Camille Kroll

This project examines how pain specialists reimagine good care –morally and technically- in the wake of the “U.S. Opioid Overdose Crisis.” This crisis framing sanctioned the proliferation of risk management practices in the clinic, including heightened surveillance and criminalization of opioid prescribers. As long-term pain treatment moves from primary care to pain management, pain specialists negotiate their relationships with opioid prescribing and treating opioid use disorder (OUD) –practices once outside the field’s scope. In a historical moment that has deemed this work risky, pain specialists often consider pain to be routine and non-emergent. Through long-term ethnographic observation at two pain management clinics, only one that treats coexisting OUD, this project attends to how U.S. pain specialists incorporate risk into their daily practices. It contributes to anthropologies of morality and risk by theorizing risk as a lived moral and temporal condition for pain specialists: risk demands anticipating future harms of patient overdose or personal criminal liability that exist in tension with pain’s present claim for acknowledgement and relief. I examine how pain specialists reconcile competing temporal logics of risk and pain, creating hierarchies of risk that emerge from their understandings of pain and addiction and shape their conceptions of good care.