Dr. Russell Portenoy Character Analysis

Dr. Russell Portenoy and his mentor Dr. Kathleen Foley were important figures in America’s pain revolution in the latter half of the 20th century. Portenoy believed Palliative care—the treatment of pain in the seriously ill—to be “guided by moral issues of patient autonomy and respect for cultural and individual differences.” Throughout Portenoy’s career, his acceptance of opiates came from a place of well-intentioned moral integrity. He believed he was part of a revolution made possible by the technological advancements of the pharmaceutical industry. In 1986, Portenoy and Foley published a paper in the medical journal Pain that argued in favor of the normalization of opiates in pain medicine. Portenoy and Foley claimed that opiates weren’t inherently addicting, arguing instead that addiction was more dependent on the patients to whom opiates were prescribed. The paper would be used regularly by doctors and drug companies to defend the expanded use opiates in medicine. Portenoy was also one of the pain researchers who received funding from Purdue Pharma, and he would come to regard the company as an ally. He spoke regularly at conferences, urging doctors to explore innovative approaches to pain management, including the use of time-release opiates like OxyContin. Quinones portrays Portenoy as a complicated figure throughout Dreamland: his reasons for embracing OxyContin and other drugs like it were not inherently nefarious, but he allowed his message to be exploited and inflated by Purdue and may thus be seen as complicit in the effects of the opiate epidemic.