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- UFV among Canada’s best in Globe and Mail’s 2012 University Report
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UFV among Canada’s best in Globe and Mail’s 2012 University Report
Metrics details. Independently and in duplicate, reviewers manually extracted qualitative data from articles and identified emergent themes. Articles were screened independently by both reviewers based on the inclusion criteria. Conflicts were resolved by discussion and consensus. Social representation theory was used as a framework for describing how the opioid crisis is portrayed in Canada.
Our search yielded relevant opioid articles. The number of articles peaked in , , and in , coinciding with major developments in the epidemic. The language used in this discourse has evolved over the years and has slowly shifted towards less stigmatizing language.
Content analysis of the articles revealed common social representations attributing responsibility to pharmaceutical companies, physicians, and foreign countries. Journalists face several obstacles to achieve greater focus and framing of the opioid crisis; a closer working relationship between the media and the research community is needed. Since the late s, there has been a considerable increase in the use of prescription opioids for the relief of chronic pain [ 1 ].
This has resulted in increasing levels of non-medical use of prescription opioids and associated increases in morbidity and mortality due to opioid overdoses [ 2 , 3 ]. Today, North America is witnessing an ever-increasing rate of opioid misuse contributing to substantial drug-related harms, including dependence and both fatal and non-fatal overdose. In , approximately 3. Canadians are the second-highest per-capita consumers of opioids in the world, after only the United States [ 2 ], and opioid misuse has become a public health issue of national concern [ 9 ].
This trend is aligned with a growing rate of non-medical prescription opioid use in Canada since [ 2 ]. A Health Canada survey found that roughly one-third of Canadians who used opioids in used them illicitly [ 2 ]. Historically, media coverage of various epidemics has helped shape the policy agenda [ 10 , 11 ], while also reflecting ongoing policy discussions, debates and developments.
In a year study of the four highest-circulation national U. Canadian news media coverage of opioid-related harm reduction strategies showed that Canadian print newspapers are capable of shaping public discourse on developments in harm reduction by selectively reporting on supervised opioid consumption and naloxone, leading to increased public support for these strategies compared to other evidenced-based alternatives e. However, a comprehensive portrayal of the opioid crisis that is not limited only to harm reduction is still poorly understood, especially with regards to how it evolved over the previous two decades [ 17 ].
Social representation theory SRT [ 18 ] focuses on explaining how social representations of public issues are formed and how these social representations help individuals, groups and communities make sense of unfamiliar, problematic events or issues. Anchoring, one of the processes by which social representations are formed, involves integrating unfamiliar objects into pre-existing knowledge and fitting novel information into previously formed ideas, thus making unfamiliar concepts familiar [ 24 , 25 ].
This is often done by attributing responsibility to specific collectives e. Determining how the media could have impacted social representation of the opioid crisis by attributing responsibility to different collectives over time provides a deeper understanding of how the issue could be understood and perceived by every-day Canadians. The Globe and Mail had the widest circulation and highest print readership in 6. The Globe and Mail prints separate editions for the following cities across Canada: Montreal, Toronto, Winnipeg, Calgary and Vancouver, featuring a combination of national stories and local stories.
The Globe and Mail also does not have a strong political slant like the next two largest circulation dailies National Post and Toronto Star. Q , within an year timeframe 1 January —1 June Inclusion criteria were defined as any articles referring to opioid-related news or the epidemic, its victims, and mitigation or harm reduction strategies.
Exclusion criteria were defined as any articles focusing on drugs that are neither opioids, opiate derivatives, nor related substances e. Both reviewers screened articles independently based on the inclusion criteria, then resolved all conflicts by discussion and consensus. A data extraction form was developed as a means of objectively and systematically recording data obtained from the articles. Using this form, reviewers manually extracted qualitative data from articles independently and in duplicate.
Information such as date, location, authors, title, drugs mentioned, experts mentioned, language describing people who use opioids, role of opioids i. In line with the aims of the study and the SRT framework, the articles were also sorted and coded into groups by type of article, type of evidence, location of article and attribution of responsibility. The coding process was performed manually. Due to the evolving nature of the opioid epidemic and the surrounding discourse, the extraction form and coding framework were modified as needed through a joint and iterative process [ 30 ].
