Diverting Data and Drugs: A Narrative Review of the Mallinckrodt Documents.

U.S. law imposes strict recording and reporting requirements on all entities that manufacture and distribute controlled substances. As a result, the prescription opioid crisis has unfolded in a data-saturated environment. This article asks why the systematic documentation of opioid transactions failed to prevent or mitigate the crisis. Drawing on a recently disclosed trove of 1.4 million internal records from Mallinckrodt Pharmaceuticals, a leading manufacturer of prescription opioids, we highlight a phenomenon we propose to call data diversion, whereby data ostensibly generated or collected for the purpose of regulating the distribution of controlled substances were repurposed by the industry for the opposite aim of increasing sales at all costs. Systematic data diversion, we argue, contributed substantially to the scale of drug diversion seen with opioids and should become a focus of policy intervention.

The symbolic economy of drugs.

This essay reviews four recent studies representing a new direction in the history of pharmaceuticals and pharmaceutical science. To this end, it introduces the notion of a symbolic economy of drugs, defined as the production, circulation, and reception of signs that convey information about drugs and establish trust in them. Each of the studies under review focuses on one key signifier in this symbolic economy, namely the brand, the patent, the clinical trial, and the drug itself. Drawing on Pierre Bourdieu's theory of the economy of symbolic goods, I conceptualize these signifiers as symbolic assets, that is, as instruments of communication and credit, delivering knowledge, carrying value, and producing authority. The notion of a symbolic economy is offered with a threefold intention. First, I introduce it in order to highlight the implications of historical and anthropological work for a broader theory of the economy of drugs, thus suggesting a language for interdisciplinary conversations in the study of pharmaceuticals. Second, I deploy it in an attempt to emphasize the contributions of the recent scholarship on drugs to a critical understanding of our own contemporary ways of organizing access to drugs and information about drugs. Finally, I suggest ways in which it might be of use to scholars of other commodities and technologies.