WHAT MOTIVATES LEGISLATORS TO ACT: PROBLEM DEFINITION & THE OPIOID EPIDEMIC, A CASE STUDY (original) (raw)

Abstract

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This article examines the motivations behind legislators' decisions to classify the opioid epidemic as a health issue rather than a criminal justice problem. It argues that local needs, voter preferences, and the influence of interest groups play a crucial role in this redefinition. The work proposes a legislative decision-making framework that encompasses these factors and explores the implications of this shift in perspective on the policy response to the opioid crisis.

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References (128)

  1. Disease Management" the Answer to Our Problems? No! Population Health Management and (Disease) Prevention Require "Management of Overall Well-Being", 16 BMC HEALTH SERVS. RES. 500 (2016).
  2. FRANK R. BAUMGARTNER ET AL., LOBBYING AND POLICY CHANGE: WHO WINS, WHO LOSES, AND WHY (U. Chicago Press 2009).
  3. Baumgartner et al.'s analysis of ninety-eight policy issues over four years demonstrated only one instance of problem redefinition. Id. See also ANNE LARASON SCHNEIDER & HELEN INGRAM, POLICY DESIGN FOR DEMOCRACY (1997).
  4. See BAUMGARTNER ET AL., supra note 14. Baumgartner et al. conducted more than 300 interviews with policy-makers and organizations on a random sample of 98 policy issues for two congressional sessions. Id. Their dataset included these interviews and publicly available information with which they created measures of monetary and non-monetary resources that may advantage some interest groups over others in influencing different phases of the policy process. In their analysis of these interviews, the authors also analyzed problem redefinition. Id.
  5. Id.
  6. See DAVID T. COURTWRIGHT, DARK PARADISE: OPIATE ADDICTION IN AMERICA BEFORE 1940 (2d 2001) [hereinafter COURTWRIGHT, DARK PARADISE];
  7. DAVID T. COURTWRIGHT, FORCES OF HABIT: DRUGS AND THE MAKING OF THE MODERN WORLD (2001) [hereinafter COURTWRIGHT, FORCES OF HABIT];
  8. DAVID F. MUSTO, THE AMERICAN DISEASE: ORIGINS OF NARCOTIC CONTROL (3d ed. 1999);
  9. FEDERAL DRUG CONTROL: THE EVOLUTION OF POLICY AND PRACTICE (Jonathon Erlen & Joseph F. Spillane eds., 2004) [hereinafter Erlen & Spillane].
  10. 19 The criminalization of possession of illicit substances in the U.S. has stigmatized problem drug use and created a criminal subculture associated with drug use. See EDWIN M. SCHUR, CRIMES WITHOUT VICTIMS: DEVIANT BEHAVIOR AND PUBLIC POLICY: ABORTION, HOMOSEXUALITY, DRUG ADDICTION (1965).
  11. 20 see TAMYKO YSA ET AL., GOVERNANCE OF ADDICTIONS: EUROPEAN PUBLIC POLICIES (2014) (providing a review of such solutions).
  12. 21 Criminal justice, punitive solutions, or supply side solutions have not only been deemed ineffective by foreign governments, former U.S. President Barack Obama and former Drug Czar Michael Botticelli. See Bernd Debusmann, Obama and the Failed War on Drugs, REUTERS (Apr. 16, 2012, 1:55 PM), http://www.reuters.com/article/us-column-debusmann-drugs/obama- and-the-failed-war-on-drugs-bernd-debusmann-idUSBRE83F0ZR20120416 [https://perma.cc/4YCP-CAAP\].
  13. 22 While drug epidemics of the 1980s and 1990s primarily affected African Americans, the current opioid epidemic has purportedly affected White Americans at greater rates than minority populations. Recent data, however, suggests that the overdose rates of racial and ethnic minorities are increasing and approaching those of Whites. Meredith S. Shiels et al., Trends in U.S. Drug Overdose Deaths in Non-Hispanic Black, Hispanic, and Non-Hispanic White Persons, 2000--2015, 168 ANNALS INTERNAL MED. 453 (2018).