All sorting and reporting disagreements were resolved by consensus. Our initial search yielded Globe and Mail articles. Of these, duplicate articles were removed, and the remaining articles were screened based on the inclusion criteria. We ultimately identified relevant articles for content analysis Fig.
Initial reporting began in ; the early years had very few to no opioid-related articles Fig. News reports and editorials were typically centered around statements of risk or criminal activity, while the anecdotes and opinion-based stories tended to focus on the far-reaching implications of opioid dependence from either the patient or the healthcare provider perspective.
Of the different authors present in this study, the leading authors were Woo, Howlett, Weeks, Giovannetti, and Paperny, with , 67, 28, 22, and 18 published articles, respectively. The number of opioid-related articles peaked in , again in , and substantially increased in Manual review of the opioid-related stories revealed that peaks in news coverage often coincided with major developments in or reports on the epidemic Fig. Of all articles, Many of these statement of risk articles focused on the potency of fentanyl and other illicit drugs that may be mixed with opioids when sold illegally.
Articles covering this topic also frequently called for more public awareness, more provincial and federal action to expedite harm reduction programs such as methadone clinics and naloxone training programs and warned about the risks of overdose. Proportion of articles and language used to describe individuals suffering with substance use disorder — Of the articles that referred to some form of scientific study as evidence, the majority occurred between and Interestingly, shifts in the language used over time differed between many authors.
Woo tended to focus on covering legal implications of harm reduction actions and overdose prevention, shifting to less stigmatizing language use later — than most other authors. Overall, the shift towards less stigmatizing use of language was closely interlinked with the framing of the opioid crisis as a public health, rather than criminal, issue for all authors.
A common framing characteristic of media reporting of opioid use and dependence is the use of hyperbole that dramatizes or sensationalizes the issue [ 37 ]. This may lead to the formation of harmful stereotypes towards people who use opioids. From to , framing of the opioid crisis centred on the abuse of prescription opioids, opioid-seeking behaviour leading to crime and theft, and double-doctoring seeking prescriptions from multiple physicians [ 42 , 43 ].
Notably, methadone programs and supervised injection sites were portrayed as mediums to promote opioid abuse [ 44 ]. From —, a transition in the framing of the opioid crisis from a criminal and legal issue towards one of public health started to emerge more prominently. From onwards, the opioid crisis continued to be portrayed most often as a public health issue [ 47 ].
Content analysis of the articles revealed themes associated with key groups. The representation of these in The Globe and Mail over time is presented in Fig.
Proportion of articles stratified by response attribution designated — The role of the pharmaceutical industry in motivating the massive rise in opioid prescriptions [ 49 , 50 ], and how, if at all, they were being held responsible for their actions in Canada and abroad were widely discussed.
Articles explored out-dated provincial opioid prescribing guidelines [ 52 , 53 ], and the creation of national opioid prescribing guidelines to improve and standardize prescribing practices [ 54 , 55 , 56 ]. Within the overall discourse surrounding the illicit drug supply, responsibility was also frequently attributed to a foreign country. An investigation into the source of illicit fentanyl, conducted by The Globe and Mail in [ 60 ] was often referenced to confirm that tainted drugs were responsible for an increase in opioid-related deaths.
Many articles thereafter detailed drug trafficking [ 61 , 62 ], and joint efforts between China and Canada to curb such activities [ 63 ]. Interestingly, patterns of responsibility attribution in The Globe and Mail varied geographically across Canada. National stories, accounting for Similarly, local stories also attributed responsibility predominantly to physicians and gaps in the healthcare system but varied in attributing responsibility to Big Pharma and foreign countries.
Local stories in British Columbia focused more commonly on the illicit drug trade from foreign countries than physician prescribing of opioids, whereas local stories from Ontario showed the opposite trend. Examples of B.
