It’s the fourth most-watched series in MAX’s history, with each episode garnering over 16 million views on average. Can you guess? It’s Euphoria—a TV series that follows Rue Bennett (Zendaya) as a troubled teenage drug addict who struggles to get sober, find her place in the world, and adjust to her relationships after rehab. Rue is overcome by the circumstances in her life that lead her to drugs. “[F]ollowing her father’s cancer diagnosis…[a]s he undergoes treatment, Rue’s father is prescribed pain medication to be taken at home. The challenge of seeing her parent suffer, coupled with her own mental health struggles, drives Rue to steal medication in an attempt to escape her reality. She becomes quickly hooked on the feeling of euphoria that the medication provides,” says Cat Wang in her article on the topic.
Reviewers say part of the show’s overwhelming success is that although the show’s world is fictional, many of the characters’ experiences are based in reality and resonate with today’s youth.
If this insight, that many of today’s youth feel a connection to Rue’s reliance on opioids to help her cope with her circumstances, feels alarming, it should. Even more alarming? Current data supports the hypothesis that an increasing number of people are turning to opioid use—especially in rural areas.
A December 2017 survey found that the opioid crisis has impacted 74% of farmers, and a 2023 KFF poll revealed startling information that “three-in-ten adults (29%) say they or someone in their family have ever been addicted to opioids, including prescription painkillers and illegal drugs like heroin. Rural residents (42%) and White adults (33%) are among the groups hardest hit.” Additionally, as of March 2021, deaths caused by drug overdoses were still on the rise in both rural and urban areas.
Opioids represent a clear threat to American public health. In fact, a 2023 Axios-Ipsos poll found that 25% of Americans think it’s the biggest threat.
Why is that? What drives individuals to “hire” opioids? What is the progress they are seeking that leads to this choice?
Jobs Theory provides an avenue to better understand the drivers behind opioid use
Jobs Theory was developed by the late Harvard Business School Professor Clayton Christensen and his longtime collaborator Bob Moesta. The Theory of Jobs to Be Done (or Jobs Theory) is a framework that helps explain individual behavior.
It highlights the fact that people don’t simply buy products or services; they “hire” them to make progress in specific circumstances (what we call their Job to Be Done, or “job” for short). Understanding the “job” or progress for which customers hire a product or service helps innovators more accurately develop products or services that align with what people are already trying to accomplish, or solutions for issues people face.
A recent article reveals that one reason for “hiring” drugs is the absence of anything to do. It discusses that when there is a lack of social infrastructure where people can gather, engage in community, and form bonds, some individuals turn to drugs. This assessment reminded me of the role social health plays in our health outcomes (a topic I recently wrote about here) and the possibility that drug addiction may be a cause or a symptom of poor social health.
I want to emphasize that I’m saying it may be one of many causes, such as chronic pain, or a symptom of many ills, such as loneliness. If it is, then part of the solution to drug addiction and the opioid epidemic may be improving, fostering, and maintaining better social health. A 2017 study supports this hypothesis. The study found evidence that social capital attenuates drug overdose deaths.
As noted, there are a host of reasons why people do drugs, including economic challenges, physical and emotional pain, trauma, low community cohesion, etc. It may even be as simple as the immediate enjoyment or euphoria drugs can provide. These reasons might be the true drivers of use, but the best way to uncover the causal factors behind human behaviors is to do a series of Jobs Theory analyses. Through two Jobs analyses, researchers could uncover why people use drugs and what helped them stop. This knowledge could enable public health leaders, health systems, the government, etc., to improve the addiction prevention and treatment work that is already being done.
Performing Jobs analyses to enhance addiction prevention and treatment work
An organization like the US Department of Agriculture, whose vision, in part, is “to provide economic opportunity through innovation, helping rural America to thrive,” would be well suited to lead these analyses given the high rates of addiction in rural areas. To do so, they would interview people who had previously “hired” drugs and then discuss with these individuals why they later “fired” addiction. Some things they would seek to uncover would include the details of individuals’ life circumstances that led them to drugs, what habits and anxieties hindered them from “firing” drugs, and what ultimately led to their recovery. They might find that a cohort of people are under a great deal of stress, lack social interaction, and have emotional pain or actual pain that led to their addiction.
Addiction is complex, and there are a host of reasons driving why and how people get addicted to substances. Perhaps if Rue and her family had more support during their tough time, she wouldn’t have turned to drugs.
If we can gain a deeper understanding of the causal drivers behind addiction, we will be better equipped to both 1) develop solutions that help people who are currently struggling with addiction and 2) provide services that prevent introduction and addiction to drugs. Jobs Theory is a powerful tool to aid in accomplishing these goals.