  14. 23 Institutionalized racism refers to racism that is imbedded in political or societal institutions. See MICHELLE ALEXANDER, NEW JIM CROW: MASS INCARCERATION IN THE AGE OF COLORBLINDNESS (2010). Historically, in the U.S., punitive solutions have been pursued to address problem drug use most often when the drug users come from marginalized populations, including racial minorities. See COURTWRIGHT, DARK PARADISE, supra note 18. See also Taleed El- Sabawi, Defining the Opioid Epidemic: Congress, Pressure Groups and Problem Definition, U. Memphis L. J. 2018. 24 In the past, government agencies may have defined the nation's drug problem as being characterized by street drug use, in describing the current epidemic, federal agencies have focused more so on attributing the cause to over-prescription. See America's Addiction to Opioids: Heroin and Prescription Drug Abuse: Hearing Before the S. Caucus on Int'l Narcotics Control, 113th Cong. (2014) (statement of Nora D. Volkow, Director, National Institute on Drug Abuse).
  15. Stat. 3207; Anti-Drug Abuse Amendments Act of 1988, Pub. L. No. 100-690, 102 Stat. 4312; and Crime Control Act of 1990, Pub. L. No. 101-647, 104 Stat. 4789 (codified as amended in scattered sections of 18 U.S.C.). There were a few departures from purely criminal justice oriented legislative. Arguably, the Drug Abuse Control Amendments of 1965 and the Narcotic Addict Rehabilitation Act of 1966 were less criminal justice and more "medical treatment" focused. See COURTWRIGHT, DARK PARADISE, supra note 18, at 163; Drug Abuse Control Amendments of 1965, Pub. L. No. 89-74, 79 Stat. 226 (1965); Narcotic Addict Rehabilitation Act of 1966, Pub. L. No. 89-793, 80 Stat. 1438 (1966). But both pieces of legislation were replaced two years later by Nixon's CDAPCA, so they did not have a lasting effect. The Drug Abuse Office and Treatment Act of 1972, which resulted in the creation of NIDA, and the 1974 legislation that created the Alcohol, Drug Abuse, and Mental Health Administration ("ADAMHA"), which later became SAMHSA, were not criminal justice oriented either, but only resulted in the creation of agencies within the administration. See Drug Abuse Office and Treatment Act of 1972, Pub. L. No. 92-255, 86 Stat. 65 (codified as amendment 21 U.S.C. § § 1101-81); ADAHMA Reorganization Act of 1992, Pub. L. No. 102-321, 106 Stat. 323 (codified as amended in scattered sections of 42 U.S.C.). Moreover, the 2007 Second Chance Act focused on increasing treatment options and rehabilitation options to those who had been convicted and completed their sentence. See 2007 Second Chance Act, Pub. L. No. 110-199, 122 Stat. 657 (2008) (codified as amended in scattered sections of 42 U.S.C.). Although this footnote does not provide an exhaustive list of legislation, it provides the reader with an overview of the legislation that is most typical of U.S. drug policy.
  16. 50 According to Title IV, Sec. 401 of CARA, collateral consequences are penalties or disadvantages imposed on such individuals by law, an administrative agency, or a court, not including consequences imposed at sentencing. See Comprehensive Addiction and Recovery Act of 2016 § 401(b).
  17. 51 Comprehensive Addiction and Recovery Act § 401.
  18. COURTWRIGHT, DARK PARADISE, supra note 18; MUSTO, supra note 18.
  19. 53 Press Release, Rob Portman, Portman, Whitehouse, Ayotte, Klobuchar Cheer Final Passage of Comprehensive Addiction and Recovery Act (July 13, 2016).
  20. See GARY W. COX & MATHEW DANIEL MCCUBBINS, LEGISLATIVE LEVIATHAN: PARTY GOVERNMENT IN THE HOUSE (Cambridge U. Press, 2nd ed. 2007). See also GARY W. COX & MATHEW DANIEL MCCUBBINS, SETTING THE AGENDA: RESPONSIBLE PARTY GOVERNMENT IN THE U.S. HOUSE OF REPRESENTATIVES (2005). See also Tim Groseclose & James M. Snyder, Interpreting the Coefficient of Party Influence: Comment on Krehbiel, 11 POL. ANALYSIS, Winter 2003, at 104-07.
