Conflict or Cooperation?: Institutional Responses to the Opioid Crisis and the Role of Religious Communities
Brett McCarty, ThD, Assistant Research Professor of Theological Ethics and Assistant Professor in Population Health Sciences, Duke University
The contemporary opioid crisis is consuming lives; over 50,000 Americans died of opiate overdoses last year alone. Various sectors of American society, including and especially healthcare, have been scrambling to respond. In 2017, the then-U.S. Surgeon General, Dr. Vivek Murthy emphasized that “the opioid epidemic cannot be solved by government alone. It will require the engagement and leadership of all segments of society, particularly clinicians.” [1]
But how will that work, practically? How should clinicians cooperate with leaders in other segments of their local community, such as social service agencies, the criminal justice system, and the economic sector? There is a general recognition that significant obstacles stand in the way of such cooperation between these secular entities. However, in the rush to respond to the opioid crisis, there has been little examination of the conceptual background to how these entities have developed into offering incongruent responses to the crisis.
In response, this paper proposes to excavate and articulate the theological, philosophical, and political sources that have shaped the conflicting social imaginaries found within these diverse sectors. By examining these roots in four distinct arenas (healthcare, social services, criminal justice, and economics), this paper will describe the trajectories that have led to oftentimes incommensurable responses to the opioid crisis.
Over the past several decades, significant intellectual work has been on the theological and philosophical origins of these contemporary structures. “Secular modernity” is no longer an uncontested way to describe our current moment, as wide-ranging scholarship has uncovered religious roots undergirding much of our social landscape. The theological and philosophical roots of healthcare have been examined in the work of Michel Foucault, Stanley Hauerwas, Gerald McKenny, and Jeffrey Bishop, among many others. Distinct and divergent religious roots of our criminal justice system have been explored recently by David Garland, Jennifer Graber, and Winnifred Fallers Sullivan. Recent works on humanitarianism by Didier Fassin, Luke Bretherton, and others have shown that our social service sector is informed by particular theological, philosophical, and political accounts of need, agency, and moral responsibility. Finally, William Cavanaugh and Kathryn Tanner represent new examinations of the religious assumptions undergirding our modern economic order.
This paper will draw from these resources in order to articulate the conflicting social imaginaries uncovered through the author’s ethnographic research on the opioid crisis in southern Appalachia. By excavating the theological, philosophical, and political roots informing divergent responses to the opioid crisis, it becomes easier to understand the constructive role that religious communities (Christian communities, given the context of the author’s fieldwork) can play in the opioid crisis. In particular, churches can call these supposedly secular modern entities to conversion. Rather than frustrating human flourishing, these institutions can become ordered toward the local common good, “that through the church the wisdom of God in its rich variety might now be made known to the rulers and authorities in the heavenly places” (Eph. 3:10, NRSV).
[1] Murthy, Vivek H. "Ending the Opioid Epidemic — a Call to Action." NEJM 375, no. 25 (2016): 2415.
But how will that work, practically? How should clinicians cooperate with leaders in other segments of their local community, such as social service agencies, the criminal justice system, and the economic sector? There is a general recognition that significant obstacles stand in the way of such cooperation between these secular entities. However, in the rush to respond to the opioid crisis, there has been little examination of the conceptual background to how these entities have developed into offering incongruent responses to the crisis.
In response, this paper proposes to excavate and articulate the theological, philosophical, and political sources that have shaped the conflicting social imaginaries found within these diverse sectors. By examining these roots in four distinct arenas (healthcare, social services, criminal justice, and economics), this paper will describe the trajectories that have led to oftentimes incommensurable responses to the opioid crisis.
Over the past several decades, significant intellectual work has been on the theological and philosophical origins of these contemporary structures. “Secular modernity” is no longer an uncontested way to describe our current moment, as wide-ranging scholarship has uncovered religious roots undergirding much of our social landscape. The theological and philosophical roots of healthcare have been examined in the work of Michel Foucault, Stanley Hauerwas, Gerald McKenny, and Jeffrey Bishop, among many others. Distinct and divergent religious roots of our criminal justice system have been explored recently by David Garland, Jennifer Graber, and Winnifred Fallers Sullivan. Recent works on humanitarianism by Didier Fassin, Luke Bretherton, and others have shown that our social service sector is informed by particular theological, philosophical, and political accounts of need, agency, and moral responsibility. Finally, William Cavanaugh and Kathryn Tanner represent new examinations of the religious assumptions undergirding our modern economic order.
This paper will draw from these resources in order to articulate the conflicting social imaginaries uncovered through the author’s ethnographic research on the opioid crisis in southern Appalachia. By excavating the theological, philosophical, and political roots informing divergent responses to the opioid crisis, it becomes easier to understand the constructive role that religious communities (Christian communities, given the context of the author’s fieldwork) can play in the opioid crisis. In particular, churches can call these supposedly secular modern entities to conversion. Rather than frustrating human flourishing, these institutions can become ordered toward the local common good, “that through the church the wisdom of God in its rich variety might now be made known to the rulers and authorities in the heavenly places” (Eph. 3:10, NRSV).
[1] Murthy, Vivek H. "Ending the Opioid Epidemic — a Call to Action." NEJM 375, no. 25 (2016): 2415.