{"id":11858,"date":"2024-08-22T20:51:22","date_gmt":"2024-08-22T20:51:22","guid":{"rendered":"https:\/\/thesocietypages.org\/discoveries\/?p=11858"},"modified":"2024-08-22T20:51:23","modified_gmt":"2024-08-22T20:51:23","slug":"pharmacist-deputies","status":"publish","type":"post","link":"https:\/\/thesocietypages.org\/discoveries\/2024\/08\/22\/pharmacist-deputies\/","title":{"rendered":"Pharmacist Deputies"},"content":{"rendered":"<div class='citation'>\n    <span class='authors'>Elizabeth Chiarello, <\/span><span class='link'><a href=\"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031224231209445\">&ldquo;Trojan Horse Technologies: Smuggling Criminal-Legal Logics into Healthcare Practice,&rdquo; <em>American Sociological RevieTrojan Horse Technologies: Smuggling Criminal-Legal Logics into Healthcare Practicew<\/em>,<\/a><\/span><span class='year'> 2023<\/span><\/div>\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/thesocietypages.org\/discoveries\/files\/2024\/08\/pexels-polina-tankilevitch-3735715-scaled.jpg\"><img loading=\"lazy\" decoding=\"async\" width=\"2560\" height=\"1706\" src=\"https:\/\/thesocietypages.org\/discoveries\/files\/2024\/08\/pexels-polina-tankilevitch-3735715-scaled.jpg\" alt=\"\" class=\"wp-image-11859\" srcset=\"https:\/\/thesocietypages.org\/discoveries\/files\/2024\/08\/pexels-polina-tankilevitch-3735715-scaled.jpg 2560w, https:\/\/thesocietypages.org\/discoveries\/files\/2024\/08\/pexels-polina-tankilevitch-3735715-300x200.jpg 300w, https:\/\/thesocietypages.org\/discoveries\/files\/2024\/08\/pexels-polina-tankilevitch-3735715-600x400.jpg 600w, https:\/\/thesocietypages.org\/discoveries\/files\/2024\/08\/pexels-polina-tankilevitch-3735715-768x512.jpg 768w, https:\/\/thesocietypages.org\/discoveries\/files\/2024\/08\/pexels-polina-tankilevitch-3735715-1536x1024.jpg 1536w, https:\/\/thesocietypages.org\/discoveries\/files\/2024\/08\/pexels-polina-tankilevitch-3735715-2048x1365.jpg 2048w\" sizes=\"auto, (max-width: 2560px) 100vw, 2560px\" \/><\/a><\/figure>\n\n\n\n<p><em>A pharmacist wearing a white coat\u00a0working at their lab station. Image by <\/em><a href=\"https:\/\/www.pexels.com\/@polina-tankilevitch\/\"><em>Polina Tankilevitch<\/em><\/a><em> under <\/em><a href=\"https:\/\/www.pexels.com\/license\/\"><em>Pexels license<\/em><\/a><em>.<\/em><\/p>\n\n\n\n<p><a href=\"https:\/\/www.cdc.gov\/museum\/pdf\/cdcm-pha-stem-uncovering-the-opioid-epidemic-lesson.pdf\">Over 500,000 Americans<\/a> have died as a result of opioid overdose since 1999. Policymakers, police, and medical professionals are all trying to understand and prevent overdose. For example, pharmacists now use computer programs that track how often patients refill their prescriptions called \u2018Prescription Drug Monitoring Programs\u2019 (PDMPs).&nbsp;<\/p>\n\n\n\n<p>Because these prescription tracking programs were designed for law enforcement, some worry they might be subtly pressuring pharmacists to be more focused on <em>policing <\/em>than providing patients with care. Supporters of these PDMPs say they can eliminate biases by automating decisions about prescription eligibility and giving pharmacists a formal justification to turn patients away.<\/p>\n\n\n\n<p><a href=\"https:\/\/www.lizchiarello.com\/\">Elizabeth Chiarello<\/a> interviewed 118 community-placed pharmacists to learn how the new PDMP databases affected their work routines and relationships with other professionals.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Chiarello found that as pharmacists used the PDMPs, they reoriented their work around crime and the legal system, rather than health care logics. This shifted their treatment of prescription misuse from a rehabilitative one to a more punitive one. She therefore describes PDMPs as \u2018Trojan Horse Technologies,\u2019 based on the classic story of the soldiers hidden inside the giant horse that the Greeks gifted to the Trojans;&nbsp;<\/p>\n\n\n\n<p><em>\u201cWhereas the Greeks leapt out of the horse to massacre their enemies,\u201d Chiarello writes, \u201cthe criminal-legal logics embedded in the PDMP emerge slowly as pharmacists use PDMPs in daily practice,\u201d which gradually transforms the pharmacy field.&nbsp;&nbsp;<\/em><\/p>\n\n\n\n<p><div class=\"pull-this-show\" id=\"pull-this-show-11858-ex2\" style=\"display:none;\"><\/div>Pharmacists are now expected to act as an extension of law enforcement, <span class=\"pull-this-mark\" id=\"pull-this-mark-11858-ex2\" style=\"display:none;\">reporting patients and restricting their ability to access medicine rather than helping them get the treatment they need.