Salutogenic Approach to the Opioid Epidemic

Leveraging my training as a physician and specialty in psychiatry, this article will focus on the “social determinants” that contribute to the opioid epidemic. In particular I will utilize the concept of Salutogenesis, originally developed by Aaron Antonovsky (1979, 1987), a professor of medical sociology at Ben Gurion University, to contextualize the epidemic as a biopsychosocial political spiritual process and provide suggestions for a holistic approach to address the challenges it presents. In the broadest sense, salutogenesis refers to a scholarly orientation focusing attention on the study of the origins of health, instead of the origins of disease. In essence, unlike pathogenesis the framing paradigm of allopathic medicine which focuses of disease creation and removal of pathology, salutogenesis is concerned with positive health, creating coherent living environments, strengthening socio-ecological health resources as well as strengthening the sense of coherence of individuals and groups. Salutogenesis as defined by Aaron Antonovsky, describes an approach focusing on factors that support human health and well-being, rather than on factors that cause disease (pathogenesis). Viewed with a Salutogenic lens, the opioid epidemic provides a case study and framework to study other challenges confronting our society. For example, understanding the social and political issues associated with the epidemic, examining the current healthcare system with a goal of identifying correctable challenges that can benefit patients, consumers and citizens.

My medical training had been inspired by my mentor, Aaron Antonovsky as he was developing the concept of Salutogenesis. For Antonovsky, understanding the complexity of the upstream factors are essential for addressing medical challenges. It has become clear to me that to address the challenges of pain and opioid abuse and overdose I would need to explore and address as an engaged citizen with the complexity of the Pain Opioid Ecosystem.



What is the Salutogenic orientation?

In the broadest sense, salutogenesis refers to a scholarly orientation focusing attention on the study of the origins of health, instead of the origins of disease. In essence, salutogenesis is concerned with positive health, creating coherent living environments, strengthening socio-ecological health resources as well as strengthening the sense of coherence of individuals and groups. As all these aspects well align with the orientation of health promotion, salutogenesis has become a guiding theory for the field of health promotion (see Handbook of Salutogenesis).

The Meanings of Salutogenesis


It is clear that the federal response to the problem of drug use in general and the Opioid Epidemic has been less than successful in achieving the articulated goals. It has however created empires that have had their own devastating impact on many Americans and people around the world… (Use data regarding outcomes)

This section utilizes the concept of Salutogenesis, originally developed by Aaron Antonovsky in 1979 and expended on in 1987 to contextualize the pain-opioid epidemic as a biopsychosocial political spiritual process and provide suggestions for a holistic approach to address the challenges it presents. The effort is focused on proposing a citizen oriented approach to social- political challenges within the body politic. In the broadest sense, salutogenesis refers to a scholarly orientation focusing attention on the study of the origins of health, instead of the origins of disease. In essence, unlike pathogenesis the framing paradigm of allopathic medicine which focuses of disease creation and removal of pathology, salutogenesis is concerned with positive health, creating coherent living environments, strengthening socio-ecological health resources as well as strengthening the sense of coherence of individuals and groups. Viewed with a Salutogenic lens, the opioid epidemic provides a case study and framework to study other challenges confronting our society. For example, understanding the psychological, spiritual, social, economic and political issues associated with the epidemic, impacting communities and individuals examining.


The Salutogenesis Approach: Response to the “Deaths of Despair” google Docs


How can meaning and purpose contribute to one's wellbeing?

Sir Harry Burns explores the concept of salutogenesis and the impact it has on the most disadvantaged members of our community. As the former Chief Medical Officer (CMO) for Scotland, the Scottish Government’s Principal Medical Adviser and Head of the Scottish Medical Civil Service, Sir Harry is dedicated to improving people’s health and social well being.

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