AMERICANS AS THE CAUSE, I

[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 reporting a set of factoids on the responsibilities Americans bear for its tragic consequences.]

The last posting that addressed the opioid epidemic, July 13, 2018, a brief description was given on how modest amounts of abusing prescribed doses of opioids can easily lead to addiction.  This posting will begin looking at the responsibility consumers of opioids have in causing the accompanying epidemic.  Central to understanding this addiction problem is to gather a sense of its magnitude.  And this has led observers to the eyepopping numbers of people being addicted. 

A few of those numbers give one a sense to the extent this epidemic has grown.  Initially, opioid consumption did not begin on its own impetus; Americans did not wake up one morning and decide to take these drugs.  Reacting to the reported incidence of chronic pain in the late 1990s – in the neighborhood of 100 million people – both the drug companies and the federal government began to encourage these afflicted people to take painkilling opioids.[1] 

To what degree?  Here is part of the statistics:  from 1991 to 2011 prescriptions rose from 76 million per year to 219 million and then to 289 million in the year 2016.[2]

          As this volume rose, the numbers of people being treated for substance abuse followed as well as those of deaths due to opioid overdoses – as reported in previous postings.  Not surprising given the fact that from 2002 to 2012 the rate of drug users being prescribed drugs more powerful than morphine jumped from one-in-six drug users to one-in-three.  Most common drugs prescribed were oxycodone and hydrocodone.[3]

          An angle to this problem that has been given little attention is how Americans dispense healthcare.  This nation’s system often leaves individuals to obtain private insurance and, in turn, these companies heavily favor drug treatment over costly therapies.  According to the expert, Judith Feinberg of West Virginia University, “Most insurance, especially for poor people, won’t pay for anything but a pill.”[4]  This bias places the US with a 40 percent higher rate of prescribing opioids than Germany or Canada.[5]

          Another expert from University of Utah, Josef Stehlik, chimes in: 

Opioids are treated differently [in the US].  First, there’s much less prescription of opioid for pain in Europe, so there’s less chance of addiction from people who started opioid use in a legal, medical way.  Second, in many but not all European countries, the rate of illicit opioid use is either stagnant or decreasing.[6]

And one can ask:  does this prescription rate in the US lead to less reported incidences of pain?  Given that with the increase of opioid prescriptions there has been a decrease in non-opioid prescriptions, such as for aspirin or ibuprofen, has there been noted change in reported pain?  In the US, the answer is no.  This has caused many to question the curative effectiveness of opioids.[7]

With these factoids established, one can better answer the question with which this posting began:  what is the responsibility of Americans in causing the outbreak of this epidemic?  This blog will take up the rest of the answer in the next posting.

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[1] “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 .

[2] “Opioid Epidemic,” Wikipedia, accessed July 18, 2018, https://en.wikipedia.org/wiki/Opioid_epidemic .

[3] “America’s Opioid Epidemic Is Worsening,” The Economist.  Of note:  oxycodone sells under the brand name OxyContin or Percocet and hydrocodone under Vicodin.

[4] Owen Amos, “Why Opioids Are Such an American Problem,” BBC, October 25, 2017, accessed July 19, 2018, https://www.bbc.com/news/world-us-canada-41701718 .

[5] Amanda Erickson, “Opioid Abuse in the U. S. Is so Bad It’s Lowering Life Expectancy:  Why Hasn’t the Epidemic Hit Other Countries?,”  Washington Post, December 28, 2017, accessed July 19, 2018, https://www.washingtonpost.com/news/worldviews/wp/2017/12/28/opioid-abuse-in-america-is-so-bad-its-lowering-our-life-expectancy-why-hasnt-the-epidemic-hit-other-countries/?utm_term=.c5d14bc5db2c .

[6] Ed Cara, “The U. S. Opioid Crisis Is So Devasting, It’s Made More Organ Available for Transplant,” Gizmodo, May 16, 2018, https://gizmodo.com/the-u-s-opioid-crisis-is-so-devastating-its-made-more-1826053571 .