<\/span>\u00a0<\/p>\n\n\n\n<p>Through the adoption of PDMPs, law enforcement may have subtly deputized pharmacists to criminalize prescription misuse. Although pharmacists have historically resisted this role, PDMPs have become systematized and made pharmacists more comfortable policing their patients. Chiarello concludes that pharmacists would be less inclined to police patients, and more inclined to care for them, if they had access to different<em> treatment<\/em> tools, such as the ability to provide medications for substance use treatment under a physician\u2019s supervision.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Elizabeth Chiarello, &ldquo;Trojan Horse Technologies: Smuggling Criminal-Legal Logics into Healthcare Practice,&rdquo; American Sociological RevieTrojan Horse Technologies: Smuggling Criminal-Legal Logics into Healthcare Practicew, 2023 A pharmacist wearing a white coat\u00a0working at their lab station. Image by Polina Tankilevitch under Pexels license. Over 500,000 Americans have died as a result of opioid overdose since 1999. Policymakers, police, [&hellip;]<\/p>\n","protected":false},"author":2217,"featured_media":11859,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[124,15,33],"tags":[138756,138760,138775,138781,138757,138790,138773,138786,138782,138749,138763,138758,138769,138791,138774,138747,138778,138768,138762,138779,138789,138744,138767,138753,138787,138751,138765,138783,138772,138754,138746,138788,138764,138784,138780,138771,138761,138745,138755,138752,138785,138748,138750,138770,138766,138776,17580,138759,138777],"class_list":["post-11858","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-crime","category-culture","category-health","tag-automated-healthcare-systems","tag-community-pharmacists","tag-crime-logics","tag-criminal-legal-logics","tag-criminalization-of-prescription-misuse","tag-drug-use-criminalization","tag-elizabeth-chiarello","tag-health-professional-police-relations","tag-health-surveillance","tag-health-vs-crime-logics","tag-healthcare-and-legal-system","tag-healthcare-automation","tag-healthcare-ethics","tag-healthcare-policy","tag-healthcare-system-transformation","tag-law-enforcement-in-healthcare","tag-law-enforcement-tools","tag-legal-logics-in-medicine","tag-medical-decision-automation","tag-medication-access","tag-opioid-addiction","tag-opioid-crisis","tag-opioid-epidemic","tag-opioid-overdose","tag-opioid-prescription-control","tag-patient-care","tag-patient-rehabilitation","tag-patient-reporting","tag-pharmacist-decision-making","tag-pharmacist-policing","tag-pharmacist-roles","tag-pharmacist-supervision","tag-pharmacists-as-law-enforcers","tag-pharmacy-field-changes","tag-pharmacy-work-routines","tag-policing-in-pharmacies","tag-prescription-bias","tag-prescription-drug-monitoring-programs-pdmps","tag-prescription-eligibility","tag-prescription-misuse","tag-prescription-monitoring-tools","tag-prescription-overdose-prevention","tag-prescription-refills","tag-prescription-tracking-programs","tag-punitive-healthcare","tag-rehabilitative-care","tag-substance-abuse","tag-substance-use-treatment","tag-trojan-horse-technologies"],"jetpack_featured_media_url":"https:\/\/thesocietypages.org\/discoveries\/files\/2024\/08\/pexels-polina-tankilevitch-3735715-scaled.jpg","_links":{"self":[{"href":"https:\/\/thesocietypages.org\/discoveries\/wp-json\/wp\/v2\/posts\/11858","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/thesocietypages.org\/discoveries\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thesocietypages.org\/discoveries\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thesocietypages.org\/discoveries\/wp-json\/wp\/v2\/users\/2217"}],"replies":[{"embeddable":true,"href":"https:\/\/thesocietypages.org\/discoveries\/wp-json\/wp\/v2\/comments?post=11858"}],"version-history":[{"count":3,"href":"https:\/\/thesocietypages.org\/discoveries\/wp-json\/wp\/v2\/posts\/11858\/revisions"}],"predecessor-version":[{"id":11862,"href":"https:\/\/thesocietypages.org\/discoveries\/wp-json\/wp\/v2\/posts\/11858\/revisions\/11862"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/thesocietypages.org\/discoveries\/wp-json\/wp\/v2\/media\/11859"}],"wp:attachment":[{"href":"https:\/\/thesocietypages.org\/discoveries\/wp-json\/wp\/v2\/media?parent=11858"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thesocietypages.org\/discoveries\/wp-json\/wp\/v2\/categories?post=11858"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thesocietypages.org\/discoveries\/wp-json\/wp\/v2\/tags?post=11858"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}