There are many models that explain journalistic technique. Most of them begin with the refrain – the most important information comes first. Accordingly, I begin with a quotation by Friedrich Nietzsche: “All things are subject to interpretation. Whichever interpretation prevails at a given time is a function of power and not truth.”
This quotation alone summarizes many articles that cover the overdose crisis. Therefore, it’s the most important. It explains why we struggle to cover the opioid crisis. Journalism relies on facts. The foundation of the field is a balanced portrayal of facts. One story, two sides, two sets of facts, all explained as objectively as possible.
In the opioid crisis, however, there are no facts, no objectively definable truths. There are only perspectives. We can’t even agree on the data underlying core assumptions.
Take one of the more pervasive disagreements: addiction rates following the use of prescription opioids. Some have it at 20 percent, others at 3 percent. Those who believe the opioid crisis began with physicians overprescribing opioid support studies that tout the larger number. Those who believe the crisis began out of a confluence of trends – a growing number of pain patients and a trend toward heroin as the drug of choice for drug abusers – tout for the smaller number.
We fixate on such numbers. And we ceaselessly argue over which is right. But ultimately, they’re numbers devoid of context. Just ask any chronic pain patient, or a patient struggling with substance use dependency: those numbers mean nothing. They’re a thin veneer of data covering what is otherwise a fundamentally subjective experience.
Think of the pain scale. Remember being asked or overhearing someone being asked: what is your level of pain on a scale from one to ten? How is that anything but subjective? And in continuing that logic, let’s not forget how that number would be subsequently interpreted by a treating provider. In short order, we have two subjective points of assessment. On it goes – every interaction, a subjective assessment, to which we ascribe a proverbial data point, just to make it feel like we’re being objective.
We’re not – like we’re not applying a valid journalistic framework when we use specious data to craft a journalistic narrative. There are no sides to the opioid crisis. We are just beginning to understand addiction absent its moralistic façade, in solely medical terms.
So if we still lack a basic understanding of the opioid crisis, of what value is the journalistic framework in analyzing it? You can’t write about something you don’t understand. In this vein, I’ve constructed three back-of-the-envelope rules to help journalists make sense of the opioid crisis and frame the journalistic narrative around a complex, not yet defined concept.
- Chronic pain and addiction are uniquely experiential because they are subjective. Data is less reliable than in other medical disciplines.
- Most clinical studies in these two fields lack consistency in design or are biased in their methodologies. Avoid using multiple studies to derive one conclusion.
- Instead of identifying a single narrative, learn to think in a contrarian way when you piece together the elements of the story. The lack of a cohesive narrative is sometimes the most accurate story.