[7] Matthew Daubresse, Hsien-Yen Chang, Yuping Yu, and George Caleb Alexander, “Ambulatory Diagnosis and Treatment of Non-Malignant Pain in the United States, 2000-2010,” Medical Care, vol. 51, no. 10, October, 2013, accessed July 19, 2018, https://www.researchgate.net/publication/256500618_Ambulatory_Diagnosis_and_Treatment_of_Non-Malignant_Pain_in_the_United_States_2000-2010 , AND Robert Gebolhoff, “The Opioid Epidemic Could Turn into a Pandemic If We’re Not Careful,” Washington Post, February 9, 2017 AND “Facing Addiction in America,” U. S. Surgeon General (SurgeonGeneral.com), 2016, site page no longer posted, see https://addiction.surgeongeneral.gov/executive-summary .  Reported decreases of prescribed non-opioids range from 38% to 29%.

HOW TO DEFINE AND EVALUATE THEORIES

[Note:  At the end of the last posting the reader was advised that this posting would continue this blog’s report on the development of a civics unit of study.  Due to certain requests, this will happen next posting.  As for this posting, the following is an overview of what a political construct is; what is the function of a political construct; and how to evaluate a construct.]

Theories, models, and often constructs are explanations of some set of phenomena.  One such example in the field of political science is cybernetics which is an off-shoot of systems theory.  It deals with communication and control.  It does not pretend to explain all political phenomena, but through its lens it does shed light on most aspects of political behavior.  In turn, this explanation can be the source of political research, analysis, and even attempts at predicting a relevant future.

          In terms of research, a theory, through its explanatory quality, suggests or directly provides hypothetical relationships between or among factors.  Usually, in terms of supporting an explanation, the aim is at establishing cause and effect relationships; factor A causes factor B to happen.  While this is fine within the context of a model – its hypothetical nature does not oversell its view of reality as necessarily being reality – a study that gathers relevant information usually attempts to establish a correlation or, more technically, to disprove (falsify) a relationship.[1] 

Of course, protocol provisions in such studies are developed to strive to account for all nuances; i.e., exceptions or the identification of other factors that lead to both A and B are hopefully detected.  Of course, such study or research is prone to problems, as all human endeavors are.  One problem is the function theories, as they were described, play is that political scientists with such a view favor the positivist approach.  Political scientists who use positivist protocols adopt, to the extent possible, the methods used by natural scientists such biologists and physicists. 

A term used to describe this approach is reductionist studies.  They reduce the effort to focusing on those factors the scientist is testing.  A historical note:  political science was not always so “scientific.”  Before the behaviorist revolution in the mid-twentieth century, political science was more historical.  And this fact is relevant to what is being emphasized with this blog’s call for the utilization of federation theory.

For example, not all political questions can be reduced.  Why?  A way to view this shortcoming is offered by the political scientist, Daniel J. Elazar.  He claims that political science is not only interested in answering the questions:  how and why does political phenomena operate as they do, but, also, how should governance and politics be conducted?  Often, these “should” questions, while, at times, assisted by asking reductionist questions, cannot be fully answered by them.[2]

So, scholars that utilize the non-reductionist, federalist model to guide their research, such political scientists as Elazar, Donald Lutz, Martin Diamond, and Stephen L. Schechter, tend to be more historical in their approaches as they ask federalist questions of the past.  But as is the case, the federalist model is one of many models and, given the purposes of a consumer of such models might have, such as the case of a civics teacher, what questions should he/she ask of a political science model?

Eugene J. Meehan[3] offers such a criteria:

·        Comprehension:  Does the explanation explain as many phenomena as possible which are related to the area of concern?

·        Power:  Does the explanation control the explanatory effort by being valid and complete in its component parts and in the relations between those parts?

·        Precision:  Does the explanation specifically and precisely treat its concepts, making them clear in their use?

·        Consistency or Reliability:  Does the explanation explain its components and their relations the same way time after time?

·        Isomorphism:  Does the explanation contain a one to one correspondence with that portion of reality it is trying to explain?

·        Compatibility:  Does the explanation align with other responsible explanations of the same phenomena?

·        Predictability:  Does the explanation predict conditions associated with the phenomena in question?

·        Control:  Does the construct imply ways of controlling the phenomena in question?

These criteria are geared to assist social scientists in terms of them evaluating the various explanations their discipline hold or propose given the areas of concern the discipline studies.  But given the above concern of Elazar, might there be one more criterion?  Here is what it could be:

·        Normative determination:  Does the construct indicate what normative/moral political behavior is and how the subject of the model’s use – the polity and its participants – measure up to that standard?

