How the Suboxone Education Programme presented as a solution to risks in the Canadian opioid crisis: a critical discourse analysis

Sud, Abhimanyu; Strang, Matthew; Buchman, Daniel Z.; Spithoff, Sheryl; Upshur, Ross; Webster, Fiona; Grundy, Quinn

doi:10.1136/bmjopen-2021-059561

Cited by 4 publications

(4 citation statements)

References 37 publications

(78 reference statements)

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“…The implication, then, is that restrictions on such activities would be opposed to the intended impact of Health Canada's measures aiming to reduce risks related to opioids. This messaging is consistent with other analyses that have examined specifically how the concept of risks within health crises can legitimize industry involvement in crisis interventions and over-ride other moral imperatives of avoiding industry conflicts of interest [43].…”

Section: Plos Onesupporting

confidence: 86%

Pharmaceutical company responses to Canadian opioid advertising restrictions: A framing analysis

et al. 2023

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The pharmaceutical industry’s promotion of opioids in North America has been well-documented. Yet despite the clear consequences of improperly classifying pharmaceutical company messaging and frequently permissive approaches that allow the pharmaceutical industry to self-regulate its own advertising, there has been scarce investigation to date of how pharmaceutical industry stakeholders interpret definitions of “advertising.” This study explores how variations of “marketing” and “advertising” are strategically framed by the different actors involved in the manufacturing and distribution of pharmaceutical opioids. We employed a framing analysis of industry responses to Health Canada’s letter to Canadian manufacturers and distributors of opioids requesting their commitment to voluntarily cease all marketing and advertising of opioids to health care professionals. Our findings highlight companies’ continuing efforts to frame their messaging as “information” and “education” rather than “advertising” in ways that serve their interests. This study also calls attention to the industry’s continual efforts to promote self-regulation and internal codes of conduct within a highly permissive federal regulatory framework with little concern for violations or serious consequences. While this framing often occurring out of public sight, this study highlights the subtle means through which the industry attempts to frame their promotion strategies away from “marketing”. These framing strategies have significant consequences for the pharmaceutical industry’s capacity to influence healthcare professionals, patients, and the general public.

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Section: Plos Onesupporting

confidence: 86%

Pharmaceutical company responses to Canadian opioid advertising restrictions: A framing analysis

et al. 2023

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“…This is despite known concerns around pharmaceutical industry involvement in product promotion and documented irregularities, or what some have called abuses, of the regulatory approval processes for branded opioid agonist therapies 85 . This may, in part, be due to the high rate of nondisclosure of financial conflicts of interest in this sample compared to other studies 86 and suggests that other study designs are may be better suited to understand the role of industry in disseminating less stringent regulations for opioid agonist therapies as solutions to the opioid‐related harms 87 …”

Section: Discussionmentioning

confidence: 99%

“…85 This may, in part, be due to the high rate of nondisclosure of financial conflicts of interest in this sample compared to other studies 86 and suggests that other study designs are may be better suited to understand the role of industry in disseminating less stringent regulations for opioid agonist therapies as solutions to the opioid-related harms. 87 This study does not fully inform why these citation patterns, and provisional problem/solution constructions, developed. Future research, for example using qualitative analysis, might explore such questions to provide a deeper understanding of the nature of policy framings necessary to help ensure that the most suitable and contextually appropriate responses are provided.…”

Section: Problem Representations Are Disseminated Unequallymentioning

confidence: 89%

How policy problems and solutions travel in the scientific literature: An international scientometric analysis of the French Model of opioid use disorder care

Gamage

Chiu

Ryk

et al. 2023

Evaluation Clinical Practice

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Rationale The 2007 article ‘Why buprenorphine is so successful in treating opiate addiction in France’ has been widely cited to promote various solutions to growing opioid‐related harms across multiple jurisdictions globally. However, selective promotion of aspects of the French experience or promotion of the French experience without considering relevant contextual factors may inform policies that will not bring the same outcomes as in France, including the introduction of possible unintended negative consequences. The scientific literature is one important arena in which policy solutions are identified, evaluated, promoted and disseminated. Scientific communication of the French opioid use disorder care model offers a timely and relevant example through which to examine how problem representations travel and to consider the effects of these representations. Aims and Objectives We aimed to explore where, when, and how the content of this 2007 index article has travelled through the scientific literature. Method Informed by Bacchi's understanding of problem representation, we conducted a scientometric analysis of the index article. This included categorical analyses using a combination of citation metadata and content data to identify patterns across locations and time. Results Researchers in the United States and Anglophone countries affirmatively cited specific index study content, namely less stringent regulations and positive outcomes, such as reductions in overdose deaths and increases in buprenorphine utilization. These citations were more common after 2015 and were more likely to be in discussion sections of nonempirical publications. Researchers from France cited similar content but did so nonaffirmatively, and throughout the study period. Likewise, the French citations were mostly agenda‐setting citations in the introductory sections of empirical studies. US studies received the highest attention based on number of citations and Altmetric scores. Conclusion US studies, by focusing on less stringent buprenorphine regulation as the primary solution of concern, have constructed opioid‐related harms as a problem of restrictive regulations for buprenorphine. This selective focus on regulation, as opposed to other aspects of the French Model elucidated in the index article such as changes pertaining to the values and financing that structure health service delivery, represents an important missed opportunity for evidence‐informed policy learning across jurisdictions.

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“…Medications for OUD are among the most highly regulated pharmaceuticals ( Sud et al 2022 ). Opioid agonists are considered controlled substances and, until recently, providers were required to obtain a Canadian federal Section 56 Exemption from the Controlled Drugs and Substances Act (1996) in order to prescribe, sell, provide or administer methadone ( CRISM 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Methadone Prescribing Regulation for Opioid Use Disorder in Canada: Evidence for an East–West Policy Divide

Campbell,

Chiu,

Sud

2024

hcpol

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Opioid agonist therapy (OAT) is a key element in the response to opioid-related harms in Canada. In May 2018, Health Canada rescinded the requirement for obtaining a federal exemption for methadone prescribing. This comparative analysis examined provincial OAT policies and policy changes in response to this federal policy change. Policies and changes were regionalized; despite having lower rates of opioid-related harms, eastern provinces had looser regulatory regimes compared with western provinces, which became even looser after the federal policy change. Diverse knowledge and policy networks need to be fostered to bridge this east–west divide in substance use care policy.

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How the Suboxone Education Programme presented as a solution to risks in the Canadian opioid crisis: a critical discourse analysis

Cited by 4 publications

References 37 publications

Pharmaceutical company responses to Canadian opioid advertising restrictions: A framing analysis

Pharmaceutical company responses to Canadian opioid advertising restrictions: A framing analysis

How policy problems and solutions travel in the scientific literature: An international scientometric analysis of the French Model of opioid use disorder care

Methadone Prescribing Regulation for Opioid Use Disorder in Canada: Evidence for an East–West Policy Divide

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