{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:38:03Z","timestamp":1792111083792,"version":"4.4.0"},"reference-count":58,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"unspecified","delay-in-days":250,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"DOI":"10.13039\/501100000155","name":"Social Sciences and Humanities Research Council of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Law. Med. Ethics"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The opioid overdose crisis has become a global public health emergency, claiming more than 100,000 lives each year. In North America, shifting opioid prescribing practices in response to the crisis have profoundly affected people living with chronic pain, who now face reduced access to prescription opioids. Against this backdrop, pain stakeholders have become increasingly active in policymaking arenas to shape how opioids and pain are understood. This study examines the Canadian Pain Task Force (CPTF) \u2014 a federal advisory body charged with creating a national pain strategy \u2014 by analyzing its reports, public and patient consultations, and internal documents. Through qualitative framing analysis, we find that stakeholders overwhelmingly depicted the overdose crisis as the result of illicit and irresponsible opioid use, while positioning stigma as both a driver and consequence of the crisis that compounded the challenges faced by people with chronic pain. From these problem definitions flowed policy proposals centered on expanding opioid access, reducing stigma, and advancing patient-centered care. These findings demonstrate how pain stakeholders shape, and are simultaneously shaped by, opioid policy debates \u2014 with consequences for both overdose prevention and chronic pain management.<\/jats:p>","DOI":"10.1017\/jme.2025.10158","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T10:23:22Z","timestamp":1757327002000},"page":"552-560","source":"Crossref","is-referenced-by-count":2,"title":["Constructing Opioid Legitimacy: The Canadian Pain Task Force\u2019s Framing of the Overdose Crisis"],"prefix":"10.1017","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9451-9668","authenticated-orcid":false,"given":"Daniel","family":"Eisenkraft Klein","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03dbr7087","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Toronto"},{"id":[{"id":"https:\/\/ror.org\/04b6nzv94","id-type":"ROR","asserted-by":"publisher"}],"name":"Brigham and Women\u2019s Hospital"},{"id":[{"id":"https:\/\/ror.org\/03vek6s52","id-type":"ROR","asserted-by":"publisher"}],"name":"Harvard Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7640-8614","authenticated-orcid":false,"given":"Quinn","family":"Grundy","sequence":"additional","affiliation":[{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Hawkins","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/052578691","id-type":"ROR","asserted-by":"publisher"}],"name":"MRC Epidemiology Unit, University of Cambridge"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Schwartz","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03dbr7087","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"S1073110525101587_r26","unstructured":"26. Canadian Pain Task Force, Exploring People\u2019s Experience with Chronic Pain (2019), unpublished, on file with author, hereinafter referred to as Experience with Chronic Pain."},{"key":"S1073110525101587_r13","first-page":"4","volume-title":"Chronic Pain in Canada: Laying a Foundation for Action","year":"2019"},{"key":"S1073110525101587_r57","volume-title":"Case Study Research and Applications: Design and Methods","author":"Yin","year":"2017"},{"key":"S1073110525101587_r44","unstructured":"44. Canadian Pain Task Force, Working Together to Better Understand, Prevent, and Manage Chronic Pain: What We Heard. p. 34."},{"key":"S1073110525101587_r52","doi-asserted-by":"publisher","DOI":"10.1353\/book.30085"},{"key":"S1073110525101587_r46","unstructured":"46. Canadian Pain Task Force, An Action Plan for Pain in Canada, at 5."},{"key":"S1073110525101587_r31","unstructured":"31. Canadian Pain Task Force, Experience with Chronic Pain, p. 40."},{"key":"S1073110525101587_r2","unstructured":"2. UNODC, World Drug Report 2024."},{"key":"S1073110525101587_r54","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002270"},{"key":"S1073110525101587_r45","unstructured":"45. Canadian Pain Task Force, Laying a Foundation, at 5."},{"key":"S1073110525101587_r43","unstructured":"43. Canadian Pain Task Force, What We Heard (2020), p. 32."},{"key":"S1073110525101587_r28","unstructured":"28. Canadian Pain Task Force, An Action Plan for Pain in Canada, at 6."},{"key":"S1073110525101587_r16","doi-asserted-by":"publisher","DOI":"10.1177\/0275074014533142"},{"key":"S1073110525101587_r6","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-021-01496-1"},{"key":"S1073110525101587_r58","unstructured":"58. Yin, Case Study Research and Applications."},{"key":"S1073110525101587_r30","unstructured":"30. Canadian Pain Task Force, Experience with Chronic Pain, p. 34."},{"key":"S1073110525101587_r35","unstructured":"35. What We Heard, p. 68."},{"key":"S1073110525101587_r14","first-page":"23","volume-title":"An Action Plan for Pain in Canada","year":"2021"},{"key":"S1073110525101587_r7","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2016.303297"},{"key":"S1073110525101587_r32","unstructured":"32. Canadian Pain Task Force, Working together to better understand, prevent and, manage chronic pain: What We Heard (Health Canada, 2020), at p. 29. Hereinafter referred to as What We Heard."