Problematizing Opioid Agonist Treatment: The Social Organization of Pharmacy Employee Well-Being

As the toxic drug crisis continues to pose unrelenting challenges for our communities and systems of care, more attention is being drawn to how society and our systems coordinate harmful experiences for people who use opioids and those they come into contact with as a result of the toxic drug supply. The overburdened and under-resourced state of our healthcare system is organizing pervasive rates of phenomena such as burnout, compassion fatigue, and moral injury, and the toxic drug supply is undoubtedly a contributing factor to the fractured state of our healthcare system. While it is evident that an upstream approach is well overdue, reactive interventions to ongoing opioid use continue to prevail; one such approach is opioid agonist treatment (OAT) – a pharmacological intervention designed to treat opioid use disorder. OAT is often regarded as a “best practice” or “gold standard” but remains stigmatized and racialized and has stringent treatment regulations that result in people who adhere to OAT enduring or remaining vulnerable to structurally produced hardships; this downstream intervention shapes the experiences of those who take these medications in alarming ways but also coordinates the daily lives of those who are involved in its provision. However, the work done in relation to OAT needs more exploration, especially concerning how this treatment organizes the well-being of those who provide and prepare it. Despite knowing that pharmacy employees – regardless of their involvement with OAT – are at an exceptionally high risk of burnout, the structural factors that shape their wellness have garnered little sociological attention. In this presentation, I share insights from my institutional ethnographic inquiry into how OAT coordinates pharmacy employees’ well-being, problematizing the individualistic approaches to supporting healthcare professionals’ wellness when the roots of their adverse well-being outcomes are entangled within structural deficits, not personal ones.