  21. 55 Some scholars argue that political parties also influence legislative behavior. However, once controlling for ideology and voting records, evidence for an independent party effect is weak. See Keith Krehbiel, Where's the Party?, 23 BRIT. J. POL. SCI. 235, 235-66 (1993).
  22. Id.
  23. John H. Aldrich & David Rohde, The Consequences of Party Organization in the House: The Role of the Majority and Minority Parties in Conditional Party Government, in POLARIZED POLITICS: CONGRESS AND THE PRESIDENT IN A PARTISAN ERA (Jon R. Bond & Richard Fleisher ed., 2000).
  24. 58 See generally JOHN E. MCDONOUGH, INSIDE NATIONAL HEALTH REFORM (2012).
  25. See Donald Matthews & James Stimson, Decision-making by U.S. Representatives, in POLITICAL DECISION-MAKING 14-43 (S. Sidney Ulmer, ed., 1970). See also DONALD MATTHEWS & JAMES STIMSON, YEAS AND NAYS: NORMAL DECISION-MAKING IN THE U.S. HOUSE OF REPRESENTATIVES (1975).
  26. See COURTWRIGHT, supra note 18, which provides evidence of legislators' efforts to please their constituency by being tough on drugs. There does not appear to be any systematic analysis of legislative cue-taking on the issue of drug policy. 63 CLEO CHERRYHOLMES & MICHAEL SHAPIRO, REPRESENTATIVES AND ROLL CALLS (1969). Keith T. Poole, Changing Minds? Not in Congress!, 131 PUB. CHOICE, 435, 435-51 (2007);
  27. Keith T. Poole & Howard Rosenthal, Patterns of Congressional Voting, 35 AM. J. POL. SCI., 228, 228-78 (1991);
  28. Keith T. Poole & Howard Rosenthal, Are Legislators Ideologues or the Agents of Constituents?, 40 EUROPEAN ECON. REV. 717, 717 (1996) [hereinafter POOLE & ROSENTHAL 1996].
  29. 64 POOLE & ROSENTHAL 1996, supra note 63.
  30. Jeffrey R Lax & Justin H. Phillips, The Democratic Deficit in the States, 56 AM. J. POL. SCI. 148, 148-66 (2012);
  31. John G. Matsusaka, Popular Control of Public Policy: A Quantitative Approach, 5 Q. J. POL. SCI. 133, 133-67 (2010).
  32. Martin J. Osborne & Al Slavinski, A Model of Political Competition with Citizen-Candidates, 111 Q. J. POL. SCI. 65, 65-96 (1996);
  33. Timothy Besley & Stephen Coate, An Economic Model of Representative Democracy, 112 Q. J. POL. SCI. 85, 85-114 (1997). 68 For the House vote, see Jeffrey B. Lewis et al., VOTEVIEW: CONGRESSIONAL ROLL-CALL VOTES DATABASE (2017), https://voteview.com/rollcall/RH1141099 [https://perma.cc/CX2Z-6NZF\]. For the Senate vote, see Jeffrey B. Lewis et al., VOTEVIEW: CONGRESSIONAL ROLL-CALL VOTES DATABASE (2017), https://voteview.com/rollcall/RS1140373 [https://perma.cc/8Y82-9LE7\].
  34. 69 See also MORRIS P. FIORINA, REPRESENTATIVES, ROLL CALLS, AND CONSTITUENCIES (1974).
  35. DAVID R MAYHEW, CONGRESS: THE ELECTORAL CONNECTION (1974).
  36. Kingdon, supra note 61.
  37. Id. Since a legislator's ideology is often strongly correlated with the ideology of her constituents, it is difficult to ascertain the independent effect of ideology after controlling for constituent ideology. Id.
  38. 73 For example, Kingdon confirmed that legislators consulted their own individual preferences. Kingdon, supra note 61. These "preferences" are the predecessors for what scholars, like Poole & Rosenthal, later quantified as "ideology." 74 Kingdon, supra note 61.
  39. Id. 81 Such statistics focused on reporting increases in the number of drug related arrests as opposed to statistics highlighting better treatment outcomes for problem drug users. See MUSTO, supra note 18; Erlen & Spillane, supra note 18. 82 See Erlen & Spillane, supra note 18; MUSTO, supra note 18.
