Citizens encounter various issues in their environment. They expect the government to provide appropriate and adequate solutions to their challenges. Policy analysis describes the processes involved in translating suggestions about solutions to public issues into actionable government proposals. In most cases, it involves selecting an appropriate policy from a pool of possible solutions. Rational, institutional, political, and system approaches constitute some of the most common policy models practitioners and theorists apply in public administration. The opioid epidemic is a significant public health issue, with people hooked on painkillers and some dying from overdose. The opioid case study applies some aspects of the political model in its policy analysis.
The Opioid case study describes the rising problem of painkiller addiction. It describes the contributing factors, including the pharmaceutical companies, doctors, and politicians. It also describes the controversial political solutions laced with racial prejudice. The opioid case study supports political and against the rational and policy process models. The rational policy analysis model is based on a choice between alternatives (Leoveanu, 2013). Also, it presupposes that the proposals have objectives that should be ranked in order of importance and executed based on cost-benefit analysis. The Opioid case does not favor the rational model of policy analysis as it does not contain the concepts of choice and ranked objectives.
Further, the opioid case study does not favor the policy process model. Policy process models involve converting a societal demand into a government-driven actionable proposal. Proponents of the model suggest that the creation of a policy follows a determined path, from identification in the environment and through several stages where it is converted into inputs. It is later converted into demands directed at the government and eventually emerges as policy outputs. In the opioid case study, one cannot easily identify the various stages of the case development. Therefore, the opioid case does not favor the policy process model.
However, the opioid case study favors a political policy analysis model as it views selecting and implementing public policies as primarily political. In the political policy analysis model, the administrators must select the proposals bearing in mind their ramifications. A fundamental consideration is the public opinion. In the opioid case study, the politicians drive the process, with comments from political figureheads such as Trump driving the agenda. There is a concerted effort to change the narrative of opioid abuse from a crime where the victims are locked up to a medical condition where the addicted get treatment. The shift in values seems to be informed by the fact that most of the opioid addiction and overdose cases are primarily racially white. The white politicians prefer establishing treatment centers instead of taking the opioid abusers to jail, as has been the tradition in the war on drugs policies.
Before an issue becomes a policy, it passes through various stages. An issue is a conflict that arises when the public perception and the government or organization’s performance differ. The problems may arise in the individual or group’s environment, and they require government intervention. However, the government has many responsibilities and limited time and resources. Therefore, individuals must make their issues salient to become part of the agenda. Cobb and Elder developed the agenda-setting proposal in 1972, describing the process of converting an issue into a salient concept for policymakers. The first stage in their model is issue creation, where the initiator identifies a problem or grievance and converts it from private to public (Bali & Halpin, 2021). The second stage is the issue expansion, where the people affected mobilize support from the public for their position regarding the problem. When they garner significant support, it becomes a salient issue that the policymakers are unlikely to ignore. It enters the third stage, becoming part of the government agenda options.
One can identify various elements of Cobb & Elder’s three-stage agenda-setting model in the Opioid case study. The prescription opioid problem has already passed the first stage of issue creation. The public in the US is aware of the devastating effects of prescription opioids such as Vicodin in society (Jalali et al., 2020). The initiators have identified the problem of addiction and overdose deaths associated with painkillers. They are mobilizing support from the general public, encouraging them to back their position, which constitutes the second stage of issue expansion. The initiators use narratives to explain the prevalent opioid problem in the US, including big pharma’s unethical practices and the race and opioid pandemic connection. They have been so effective at their work of mobilizing public support, provoking counterarguments from scholars and Big Pharma. It implies that the issue of deaths and addiction related to prescription Opioids is now salient.
The opioid problem in the US has reached the model’s third stage, agenda entrance. The issue is specific and concrete, enabling the public to understand it and offer their support. Also, the issue is socially significant as almost everyone in the US knows of a close relative or acquaintance who struggles with or has died from the opioid problem. The politicians have pushed the issue to become apparent that it has automatically entered the agenda placement stage. Therefore, the issue can no longer be ignored by policymakers. Various policy proposals have been tabled, including informing the doctors of their patient’s death after using opioids to reduce over-prescription of the painkillers. Also, there is a push to establish more treatment centers to support people suffering from addiction. Other suggestions include housing the victims and applying drug substitution therapies using methadone or buprenorphine.
John Kingdom’s 1984 “three streams” policy model describes the factors and processes involved for a condition in society to become a government policy. He identified three streams in his model: problem, policy, and political. The policy model sheds light on how the Opioid crisis policy is developed. The problem stream identifies a condition in society or environment that requires adjustment (Hoefer, 2022). In the opioid crisis, the citizens identified the increased addiction and related overdose cases resulting from synthetic and prescription analgesics. The problems associated with opioids constituted a significant event that garnered widespread, intense attention, releasing the problem stream. Scholars have researched and published widely on the causes and effects of the opioid crisis and proposed means of mitigating the problem. The information has been dispersed throughout society, and everyone is ready for change.
The second stage in the model is the development of the political stream. The stage occurs alongside the problem stream. It involves spreading the information to the people who can effect change. The information on opioid abuse and its consequences is in the public domain, the media, and academia. The information has provoked robust discussions, research, policy drafts, and intense debate in all quarters. The policy communities and scholars are developing appropriate proposals to help resolve or mitigate the problem. The political space requires much collaboration as the collision of individual ideas can continue endlessly without providing a viable solution. Collaboration allows some dominant proposals to emerge, which move to the next stage.
The third stage, the policy stream, involves the selection of some proposals to constitute the policymakers’ agenda. Some proposals will gain prominence and get selected for action. Republican politicians, including Trump and Christie, have been vocal advocates of change in the traditional treatment of drug problems. Their proposals regard the establishment of treatment centers and providing them with syringes and housing as opposed to earlier policies where they received lengthy prison sentences. Politicians are influential stakeholders, and their proposals will be prominent. However, the three streams must converge to constitute a window for the policy change to occur. The convergence of the three streams provides the perfect moment for policy implementation. Conditions that can create a stream convergence include change of government administration and election repercussions.
Policy formulation is a long process that commences with identifying a problem that the citizen feels needs changing and ends with implementing proposed adjustments. It uses various models, including political, rational, and institutional approaches. The opioid crisis has passed through most processes, beginning with problem identification, robust discussions and debates, extensive scientific research, and widespread public support. Some prominent proposals are evident, with most people favoring treatment instead of punishment.
References
Bali, A. & Halpin, D. (2021). Agenda-setting instruments: means and strategies for the management of policy demands. Policy and Society, 40(3), 333–344. DOI: 10.1080/14494035.2021.1955489
Hoefer, R. (2022). The multiple streams framework: understanding and applying the problems, policies, and politics approach. J of Pol Practice & Research, 3(1), 1–5. https://doi.org/10.1007/s42972-022-00049-2
Jalali, M.S., Botticelli, M., Hwang, R.C. et al. (2020). The opioid crisis: A contextual, social-ecological framework. Health Res Policy Sys 18(1), 87. https://doi.org/10.1186/s12961-020-00596-8
Leoveanu, A.C. (2013). Rationalist model in public decision making. Journal of Public Administration, Finance and Law, 1(4), 43-54.
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