Human-focused research in action:
Studying the Opioid Crisis
How might we better understand the social and personal dimensions of pain, to help explain the
ongoing opioid addiction epidemic?
What can we do on Monday?
In concert with our client, we used the results of our investigation to identify three opportunities for intervention: 1. Usage guidance. 2. Owning safe pill distribution 3. Embedding security and disposal into products.
Those opportunities became the basis of our 3 Proposals, ranging from new digital services in the guidance of opioid usage, to new products designed to aid in safe monitoring and responsible disposal.
Finally, as an added-value offering, we created a framework for our client to use in identifying future technologies for either acquisition or development.
Toward a Unified Model of Pain
The first result of our investigation was something valuable on its own: a detailed map of the use cycle for opioids, as well as the landscape of stakeholders involved in the management of pain.
We used that map to identify 5 Key Social Disorders that were (and are) integral to understanding why this decade-old crisis has persisted.
At the heart of the issue is a misconception: though opioid addiction is often seen as a failing, science is clear that every person is narcotic dependent. Meaning that all people, regardless of their lifestyle, can experience withdrawal after just four days of Opioid medication. And after a month of Opioid treatment, 32% of us will experience addiction. Pain is supposed to feel noxious. It is a message. Designed as an internal warning system. The trouble is that the message isn’t always entirely clear. Often we need an interpreter.
In 1995 Purdue’s innovations convinced people that pain is unhealthy.
Since that time we have all learned to ‘hide’ pain from our families, our colleagues and often from our selves. Even when that meant using narcotic meds–and more of them with time.
Substance misuse that starts out during the cure will spill out into the black market as the disease. Opioid dependence is called ‘The disease of despair’ because it makes no distinctions about class, race, or wealth. Regulations to curb pill mills, pill diversion, and safe injection sites will do little to remedy the epidemic misuse of drugs in our cities. So why not engage the private sector in reframing our mental model of pain before it leads to a catastrophe in the first place?
What if our idea of pain is wrong?
A leading manufacturer of medical devices approached us to explore the social determinants of the opioids crisis. By carrying out interviews with users and key-stakeholders, by mapping the cycle of use, and by designing interventions, we would help mitigate the human-centered causes of a wicked problem.
And it is a wicked problem. On any given day in the US 126M people receive treatment for pain (acute, as well as chronic). Yet the dominant form of therapy today is pharmaceutical. Sadly, pharmacology leads health consumers into experiences of withdrawal, addiction and sometimes to overdose. And by extension, into dangerous black markets for heroin and fentanyl when prescriptions reach an abrupt end.
Pain medication hasn’t always represented a crisis situation. But now that it represents a leading cause of morbidity for Americans under 50, it's time to reassess what was once considered a harmless product.
Our investigations would lead us to design 3 key interventions our client could use to both benefit their brand and make headway in limiting the negative effects of opioid dependency.
First, though, we had to diagnose the scope of the problem.
The Social Dimensions of Pain
We started our investigation by drawing boundaries around the issue at hand.
To do that, we conducted a thorough analysis of available science, both medical and social, as well as prevailing narratives in the media. A diverse range of sources (from the Center for Disease Control to the New York Times to The Journal of Addictive Diseases) helped us understand where to focus our attention.
Before long, we identified our area of focus: the social construction of pain and treatments for pain.
Employers, insurers, pharmacists, and doctors all struggle to make sense of pain. Each establishes policies, practices and language about pain (or its victims) that are loaded with stigma. For their part patients struggle to report accurate and complete experiences of pain in their brief meetings with a doctor or a pharmacist.
In order to explore those dimensions with accuracy, we constructed a sampling matrix which would guide our subsequent first-hand research, and eventually, the solutions we would propose. We then visited patients, doctors, caregivers, support workers, and executives from a top-5 insurance provider. We worked diligently to gather first-hand reports from all those concerned in the ongoing epidemic.