  40. COURTWRIGHT, DARK PARADISE, supra note 18. See also WILLIAM J. GONZENBACH, THE MEDIA, THE PRESIDENT, AND PUBLIC OPINION: A LONGITUDINAL ANALYSIS OF THE DRUG ISSUE, 1984-1991 (1996).
  41. BRUCE CAIN, JOHN FEREJOHN & MORRIS FIORINA, THE PERSONAL VOTE: CONSTITUENCY SERVICE AND ELECTORAL INDEPENDENCE (1987).
  42. Justin Grimmer, Solomon Messing & Sean Westwood, How Words and Money Cultivate a Personal Vote: The Effect of Legislator Credit Claiming on Constituent Credit Allocation, 106 AM. POL. SCI. REV. 703-19 (2012).
  43. Id.
  44. See, e.g., James Avery, Does Who Votes Matter? Income Bias in Voter Turnout and Economic Inequality in the American States from 1980 to 2010, 37 POL. BEHAV. 955-76 (2015).
  45. 88 Comparing the Results of Different Likely Voter Models, in PEW RES. CTR, CAN LIKELY VOTER MODELS BE IMPROVED? EVIDENCE FROM THE 2014 U.S. HOUSE ELECTIONS 14-18 (Jan. 7, 2016), http:// assets.pewresearch.org/wp-content/uploads/sites/12/2016/01/PM2016-01-07_likely-voters_FINAL.pdf.
  46. Id. 90 As of 2014, the age group with the greatest age adjusted rates of overdose deaths are white men and women between the ages of forty-five and fifty-four. See Rudd et al., supra note 27. I was unable to locate the age group with the greatest age adjusted rate of overdose deaths in the 1980s and 1990s. Persons between the age of fifty and sixty-four are overrepresented at the poll. See PEW RES. CTR., supra note 88. This suggests that they are considered likely voters whose preferences may be especially important to legislators.
  47. Fay Lomax Cook, Benjamin Page & Rachel Moskowitz, Political Participation by Wealthy Americans, 129 POL. RES. Q. 381, 381-98 (2014);
  48. KAY LEHMAN SCHLOZMAN, SIDNEY VERBA & HENRY E. BRADY, THE UNHEAVENLY CHORUS: UNEQUAL POLITICAL VOICE AND THE BROKEN PROMISE OF AMERICAN DEMOCRACY (2012).
  49. JOHN D. GRIFFIN & BRIAN NEWMAN, MINORITY REPORT: EVALUATING POLITICAL EQUALITY IN AMERICA (2008).
  50. Yosef Bhatti & Robert S. Erikson, How Poorly Are the Poor Represented in the U.S. Senate?, in WHO GETS REPRESENTED? 223-46 (Peter K. Enns & Christopher Wlezien eds., 2011).
  51. Id. There is some question, however, as to whether such differences are true differences or if they are due to the fact that districts with a majority of minority residents tend to be more ideologically heterogeneous; when such heterogeneity is controlled for, differences in legislator representation of preferences no longer exists. Brandice Canes-Wrone, From Mass Preferences to Policy, 18 ANN. REV. POL. SCI. 147, 147-65 (2015).
  52. 95 Such increased geographic distribution has a number of consequences at the state and federal level. For example, at the state level, as the problem increases in geographic range and density, it reaches magnitudes at which the state cannot afford to address the problem without federal assistance, resulting in state administrations lobbying federal legislators to provide federal funds to assist. Such pleas for federal assistance may be made using media outlets and further focuses constituents' attention on the need for federal legislative action.
  53. 96 During the crack-cocaine epidemic of the late 1980s, overdose victims were primarily poverty-stricken African Americans. See the following graph which I created using CDC data that compares the rates of overdose deaths from 1979-1998 by race: Compressed Mortality, 1979-1998 Charts, CTRS. FOR DISEASE CONTROL & PREVENTION (Aug. 13, 2017), https:// wonder.cdc.gov/controller/saved/D16/D19F641 [https://perma.cc/9YPW-H2ZK\].