},{"key":"S1073110525101587_r25","volume-title":"Social Research Methods","author":"Bryman","year":"2012"},{"key":"S1073110525101587_r42","first-page":"465","article-title":"Opioid prescribing is a surrogate for inadequate pain management resources","volume":"62","author":"Finestone","year":"2016","journal-title":"Canadian Family Physician Medecin de Famille Canadien"},{"key":"S1073110525101587_r29","unstructured":"29. Canadian Pain Task Force, An Action Plan for Pain in Canada."},{"key":"S1073110525101587_r15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0287861"},{"key":"S1073110525101587_r21","unstructured":"21. Rein et al., \u201cReframing Policy Discourse,\u201d at 146."},{"key":"S1073110525101587_r50","doi-asserted-by":"publisher","DOI":"10.1177\/0022042620986508"},{"key":"S1073110525101587_r23","doi-asserted-by":"publisher","DOI":"10.1002\/9781118715598.ch21"},{"key":"S1073110525101587_r8","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-019-0137-5"},{"key":"S1073110525101587_r19","doi-asserted-by":"publisher","DOI":"10.1215\/9780822381815-007"},{"key":"S1073110525101587_r38","unstructured":"38. Engaging Canadians to Better Understand, Prevent, and Manage Pain: Engagement Summary Report (2020) p. 10. Unpublished, on file with author, hereinafter referred to as Engagement Summary."},{"key":"S1073110525101587_r55","doi-asserted-by":"publisher","DOI":"10.18192\/cjmsrcem.v18i1.6497"},{"key":"S1073110525101587_r5","first-page":"E659","article-title":"Recent Developments in Prescription Opioid-related Dispensing and Harm Indicators in Ontario, Canada","volume":"18","author":"Fischer","year":"2015","journal-title":"Pain Physician"},{"key":"S1073110525101587_r41","unstructured":"41. Canadian Pain Task Force, What We Heard, p. 7."},{"key":"S1073110525101587_r40","unstructured":"40. Canadian Pain Task Force, What We Heard, p. 20."},{"key":"S1073110525101587_r51","article-title":"\u201cFraming Chronic Pain in U.S. News Coverage of the Opioid Epidemic (2012\u20132022),\u201d","volume":"39","author":"Jacqueline","year":"2024","journal-title":"Health Communication"},{"key":"S1073110525101587_r11","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.170363"},{"key":"S1073110525101587_r9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)33078-2"},{"key":"S1073110525101587_r12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1904190"},{"key":"S1073110525101587_r17","volume-title":"The Argumentative Turn in Policy Analysis and Planning","author":"Fischer","year":"1993"},{"key":"S1073110525101587_r53","unstructured":"53. Larson, Bonnie , Salvalaggio, Ginetta , and Bodkin, Claire , Opinion: \u201cAs physicians, the \u2018safe supply\u2019 of opioids is one of the best tools we have to tackle Canada\u2019s drug-poisoning crisis,\u201d Globe and Mail, January 6, 2022, https:\/\/www.theglobeandmail.com\/opinion\/article-as-physicians-the-safe-supply-of-opioids-is-one-of-the-best-tools-we\/ (last visited December 12, 2023)."},{"key":"S1073110525101587_r47","unstructured":"47. Canadian Pain Task Force, What We Heard, at 34."},{"key":"S1073110525101587_r1","volume-title":"World Drug Report 2024","year":"2024"},{"key":"S1073110525101587_r33","unstructured":"33. What We Heard, p. 29."},{"key":"S1073110525101587_r34","unstructured":"34. Canadian Pain Task Force, An Action Plan for Pain in Canada, at 5."},{"key":"S1073110525101587_r10","doi-asserted-by":"publisher","DOI":"10.24095\/hpcdp.38.6.02"},{"key":"S1073110525101587_r56","doi-asserted-by":"publisher","DOI":"10.17037\/PUBS.04398421"},{"key":"S1073110525101587_r27","unstructured":"27. Canadian Pain Task Force, Chronic Pain in Canada, at 2."},{"key":"S1073110525101587_r20","unstructured":"20. van Hulst et al., \u201cFrom Policy \u2018Frames\u2019 to \u2018Framing\u2019\u201d; Rein et al., \u201cReframing Policy Discourse.\u201d"},{"key":"S1073110525101587_r37","unstructured":"37. Canadian Pain Task Force, Laying a Foundation, p. 16."},{"key":"S1073110525101587_r48","unstructured":"48. Canadian Pain Task Force, What We Heard, p. 34."},{"key":"S1073110525101587_r49","unstructured":"49. Canadian Pain Task Force, An Action Plan for Pain in Canada, at p. 10."},{"key":"S1073110525101587_r18","doi-asserted-by":"publisher","DOI":"10.1093\/019924264X.001.0001"},{"key":"S1073110525101587_r24","volume-title":"Qualitative Methods for Health Research","author":"Green","year":"2014"},{"key":"S1073110525101587_r36","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2115244"},{"key":"S1073110525101587_r4","volume-title":"Prescription Opioids","year":"2020"},{"key":"S1073110525101587_r22","unstructured":"22. van Hulst et al., \u201cFrom Policy \u2018Frames\u2019 to \u2018Framing.\u2019\u201d"},{"key":"S1073110525101587_r3","volume-title":"Opioid- and Stimulant-related Harms in Canada","year":"2025"},{"key":"S1073110525101587_r39","volume-title":"Working together to better understand, prevent and, manage chronic pain: What We Heard","year":"2020"}],"container-title":["Journal of Law, Medicine &amp; Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1073110525101587","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T13:22:59Z","timestamp":1770297779000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1073110525101587\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":58,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"alternative-id":["S1073110525101587"],"URL":"https:\/\/doi.org\/10.1017\/jme.2025.10158","relation":{},"ISSN":["1073-1105","1748-720X"],"issn-type":[{"value":"1073-1105","type":"print"},{"value":"1748-720X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]}}}