Ontario physicians bore the principal responsibility for the creation of national opioid prescribing guidelines [ 68 , 69 ]. It is important to note that these media representations of responsibility attribution evolved as the long-term consequences of opioid overprescribing became more apparent. Following this — , the vast majority of articles addressed the steadily increasing rates of prescription painkiller use and fatal and non-fatal opioid overdoses [ 72 , 73 ].
During this time, gaps in the healthcare system e. Concurrently, policy-related articles also initially focused on the need for opioid prescribing guidelines for healthcare providers and pharmaceutical tracking systems [ 75 ]. From on, the growing prevalence of substance misuse was thrust into the spotlight with several high-profile overdoses [ 76 , 77 ] and the delisting of high-dose prescription opioids from province's drug plans [ 78 , 79 ].
It was also at this time that responsibility attribution patterns shifted away from physicians and the pharmaceutical industry towards a tainted and increasingly potent illicit opioids supply [ 61 , 80 ]. Next, between and mid, opioid-related overdoses continued to increase rapidly, and policies focused on better overdose surveillance and expanded access to Naloxone, a drug that can reverse opioid overdose.
Throughout the last few years mid to , policies focused on approving and opening additional supervised consumption sites [ 81 , 82 , 83 ] with the responsibility for opioid-related harms still primarily placed on the illicit drug supply of opioids from China [ 63 , 84 ].
Only few articles 1. Despite the fact that mental health issues are extremely common among people who use drugs, [ 87 ], these issues were rarely addressed [ 88 ]. Our study offers insight into news coverage of the opioid crisis in Canada from The Globe and Mail and highlights its important role in framing issues and acting as a disseminator of information.
Of note, while earlier research promoted the use of opioids for pain management [ 70 , 89 ], this could have contributed to the initial perception of their safety. This is analogous to early academic papers that also minimized risk of opioid dependence or harm and have been extensively cited as evidence of the perceived lack of risk around opioid prescribing [ 90 ].
This form of early information can create an anchoring bias that can be difficult to change, even in the presence of evidence to the contrary [ 91 ]. In this case, there was a delay between academic evidence suggesting the potential harms associated with opioid use evidence that appeared in late s to early s [ 92 ] and changes in expert opinion and media reporting, which did not consistently warn about opioid misuse and dependence until We found a significant increase in the coverage of opioids and opioid misuse from onwards Fig.
Peaks in coverage coincided with major public health or policy developments, indicating that opioids and their misuse became and have remained a priority issue in the eyes of the public over the years Fig. As suggested by the results of this study, the language used to describe people who use drugs has shifted to less stigmatizing language in recent years.
However, the continuing news framing and sensationalizing of opioid issue mimics fear-based opioid campaigns [ 93 ] and has the potential to increase the stigma surrounding drug use, shame individuals who use drugs and discourage them from seeking help [ 94 ]. Mass media campaigns that portray emotional messages such as personal testimonials, stories, and intense images have also been found to be an effective strategy in smoking cessation and changing smoking behaviours in adults [ 96 , 97 ].
This could be a beneficial strategy to educate about opioid misuse and change perceptions about the opioid crisis in Canada. This analysis revealed how newspaper coverage could have aided the development of responsibility attribution patterns towards different collectives.
It is evident that the current opioid crisis is, and is communicated as, several overlapping crises—over-prescription of pain medications by pharmaceutical companies and physicians , the growing availability of contaminated street drugs, and a failure to fully implement harm reduction measures Fig.
It is easy for both the media and the public to blame these collectives i.
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Bill Marczak and John Scott-Railton. Jeffrey Knockel and Ruohan Xiong. Petra Molnar and Lex Gill. Citizen Lab and the Foundation for Media Alternatives. Shazeda Ahmed. Shazeda Ahmed and Adrian Fong. Ng, and Masashi Crete-Nishihata.
The database for the report is available here. The report was mentioned in a Financial Post article here. An op-ed was published in the Globe and Mail. The report was also discussed in the Financial Post.
Abella, R. Equality in employment: A Royal Commission Report 4th ed. Report of the Commission on Equality in Employment.
This article was published more than 8 years ago.
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