  54. 97 Admittedly, such changes, especially involving the racial composition of the target population, likely contributed to the near- abandonment of a criminal justice approach for a health approach--due in part to the racism endemic drug policy documented by other scholars. See ALEXANDER, supra note 23.
  55. 98 Because the CDC provides income or education levels for overdose deaths in their publicly facing query system, WONDER, it is difficult to discern which income bracket has the greatest number of overdose victims. However, data from the National Survey on Drug Use and Health does indicate that persons with an annual income of less than 20,000hasthegreatestrateofheroinuse(asof2011−2013,5.5per100,000,comparedto2.3for20,000 has the greatest rate of heroin use (as of 2011-2013, 5.5 per 100,000, compared to 2.3 for 20,000hasthegreatestrateofheroinuse(asof2011−2013,5.5per100,000,comparedto2.3for20,000 to 49,999and1.6for49,999 and 1.6 for 49,999and1.6for50,000 or more). Although all income groups have seen in increase in the rate of heroin use from 2002 to 2013. See Vital Signs: Today's Heroin Epidemic, CTRS. FOR DISEASE CONTROL & PREVENTION, https://www.cdc.gov/vitalsigns/heroin/index.html [https:// perma.cc/527Y-EDJ8] (last updated July 7, 2015).
  56. Id. 100 JOHN W. KINGDON, AGENDAS, ALTERNATIVES, AND PUBLIC POLICIES (1984) [hereinafter AGENDAS, ALTERNATIVES, AND PUBLIC POLICIES].
  57. 101 V.O. KEY, PUBLIC OPINION AND AMERICAN DEMOCRACY (1961).
  58. Robert S. Erikson, Roll Calls, Reputations, and Representation in the U.S. Senate, 15 LEGIS. STUD. Q. 623-42 (1990). First, elected officials may share values with the constituents who elected them. Second, voters take cues from a legislator's stance on issues when deciding for whom to vote. Third, elected officials may give weight to their district's preferences prior to voting on a roll call. Id.
  59. See, e.g., AGENDAS, ALTERNATIVES, AND PUBLIC POLICIES, supra note 100; see also RICHARD F. FENNO, HOME STYLE: HOUSE MEMBERS IN THEIR DISTRICTS (1978).
  60. See, e.g., Matsusaka, supra note 65; Jeffrey R. Lax & Justin H. Phillips, The Democratic Deficit in the States, 56 AM. J. POL. SCI. 148, 153 (2012). These studies found legislative votes to be congruent only 59% and 48% of the time, respectively. 105 Canes-Wrone, supra note 94.
  61. 106 An example of such is Matsusaka's article analyzing congruence of roll-call votes with public opinion. John G. Matsusaka, When Do Legislators Follow Constituent Opinion? Evidence from Matched Roll Call and Referendum Votes 11-12 (Stigler Ctr. for Study Econ. and State, Working Paper No. 9, May 2017), https://research.chicagobooth.edu/\~/media/ A048F1608A6B4963A7A201259AEF03E9.pdf [https://perma.cc/JTP3-ETVU\]. Matsusaka found that legislators voted their district's preference only 65% of the time, which is 15% greater than chance. Id. Further, Matsusaka found that policy congruence may depend on type of policy issue. Id. For example, when analyzing California's gambling law, he only found a 27.9% congruence, yet a 92.4% congruence was found when looking at California's health insurance law -suggesting that policy specific factors may affect congruence. Id.
  62. 107 Larry M. Bartels, Constituency Opinion and Congressional Policy Making: The Reagan Defense Buildup, 85 AM. POL. SCI. REV. 457 (1991);
  63. Thomas Stratmann, Congressional Voting over Legislative Careers: Shifting Positions and Changing Constraints, 94 AM. POL. SCI. REV. 665 (2000).
  64. 108 Erikson, supra note 102; Christopher Warshaw, Are Senators More Responsive to Public Opinion Later in the Electoral Cycle? (Columbia University Conference on Responsiveness, Representation and Democracy, unpublished manuscript, Feb. 25, 2013), https://responsiveness2013.files.wordpress.com/2013/02/warshaw-senators-more-responsive-later-in-cycle.pdf [https:// perma.cc/XP5P-E3KY].