Different consumers, given their reasons for utilizing these criteria will have different needs.  Not all the criteria above will have the same salience for all consumers.  As a list, this seems to be fairly complete, but users of the list might find some criterion to be unimportant or the entire list might be seen as lacking some concern.  The judgement here is that each of the above concerns should be of some relevance to a teacher.

But civics teachers don’t conduct political science research.  Instead, they can rely on these models to assist them in making sense of what they teach.  They do want to be responsible in the substantive information he/she is imparting or otherwise implementing in their lesson plans.  So, the above criteria can be helpful.  As a matter of fact, his/her concerns do not end with this list.  One can add two more criteria:

·        Abstraction Level:  Does the construct’s abstraction level allow students to comprehend it?

·        Motivation:  Does the construct’s content sufficiently motivate students to study it?

Each of these standards might deserve a separate section to further explain it and to go into the implications each might have on the social sciences or, more importantly here, civics education.  As it is being used here, the idea is for a teacher to have a handle on how to critically judge what a federation approach has to offer since it is offering a construct.  That is, this blog explains what federation theory is and how it is useful in meeting the challenges civics education is facing in today’s classrooms. 

So, a teacher or curriculum developer becomes aware of a political theory or model – an explanation or construct – what then?  This now turns to be a curriculum and instruction concern.  In the curriculum literature, there are a variety of curriculum developmental models.  One that has received a bit criticism – as being too constrained – is suitable for establishing the connection between the demands of offering meaningful content material and the demands of teaching it.  That is the developmental model offered by Ralph Tyler.[4]

The Tyler model identifies three sources of curriculum:  the relevant attributes of the society/community in which the curriculum is to be utilized, the distinguishing, relevant attributes of the students to be served, and the subject matter’s elements that are to be taught.  Of most relevancy here is the last of these three – the subject matter.  It is in this way that Meehan/Elazar/ (and this writer humbly adds) Gutierrez’s criteria can be helpful.

But Tyler’s model goes on; it assumes that if one is reflecting on these three sources of curriculum, a teacher or curriculum developer will be likely to arrive at an overwhelming number of instructional objectives.  Therefore, to be more focused and direct, this number of objectives needs to be whittled down.  To do this, Tyler inserted two “screens” by which to evaluate each objective:  social philosophy (in terms of scope) and psychology (in terms of sequence).  Of course, for the purposes here, social philosophy is more important.

By social philosophy, Tyler refers to a school’s sense of its mission.  Each school – and this is generally required by accreditation bodies – has a school philosophy.  The school is to abide by the philosophy’s espoused values in the various operations or activities it either performs or sanctions.  So, if a school (usually a decision made by state or district authorities) is committed to abide by the C3 Framework,[5] this or, at least, the framework’s substantive prescriptions, would be a set of elements within a school’s philosophy.

What about schools that have not made such a formal commitment?  Chances are such schools can still implement the prescriptions of the framework since what districts, states, and even schools have in place are so vague.  All that needs to be done is interpret the wordage of district or state standards – or school philosophies – to include federalist ideas and ideals.  This is not being dishonest.  The authorities have purposefully been this vague in order not to squelch school initiatives.

          Hopefully, this overview of the functions of a political model, criteria by which to judge the usefulness of political models, and the role political models play in civics curriculum, the reader can apply these ideas in considering and, perhaps, implementing the tenets of federation theory.

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[1] Or as Karl Popper states it:  falsify a hypothesis.  See “Falsifiability,” WhatIs.com, n. d., accessed July 14, 2018, https://whatis.techtarget.com/definition/falsifiability .

[2] Daniel J. Elazar, Exploring Federalism (Tuscaloosa, AL:  The University of Alabama Press, 1987).

[3] Eugene J. Meehan, Explanations in Social Science: A System Paradigm (Homewood, IL: The Dorsey Press, 1969).

[4] Ralph W. Tyler, Basic Principles of Curriculum and Instruction (Chicago, IL:  University of Chicago Press, 1969/1949).

[5] National Council for the Social Studies, “Preparing Students for College, Career, and Civic Life,” (Washington, D. C.:  NCSS, 2013), accessed April 16, 2018, https://www.socialstudies.org/c3.  This framework is offered as part of the Common Core project by the US Department of Education.