Parallel Development: Medicalization and Decriminalization in the Changing Media Framing of the Opioid Overdose Crisis

Drawing on content analysis of 517 New York Times news reports published between 1995 and 2016, the author examines the institutionalization of opioid responses in terms of changing media framing of opioid use. The findings indicate that news frames were situated between the lenses of medicalization and decriminalization. Modes of penal social control shifted as early as the 1990s because of budgetary concerns. Drug reform efforts pushed law enforcement agencies to criminalize doctors and big pharma. Consequently, medical professionals and social activists advocated for new cultural frameworks about opioid use. However, the expansion of medical concepts alone did not medicalize opioid use, as evidenced by persistent news frames opposing opioid maintenance treatments. Instead, medicalization materialized as part of the public health solution when law enforcement agencies adopted new modes of medical social control. This article illustrates the making of a new penal-medical nexus regulating drug use.