  65. 109 Canes-Wrone, supra note 94.
  66. See, e.g., AGENDAS, ALTERNATIVES, AND PUBLIC POLICIES, supra note 100; James A. Stimson, Michael B. Mackuen & Robert S. Erikson, Dynamic Representation, 89 AM. POL. SCI. REV. 543 (1995); Thomas Hartley & Bruce Russett, Public Opinion and the Common Defense: Who Governs Military Spending in the United States?', 86 AM. POL. SCI. REV. 905 (1992);
  67. Christopher Wlezien, Dynamics of Representation: The Case of US Spending on Defence, 26 BRIT. J. POL. SCI. 81 (1996);
  68. Mark A. Smith, Public Opinion, Elections, and Representation within a Market Economy: Does the Structural Power of Business Undermine Popular Sovereignty?', 43 AM. J. POL. SCI. 842 (1999).
  69. Canes-Wrone, supra note 94, at 149. If a legislator is not aligned with voters' preferences, then she risks being replaced by another legislator. There is evidence that federal legislators are sanctioned by voters for votes that are not popular with their constituents on issues concerning the budget, Congressional salaries, and healthcare. See Gary C. Jacobson, Deficit-Cutting Politics and Congressional Elections, 108 POL. SCI. Q. 375 (1993);
  70. John A. Clark, Congressional Salaries and the Politics of Unpopular Votes, 24 AM. POL. RES. 150 (1996);
  71. Brendan Nyhan et al., One Vote Out of Step? The Effects of Salient Roll Call Votes in the 2010 Election, 40 AM. POL. RES. 844 (2012). Such accountability is more likely under certain political conditions than others. See, e.g., Steven Ansolabehere, James M. Snyder & Charles Stewart, Constituents' Responses to Congressional Roll-Call Voting, 46 AM. POL. SCI. J. 583 (2001). For example, recent research by Rodgers finds that legislators are much less likely to be held accountable by voters at the state level. Steven Rogers, Electoral Accountability for State Legislative Roll Calls and Ideological Representation, 111 AM. POL. SCI. J. 555 (2017). Some argue that this is likely a result of less media attention, more uncompetitive political elections, and incumbency advantages at the state level. See, e.g., id.; JOHN M. CAREY, RICHARD G. NIEMI & LYNDA W. POWELL, TERM LIMITS IN THE STATE LEGISLATURES (2000);
  72. THE MARKETPLACE OF DEMOCRACY: ELECTORAL COMPETITION AND AMERICAN POLITICS (Michael P. McDonald & John Samples eds., 2006). However, others like Matsusaka, supra note 65, find that electoral pressure has no statistically significant effect.
  73. 112 Stimson, Mackuen & Erikson, supra note 110, at 545; see, e.g., Hartley & Russett, supra note 110; Wlezien, supra note 110; Smith, supra note 110.
  74. Benjamin I. Page & Robert Y. Shapiro, Effects of Public Opinion on Policy, 11 AM. POL. SCI. REV. 175, 181 (1983).
  75. 114 Stimson, Mackuen, & Erikson, supra note 110.
  76. 115 Canes-Wrone, supra note 94, at 148.
  77. 116 Canes-Wrone, supra note 94.
  78. 117 STONE, supra note 8; SCHNEIDER & INGRAM, supra note 15.
  79. 118 STONE, supra note 8; SCHNEIDER & INGRAM, supra note 15.
  80. See JAMES A. MORONE, HELLFIRE NATION: THE POLITICS OF SIN IN AMERICAN HISTORY (Yale U. Press 2008).
  81. 123 COURTWRIGHT, DARK PARADISE, supra note 18.
  82. SCHNEIDER & INGRAM, supra note 15. The social construction of the affected population is not the only construction that affects public opinion and subsequently available legislative solutions. Id. Certain groups may be viewed by the public as undeserving of public benefits but are also politically powerful groups. Id. A group's political power can serve as a moderator for the effects of social construction. Id. 137 STONE, supra note 8.
  83. 141 STONE, supra note 8, at 233.
