Samenvatting

In this article, I am using Becker’s concept of moral entrepreneur to analyse the role of pain specialists in the labelling process, which has led to the normalisation of the use of opioid painkillers in the United States and ultimately to the death over 200.000 Americans. In general, the literature on labelling centres on crusading reformers, and the criminalisation and stigmatisation of transgressive behaviour. Here I will focus on the moral entrepreneurship of medical experts. What was their role in the normalisation process of opioid painkiller use and are there any similarities with the strategies of crusading reformers? My findings, based on qualitative analysis of documents such as newspaper articles and academic publications, show that, with two exceptions, pain specialists use the strategies of moral crusaders. First, in their narratives, pain specialists represented themselves as neutral objective experts without the emotional stance of moral crusaders. The second exception, which is related to the first, is that there was less emphasis in their narrative on creating villains, as they could not blame openly standard medical practice because they needed the support of the established medical world in order to normalise and legalise opioid painkillers.