"Deserving Patients" or "Potential Addicts?": Narrative Analysis of an FDA Hearing on Prescription Opioid Labeling

This study explores how stories told at a United States Food and Drug Administration (FDA) public hearing justify a label change intended to reduce the prescribing of opioids to people with chronic noncancer pain (CNCP). Drawing on a social constructionist framework, which holds that narratives play an essential role in influencing public policy, I employ Loseke's method for the empirical analysis of formula stories to examine the institutional narratives told at the hearing. I find that the stories serve to construct moral boundaries around different groups of patients with pain. Patients with cancer and life-limiting illness are constructed as unquestionably deserving of treatment with opioids, while patients with CNCP are constructed as potential "addicts" needing protection from opioid-related harm. I argue that the stories serve as moral justification for the outcome of the hearing while simultaneously marginalizing the voices of CNCP patients who rely on opioids for pain relief.