; opioid use; overdose death; pain patient; prescription opioid; prevent; public health priorities; public health relevance; racial disparity; resilience; service organization; service providers; social; social culture; social stigma; text searching; tobacco control; tool; translational framework; trend; web site

Abstract/Project Summary Understanding the role of the pharmaceutical industry in propelling the current opioid crisis in the U.S. is an essential strategy for preventing future epidemics. Using multiple forms of textual data and innovative methodologies for data mining and triangulation, this project examines the specific impacts of industry efforts to target military veterans as opioid consumers and analyzes how new industry-driven narratives, or scripts, about opioid analgesics were circulated. Veterans have many vulnerabilities and are one of the populations most severely impacted by the opioid crisis and opioid-related harms, including overdose and HIV/HCV infection. Important documents emerging in litigation against pharmaceutical companies establish that veterans were targeted as an important consumer niche through advocacy groups and paid accounts from veterans about the benefits of opioid therapies. However, only a small portion of the documents currently being revealed in the process of legal discovery have been examined by public health researchers, and very little is currently known about broader industry agendas and the processes by which pro-pharma narratives became part of veteran-specific health discourse, driving attitudes toward opioids and raising barriers to non-opioid pain management. To identify the themes and elucidate the processes by which these scripts were internalized by different veteran populations, this mixed-method research will triangulate large datasets of pharmaceutical industry marketing and legal documentation with veteran-themed publications and the lived experience of chronic pain patients. Findings will be translated into deliverables which positively impact pain management policy, practice, and the attitudes and expectations of veterans with chronic pain. The scientific team includes veterans and scientists at the forefront of uncovering how the tobacco industry targeted military personnel and veterans, along with experts on opioid use and pharmaceutical industry litigation. The systematic textual and content analyses in this study represent a critical case study in pharmaceutical industry efforts to change prescribing policy and popular culture and will serve as an important contribution to literature on the natural history of drug crises and to clinical approaches to pain by achieving the following aims: Aim 1: Use textual mining technology and analytic methods refined by tobacco researchers to explicate the pharmaceutical industry's campaign to influence veterans' (and veterans service organizations') perceptions opioid therapies, particularly within the context of chronic pain management. Aim 2: Conduct qualitative interviews among veterans with histories of pain and opioid use to understand sociocultural meanings and cognitive scripts that impede safe, effective, and medically-appropriate care. Aim 3: Based on a synthesis of data from Aims 1 and 2, conduct T0 and T1 translational research to generate concrete best practices, tools, and web resources to guide clinical and prescriber engagement with veteran and other chronic pain populations.

摘要/项目摘要 了解制药业在推动美国当前阿片类药物危机中的作用是一个重要的问题 预防未来流行病的基本战略。使用多种形式的文本数据和创新 数据挖掘和三角测量方法，该项目研究了行业努力的具体影响 将退伍军人作为阿片类药物消费者，并分析新的行业驱动的叙述或脚本如何 关于阿片类镇痛药的消息流传开来。退伍军人有很多脆弱性，是人群之一 受阿片类药物危机和阿片类药物相关危害（包括用药过量和艾滋病毒/丙型肝炎）影响最严重 感染。针对制药公司的诉讼中出现的重要文件表明 通过倡导团体和付费账户，退伍军人被定位为重要的消费群体 退伍军人了解阿片类药物疗法的好处。然而，目前只有一小部分文件正在处理中。 公共卫生研究人员对法律发现过程中披露的信息进行了审查，但很少有 目前已知更广泛的行业议程以及支持制药的叙述成为的过程 退伍军人特定健康讨论的一部分，推动人们对阿片类药物的态度，并提高非阿片类药物疼痛的障碍 管理。确定主题并阐明这些脚本被内化的过程 这项混合方法研究将针对不同的退伍军人群体对大型药物数据集进行三角测量 行业营销和法律文件，以退伍军人为主题的出版物以及退伍军人的生活经验 慢性疼痛患者。研究结果将转化为对疼痛管理产生积极影响的可交付成果 政策、实践以及患有慢性疼痛的退伍军人的态度和期望。科学团队包括 退伍军人和科学家站在揭露烟草业如何针对军事人员和 退伍军人，以及阿片类药物使用和制药行业诉讼方面的专家。系统的文字和 本研究中的内容分析代表了制药行业努力变革的关键案例研究 prescribing policy and popular culture and will serve as an important contribution to literature on the natural 毒品危机的历史和通过实现以下目标来治疗疼痛的临床方法： 目标 1：利用烟草研究人员改进的文本挖掘技术和分析方法来解释 制药行业影响退伍军人（和退伍军人服务组织）看法的活动 阿片类药物疗法，特别是在慢性疼痛管理的背景下。 目标 2：对有疼痛和阿片类药物使用史的退伍军人进行定性访谈，以了解 阻碍安全、有效和医疗适当护理的社会文化含义和认知脚本。 目标 3：基于目标 1 和 2 的数据综合，进行 T0 和 T1 转化研究，以生成 具体的最佳实践、工具和网络资源，用于指导临床和处方医生与退伍军人的互动 和其他慢性疼痛人群。