  84. 142 Press Release, Ohio Attorney Gen. Mike DeWine, Attorney General DeWine Files Lawsuit Against Opioid Manufacturers for Fraudulent Marketing; Fueling Opioid Epidemic, (May 31, 2017), www.ohioattorneygeneral.gov/Media/News-Releases/ May-2017/Attorney-General-DeWine-Files-Lawsuit-Against-Opio [https://perma.cc/D9DY-SHCN\].
  85. 143 Id. 144 Rochefort & Cobb, supra note 7; STONE, supra note 8. 145 KHN Morning Briefing: Trump Blaming Mexico For N.H.'s Opioid Crisis Exposes Lack Of Understanding Of The Epidemic, KAISER HEALTH NEWS (Aug. 4, 2017), http://khn.org/morning-breakout/trump-blaming-mexico-for-n-h-s-opioid-crisis- exposes-lack-of-understanding-of-the-epidemic/ [https://perma.cc/2CBD-JA53\]. Such a supply driven causal theory also attributes blame to the supplier who keeps in abundant supply the irresistible substance.
  86. SCHNEIDER & INGRAM, supra note 15.
  87. 148 STONE, supra note 8, at 260.
  88. SCHNEIDER & INGRAM, supra note 15, at 104.
  89. S. Bryn Austin, Constructing the Need for "Low Fat" Food, in SOCIAL PROBLEMS: CONSTRUCTIONIST READINGS 180, 180-88 (Donileen R. Loseke & Joel Best eds., 2003).
  90. Id. 152 Leech, supra note 136.
  91. Benjamin I. Page, Larry M. Barrels & Jason Seawright, Democracy and the Policy Preferences of Wealthy Americans, 11 PERSP. ON POL. 51, 51-73 (2013).
  92. Id. 156 Kalla & Broockman, supra note 135, at 547.
  93. See, e.g., JOHN MARK HANSEN, GAINING ACCESS: CONGRESS AND THE FARM LOBBY, 1919-1981 (1991);
  94. Richard L. Hasen, lobbying, Rent-Seeking, and the Constitution, 64 STAN. L. REV. 191, 191-253 (2012); Richard L. Hall & Alan V. Deardorff, Lobbying as legislative Subsidy, 100 AM. POL. SCI. REV. 69, 69-84 (2006).
  95. 160 Legislators report spending several hours per day to raise campaign funds. Ryan Grim & Sabrina Siddiqui, Call Time for Congress Shows How Fundraising Dominates Bleak Work Life, HUFFINGTON POST (Dec. 6, 2017), http:// www.huffingtonpost.com/2013/01/08/call-timecongressional-fundraising\_n\_2427291.html/ [https://perma.cc/76P9-4CZT\].
  96. 161 Eleanor N. Powell & Justin Grimmer, Money in Exile: Campaign Contributions and Committee Access, 78 J. POL. 974, 974-88 (2016);
  97. Stephen Ansolabehere & James M. Snyder, Jr., Money and Institutional Power, 77 TEX. L. REV. 1673, 1673-1704 (1999).
  98. BAUMGARTNER ET AL., supra note 14; Justin Fox & Lawrence Rothenberg, Influence without Bribes: A Noncontracting Model of Campaign Giving and Policymaking, 19 POL. ANALYSIS 325, 325-41 (2011).
  99. 163 Leech, supra note 136.
  100. 164 Id. 165 BAUMGARTNER ET AL., supra note 14.
  101. 166 It is presumed that such former staffers still have relationships in Congress, relationships that allow these former staffers to influence how a problem is framed and the types of solutions supported.
  102. BAUMGARTNER ET AL., supra note 14, found that citizens groups were much less likely than business corporations, trade and business associations, professional associations and unions to file disclosures. They also noted that unions and citizens seemed to work more with the "rank and file" government officials but that businesses had greater access to higher ranking members of the government. Id.
  103. 179 Leech, supra note 136, at 546.
  104. 180 Hall & Deardorff, supra note 159.
  105. 181 Id. 182 JEFFREY M. BERRY, THE NEW LIBERALISM: THE RISING POWER OF CITIZEN GROUPS (1999);
  106. WILLIAM P. BROWNE, CULTIVATING CONGRESS: CONSTITUENTS, ISSUES, AND INTERESTS IN AGRICULTURAL POLICYMAKING (1995).
  107. Hall & Deardorff, supra note 159, at 74.
  108. 184 Id. 185 BERRY, supra note 182.
