'Acute-on-chronic': Emergency Affect and the One-way Staircase of Pharmaceutical Escalation. Issue 3 (3rd April 2021)

• Record Type: Journal Article
• Authors: Stonington, Scott D.
• Is Part Of: Medical anthropology. Volume 40:Issue 3(2021)
• Page Start: 228
• Page End: 240
• Publication Date: 2021-04-03
• Subjects: United States -- affect -- opioids -- pain management -- social body; Medical anthropology -- Periodicals; 362.1
• DOI: 10.1080/01459740.2020.1811704
• Languages: English
• ISSNs: 0145-9740

Abstract

ABSTRACT: The opioid epidemic in the United States is often portrayed as leading to a "pendulum swing" from indiscriminate prescribing toward appropriate use. This portrayal imagines rational-ethical physicians trying to resist irrational-manipulative patients and pharmaceutical companies. Drawing on an ethnography of pain management in U.S. hospital and clinic settings, I suggest instead that chronic pain generates a constantly renewed "emergency affect, " a mutual experience for providers and patients that polarizes decisions toward either medication escalation or patient abandonment. Understanding this "emergency affect" can help provide a path forward through the opioid epidemic to embrace the discomfort of pain management.