The Impact of Pharmaceutical Industry Messaging on the Opioid Crisis among U.S. Military Veterans - Understanding the role of the pharmaceutical industry in fueling the opioid crisis is essential for developing strategies to prevent future epidemics and improve health outcomes. This project uses textual data mining, content analysis, and triangulation methods to examine how industry efforts influenced military veterans' perceptions of opioid therapies for chronic pain, including the circulation of pro-opioid narratives through veteran service organizations and advocacy channels. Evidence from ongoing litigation reveals targeted marketing to veterans as a key consumer group, yet much of the discovered material remains unexamined by public health researchers. Limited knowledge exists about how these industry-driven scripts became embedded in veteran health discourse, shaping attitudes toward opioids and creating barriers to safer, nonopioid pain management options. This mixed-methods study will triangulate pharmaceutical marketing and legal documents with veteran-focused publications and qualitative insights from veterans with chronic pain and opioid use histories. The research will identify key messaging themes and sociocultural cognitive scripts that hinder the provision of medically appropriate care. Critically, findings will be translated into actionable, evidence-based deliverables, including best practices, clinical tools, web resources, and policy addenda, to guide prescriber engagement, patient communication, and pain management practices within and beyond the Veterans Health Administration. These solution-oriented outputs aim to promote safe and effective care, reduce risky opioid perceptions and use, and contribute to measurable improvements in opioid-related health outcomes for veterans and other chronic pain populations. The project draws on precedents from tobacco industry research that successfully informed policy and practice changes to counter exploitative marketing. The scientific team includes veterans, experts in uncovering the tobacco industry’s targeting of military personnel, specialists in opioid use, and leaders in pharmaceutical litigation analysis. Through systematic textual and qualitative methods, this study will provide a critical case example of pharmaceutical industry influence on prescribing norms and public perceptions, advancing the natural history of drug crises involving iatrogenic pathways to use disorders and health sequelae by achieving the following aims: Aim 1: Use textual mining technology and analytic methods refined by tobacco researchers to explicate the pharmaceutical industry's campaign to influence veterans' (and veterans service organizations') perceptions of opioid therapies, particularly within the context of chronic pain management. Aim 2: Conduct qualitative interviews among veterans with histories of pain and opioid use to understand sociocultural meanings and cognitive scripts that impede safe, effective, and medically-appropriate care. Aim 3: Conduct T0 and T1 translational research to generate concrete best practices, tools, and web resources to guide policy as well as clinical and prescriber engagement with veteran and other chronic pain populations.