  109. 186 According to Baumgartner et al., because citizens groups have fewer resources than business interests, they were often spread thin. BAUMGARTNER ET AL., supra note 14, at 242. To succeed, they teamed up with business actors who had access to greater resources. Id. If citizens groups were unable to align themselves with interest groups with deeper pockets, they could find themselves in a "David and Goliath" situation. Id.
  110. Frederick J. Boehmke, Sean Gailmard & John Wiggs Patty, Whose Ear to Bend? Information Sources and Venue Choice in Policy-Making, 1 Q. J. POL. SCI. 139-69 (2005).
  111. AGENDAS, ALTERNATIVES, AND PUBLIC POLICIES, supra note 100.
  112. 189 GONZENBACH, supra note 83.
  113. 190 BAUMGARTNER ET AL., supra note 14.
  114. 191 Id. (conceptualizing federal agencies, not as pressure groups, but as resources to pressure groups). I conceptualize a government agency as both a resource to organized interests or as advocates and a pressure group in and of itself. After all, government agencies have their own tools of persuasion including relationships with Congressional members, the endorsement of the President, and the ability to develop and disseminate supportive research. Id.
  115. 192 Christine Mahoney & Frank R. Baumgartner, Partners in Advocacy: Lobbyists and Government Officials in Washington, 77 J. POL. 202-15 (2015).
  116. BAUMGARTNER ET AL., supra note 14, identified the following factors as important predictors of policy change: (1) changes in the types of pressure groups involved, (2) addition or departure of specific pressure groups or pressure group leadership, and (3) the changes of who is on each side. For example, in one case study, there was a change in officials overseeing an executive agency and the new official desired a different policy outcome. To accomplish this, he constructed a new narrative aligned with his policy solution, recruited the support of organized interests and was successful in reframing the policy issue. Id. In another instance, business interests entered into the policy debate and introduced a new narrative, which was quickly supported by state governments interested in achieving the same policy goals. Id. Therefore, formations of new connections, including new coalitions, can also contribute to policy reframing.
  117. 194 COURTWRIGHT, DARK PARADISE, supra note 18; MUSTO, supra note 18.
  118. 196 COURTWRIGHT, DARK PARADISE, supra note 18; MUSTO, supra note 18.
  119. 197 COURTWRIGHT, DARK PARADISE, supra note 18; MUSTO, supra note 18.
  120. 198 Id. 199 Id. 200 Id. 201 MUSTO, supra note 18; Erlen & Spillane, supra note 18.
  121. 202 MUSTO, supra note 18; Erlen & Spillane, supra note 18.
  122. MUSTO, supra note 18. These working groups included representatives from physicians associations and the drug manufacturing industry. MUSTO, supra note 18; Erlen & Spillane, supra note 18. 204 MUSTO, supra note 18.
  123. See, e.g., Testimony, S. Comm. Homeland Security and Government Affairs: Wisconsin Heroin Epidemic, 2016 WL 1572172 (Apr. 15, 2016) (statement of Timothy Westlake, M.D., Chairman, Controlled Substances Comm.).
  124. MUSTO, supra note 18; Erlen & Spillane, supra note 18.
  125. 207 Erlen & Spillane, supra note 18. 208 Id; see also COURTWRIGHT, DARK PARADISE, supra note 18.
  126. 209 See Erlen & Spillane, supra note 18.
  127. 210 Id. 211 Id. 212 See Testimony, S. Caucus on Narcotics Control: Controlled Substances Quota Process, 2015 WL 1643509 (May 14, 2015) (statement of Joseph T. Rannazzisi, Deputy Assistant Administrator Office of Diversion Control, Drug Enforcement Admin.).
  128. Id. 214 There is a litany of academic scholarship, comparative examples, and even the federal administration's own reports that indicate that the U.S. government's adoption of criminal justice solutions to address problem drug use has not been successful in decreasing the number of overdoses or cases of addiction, causing a former President Obama official to declare that the "War on Drugs," the name often used to personify this approach, has failed. See Debusmann, supra note 21; see also YSA ET AL., supra note 20.