Transition Design Assignment 4 Spatio Temporal Matrix
Spatio Temporal Matrix
For our Spatio Temporal Matrix, our group indulged in great conversation and reviewed our wicked problem as a whole. We divided the sections into three parts. Jo and Michelle tackled past, David and Patrick mastered Present, and Sofia and Ekta focused on the Future. Discussing the niche, regime, and landscape levels of the opioid epidemic, the Spatio Temporal Matrix served as a great platform for rich discussion. We were able to form a more approachable narrative to our opioid problem space.
THE PAST
Higher Systems Levels
What large, historical events, situations or trends contributed to the problem? What was a society like before the problem arose?
Beginning in the 1980s there was a shift in the medical system. There was a revolution in pain management in legitimate American medicine. Pain specialists formed alliances with big pharmaceuticals companies and pushed for ‘non-addictive’ narcotic to the entire medical community. Major medical institutions, hospitals were judged on how well pain was treated. Pain treatment became much more aggressive.
Primary Level of The Problem
What are the historical roots of the problem? When did it first begin? How were people living prior to the emergence of the problem? What had they been doing to prevent it from arising?
The history of opioids spans back to Ancient Chinese to the 2727 B.C. when cannabis and opioids were first recorded as medicine in the Chinese pharmacopeia. Pain management was dealt with in a much more holistic and herbal way, through diet, exercise, and grit. These traditional use of chemicals forgotten and taken advantage of. The first opioid epidemic in the United States occurred right around the dawn of the civil war and in the 1850s and lasted until 1914. During this time opium and morphine were highly unregulated and treated recklessly. The most present opioid epidemic started with the eschewing of direct marketing to the public, including advertising in medical journals. In 1995 Purdue Pharma successfully introduced OxyContin as a less-addictive type of drug based on the New England Journal of Medicine’s letter that stated “Addiction rare with patients treated with narcotics”. Because of this shift, people learn to treat their pain with one pill solves all mentality; Advertisement created an easy gratification solution that proved to be addictive and deadly.
Lower Systems Levels
What about everyday life and practices in the past, may have contributed to the problem? What practices in the very distant past prevented the problem from arising?
In Pittsburgh many white collar workers reporter injuries including the steel mill industry. Because of our mechanistic society, and the need to work constantly, most of these laborers fell prey to Pharma’s big corporation. Advertising reached Pittsburgh residents and addiction became rampant. This is a result of the American cultural shift — people began to demand easy, quick fix for the pain, comfort, and convenience. Patients began to push doctors to treat pain more aggressively. Many treatments were used to treat pain. Before the 1980s, doctors use a wide range of tools to treat pain and provide personalized pain treatment to each patient, such as cognitive based therapy, counseling, physical therapy, etc., which were reimbursed by insurance.
THE PRESENT
Present Higher Level
At the high-level scale for the present time, several major factors contribute to the opioid crisis. Mainly speaking, the capitalist mindset companies have, the idea that the doctor is always right, and the rising costs of healthcare, are all factors that add fuel to the fire.
Companies, specifically pharmaceutical companies, and private health insurers have and have been putting a lot of emphasis on defining success in purely monetary values. Because of this, the welfare and health of consumers are put in the backseat and are deemed as irrelevant as long as profits can be made and shareholders are happy. Another major factor contributing to the issue is a large number of trust patients have on their doctors. In their minds, the doctor is like a god, all-knowing and all-powerful, capable of curing and relieving any sort of pain. Their lack of knowledge of the dangers of drug use and painkillers leads to the unhealthy and highly risky use of opioids. Lastly, rising healthcare costs in the United States are forcing patients dealing with pain to seek cheap, immediate, and short term solutions to their problems, leading to high rates of painkiller prescription.
However, at this level, increases in media exposure of the unethical actions being taken by these big pharmaceutical companies are inspiring more and more protests at lower levels. Improvements in technology mean that people have better access to the internet and increased awareness of the dangers of opioids use. Better regulations are beginning to be set in place that will force companies to put more emphasis on the wellbeing of their consumers and make sure they are not taking advantage of the lack of knowledge from their consumers in order to gain higher profits.
