[Note: This posting is a continuation of a report on
the development of a civics unit of study.
This unit is directing students to formulate informed positions on the
opioid epidemic. Presently, this
development, in real time, is to share a set of insights (generalizations or
principles) and factoids that help describe and explain this epidemic.]
Before sharing insights
and factoids associated with the opioid epidemic, a word on the assignment the
reader was given in the last posting.
That posting listed the American states according to how many opioid prescriptions,
per 100 residents, were issued in 2012.
The assignment was to hypothesize how the information suggest a cause
and effect relationship relevant to the abuse of opioids.
Since the problem, especially early in
the development of the epidemic, was over-prescribing the drug, one could
hypothesize that in a conservative environment, one that shies away from
regulating business activities, over-prescription would be more probable since
there would be a reluctance for local government to regulate the selling of
this product.
To test this hypothesis in an off-hand
way, the writer checked which of the top 15 states – those that prescribed the
drug most readily – voted for the conservative/Republican candidate and those
that voted for the liberal/Democratic candidate in the 2016 presidential
election. He also checked the same for
the lowest 15 states. This at best is an
informal way to test this hypothetical relationship.
While
in terms of number of states voting one way or another is heavily skewed toward
Republican candidates (most states are sparsely populated and agricultural – a
conservative political landscape), a definite bias probably would indicate that this suggested hypothesis is true. So, is there such a definite bias?
Of
the top 15 listed states, 14 voted for the conservative/Republican candidate
and only one voted for the liberal/Democratic candidate. Of the bottom 15 states, 11 voted for the
liberal/Democratic candidate and 4 voted for the conservative/Republican
candidate. Without doing a
sophisticated, statistical analysis, this seems like a definite bias.
But
it should be remembered, 2012 was relatively early in the history of this
epidemic and states have become more attuned to the problem including the “Trump
state,” Florida, which has been noted for its clamping down on prescribing opioids
with regulations and prohibiting clinics from prescribing them.
To
return to the basic aim of this posting; that is to explain the function of two
curricular components useful in developing a unit of study. The first is the role insights play and the
second is the role factoids play.
Insights are generalizations or principles; that is, they identify or
highlight some relationship between or among factors.
For
example, if one states hot weather causes people to be irritable, then the
weather is one factor and dispositional behavior is the other. If the weather is characterized as being
“hot” (say the temperature is over 90 degrees Fahrenheit), that causes or is
correlated to people generally behaving in irritable (disposed to being upset) ways. In turn, such statements can generally be
tested to see if they are true.
In
terms of using generalizations or principles in argumentation or debate, they
can be used to function as warrant statements that justify some observation
with some conclusion. That is the
function Stephen Toulmin[1]
ascribes these terms in formulating a reasonable argument. In this simple example, one can argue that
since Johnny was playing baseball out in the hot sun, therefore he was bound to
get angry when he was called out on a close play.
This
might not be a good argument, but it illustrates the role of generalizations
and principles play in argumentation.
So, if the aim of a unit of instruction is for students to build
arguments, insights are useful if not necessary. Further, as just shown, factual statements
are also useful for they provide statements of observation. They, in turn, serve as the “since” or
“whereas” statements (“since Johnny was playing baseball”) in an argument.
As
for insights, here is an initial list taken from previous postings that
described some aspect of the opioid epidemic:
·
The beginning stages of an opioid
addiction is noted by patients continuing to consume the drug beyond what a
doctor prescribes to either minimize pain or to induce euphoric feelings. This is chemically enhanced since the body
builds up a tolerance – meaning the patient must consume more to induce the
desired results and/or prevent withdrawal symptoms.[2]
·
Several written accounts claim that
among the general population there has been widespread preference for a “pill”
solution for medical concerns over behavioral alterations to daily routines
such as exercise, change of diet, and efforts to reduce stress.[3]
·
Due to the extensive amount of reported
cases of chronic pain among Americans in the late 1990s (c. 100 million), drug
companies and the federal government were motivated to incentivize – to “push”
– opioid drug prescriptions.[4]
·
Correlated to the increase of opioid
prescriptions, there has been significant more people being admitted to medical
facilities for drug abuse treatments and more deaths caused by opioid
overdoses. It furthers indicates that initially
legitimate – usually clinical – prescribing of the drug has led to or diverted
to an illegal distribution system which in turn has meant more misuse,
addiction, and death.[5]
·
Due to their popularity, this increase has
encouraged producers to increase the strength or potency of prescribed opioids
such as with oxycodone (under the brand names OxyContin or Percocet) and
hydrocodone (under the brand name Vicodin).[6]
And
here are several factoids that can enrich a lesson on opioids and can,
therefore, be used as datum statements (i.e., “since” statements):
·
A
significant number of Americans reported in the late 1990s (circa 100 million
or just under a third of the population) as suffering chronic pain.[7]
·
In the
twenty years, from 1991 to 2011, prescriptions for pain (painkillers) tripled
in the US. The reported numbers were 76
million per year in 1991 and 219 million in 2011. That number increased to 289 million opioid
prescriptions in 2016. [8]
·
Strengthened
opioids – more potent than morphine – were in 2002 only prescribed to one of
every six drug users. That number jumped
to one of every three drug users by 2012.[9]
The next posting will continue reporting
relevant insights and factoids that can prove to be useful either in developing
a unit of study over the opioid epidemic/crisis or assisting students in
formulating a related argument. The
topic will refocus on the demographic factors of this epidemic.
[2] Jacqueline Howard, “Why Opioid Overdose Deaths Seem to
Happen in Spurts,” CNN, February 8, 2017, accessed July 2, 2018, https://www.cnn.com/2017/02/08/health/opioids-overdose-deaths-epidemic-explainer/
.
[3] Teresa
Carr, Too Many Meds? America’s Love Affair with Prescription
Medication, Consumer Reports, August 3, 2017, accessed July 30, 2018, https://www.consumerreports.org/prescription-drugs/too-many-meds-americas-love-affair-with-prescription-medication/ AND Jennifer Markert,
“Pills for Everything: The Power of
American Pharmacy,” June 2, 2018, accessed July 30, 2018, https://curiousmatic.com/pills-for-everything-the-power-of-american-pharmacy/ AND Victoria Bekiempis,
April 9, 2012, accessed July 30, 2018, https://www.theguardian.com/commentisfree/2012/apr/09/america-prescription-drug-addiction .
[4] “America’s Opioid Epidemic Is Worsening,” The Economist, March 6, 2017, accessed
July 19, 2018, https://www.economist.com/graphic-detail/2017/03/06/americas-opioid-epidemic-is-worsening
.
[5] G. Caleb Alexander, Stefan P. Kruszewski,
and Daniel W. Webster, “Rethinking Opioid Prescribing to Protect Patient Safety
and Public Health,” Journal of the
American Medical Association (JAMA), vol. 308, 1865-1866, see http://www.addictioneducation.co.uk/21.01.2013PsycInfo%20VCrawford[3].pdf
, accessed August 3, 2018.
[6] For example, “Oxycodone Abuse,” DrugAbuse.com, n. d., accessed July 30, 2018, https://drugabuse.com/library/oxycodone-abuse/
.
[8] “Facing Addiction in America,” U. S. Surgeon General
(SurgeonGeneral.com), 2016, site page no longer posted, see
https://addiction.surgeongeneral.gov/executive-summary .
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