Present Lower Level
The false advertisement of opioid, the mechanistic mindset for fast treatment, and the unaffordable healthcare system all have a negative impact on the lower level of people’s everyday life. As a result, many physicians and opioid users are still unaware of opioid addiction. In their spare time, they are still exposed to many false advertisements about opioid on TV and social media. Even when they realize the negative impact of opioid, many of them still cannot afford the healthcare and therefore, are forced to use opioid to treat pains. In addition, many of them are still searching for a fast way to treat the pain. The rooted “one pill could solve everything” mindset reinforce their use of opioid.
Several possible interventions at a lower level could resolve the problem. In the short run, organized protests against the opioid producers and distributors could raise public awareness about the opioid crisis. The protests could also incentivize the government to come up with regulation on opioid production and false media promotions. Education could have a long term impact on resolving the problem that it could educate people about opioid addiction, and introduce alternative ways of treating pains. In addition, some people might know ways to treat pains that are natural and have limited or no negative impact. Encouraging them to share such knowledge in the community could develop “shared knowledge” inside the community and also help introduce alternative ways of treating pains.
THE FUTURE
Higher System Levels
At a higher systems level, the rhythm of production and consumption will have slowed down, allowing for more a more liveable and humane pace of creation and attention to issues. This will affect the mindset and posture related to the delivery of public services.
In that sense, healthcare in the United States will be universal and everyone, as their right, will be covered. This coverage will not only include a modern medicinal approach but any approach the patient will want to undertake, be it indigenous, natural or holistic. The welfare state will become stronger, however leaving freedom for cities and municipalities to make autonomous decisions. Instead of a reactive approach to medicine, there will be a preventive mindset. This will be manifested through a deep change in everyday lifestyles and aims in the mid and lower systems level. Finally, pharma companies will be strictly regulated. Mainly their funding schemes for R&D. If taxpayers money is used to develop a drug painkiller, its access will be free, covered universal healthcare and dismantling the profit-based scheme through which pharma companies operated in the past.
Mid System Levels
Cities will become pivotal points of social organization. The localities of each neighborhood will allow for a redistribution of the urban environment: access to green common spaces and the organization of communities around edible gardens will allow for a diversification of food production, allowing for consumption of seasonal, organic produce. The educational scheme will change: each urban center will cater their communities with a general educational overview linked to regional or State levels, however, will have the freedom to include local knowledge and history in its materials. The standardization of services will be interpreted differently: only particular benchmarks will be demanded from a State or Federal level, yet the distribution, application, and delivery of the service will be locally informed.
This will allow for a real connection between the lower and higher systems levels: auto-determination while respecting basic human principles and rights, self-organization with universal coverage of education, health, and transportation.
This shift in mindset will be most powerful in this mid-level since it will really permeate into daily lifestyles. The “one pill fixes all” will have no place, since the perception that there can be one universal solution for anything will have faded. The figure of the doctor as a specialist, as someone who could cure patients within a mechanistic industrialized process, will change radically. Doctors will actually be wellbeing coaches, their approach will be holistic, rooted in the community’s knowledge and practices, always understanding a balance between natural processes and modern advancements is necessary and complementary.
Lower System Levels
The sale of illegal opioids drastically reduces because of more awareness and reduction in the use of opioids at the local level. People start opting for healthier and more natural alternatives rather than chemical opioids. The society is built in a way to make healthy options easily available, and to allow people to make healthier choices at a reasonable cost. The whole community supports and pushes for a more holistic approach to well being such as combating the stress culture, allowing for more leisure time, more job security and more peace of mind. Insurance will cover and incentivize holistic treatment and employers will prioritize well being of employees over profit. This change is brought about by both education and government intervention in terms of curbing opioid use by stricter regulations and using technology to create tools to monitor opioid sale and purchase.
