Medications as Social Phenomena

Abstract

This article discusses medications as socially embedded phenomena, using the class of psychoactive medications as a primary example. The analytical perspective is systemic, constructivist, and critical. We suggest that the ‘rational use of drugs’ paradigm fails to appreciate various legitimate rationalities motivating medication usages and is therefore inadequate to understand the place of medications in society. Medications have complex life cycles, with diverse actors, social systems, and institutions determining who uses what medications, how, when and why. Such understanding permits analyzing medications simultaneously as entities and representations. We outline recent changes in usage patterns of psychoactive medications (notably prescriptions to children), in pharmaceutical marketing practices (notably direct-to-consumer advertising), and in the construction of knowledge about drugs (notably the role of the Internet in legitimating consumers’ viewpoints). These changes indicate that medication life cycles evolve and mutate with social and technological change. These life cycles are viewed, then, as systems – part of other social, cultural, and economic systems, themselves in constant change. This perspective provides fertile ground to raise several research questions in order to understand better the nature of medications, their effects, and their place in society.

O atendimento farmacêutico às consumidoras da contracepção de emergência

“…Autores como Cohen et al (2001), Bursfield (2015) e Esher e Coutinho (2017) também problematizam o paradigma do "uso racional de medicamentos", identificando limites na perspectiva biomédica, que termina por desconsiderar as clivagens culturais e simbólicas que engendram usos próprios de medicamentos pelos sujeitos. Tais usos são baseados em lógicas culturais que mantêm coerência e inteligibilidade dentro de um sistema de crenças e valores peculiares.…”

“…Tais usos são baseados em lógicas culturais que mantêm coerência e inteligibilidade dentro de um sistema de crenças e valores peculiares. Tomando o medicamento como um ciclo de vida próprio que envolve atores sociais diversos, sistemas sociais e econômicos, instituições e formas de circulação que promovem fármacos e os deslocam entre prescritores e usuários, a abordagem biográfica dos medicamentos torna-se rentável para compreendermos os muitos sentidos por eles engendrados (Cohen et al, 2001;Whyte, 1989;Hardon, 1996). Decerto, essa é uma via fecunda de reflexão a ser ainda melhor explorada no tocante ao tema em estudo.…”

Regulating Direct-to-Consumer Drug Information: A Case Study of Eli Lilly’s Canadian 40over40 Erectile Dysfunction Campaign

“…Further, the public may be unable to evaluate the veracity of advertised claims, especially when the apparent purpose of the marketing campaign is to inform. Familiarization is particularly effective in an era where patients are increasingly seen -and may see themselves -as consumers of health services (Featherstone 2010), and where pharmaceutical drugs are seen as commodities (Cohen et al 2001). Because they are familiarized with a specific drug, consumers of medical information may develop misconceptions with regards to the nature of their medical condition (e.g., incidence, severity) and the benefits and (lack of ) risks of drugs (or other products) promoted to treat the condition (Bélisle Pipon and Williams-Jones 2015).…”

Painkiller purchasing in the UK

“…Web information allows consumers to acquire medication knowledge through dialogue with health professionals (Cohen et al, 2001). Manufacturers have responded to this growing consumer advocacy by publishing advertorial web pages that fulfil dual roles by fusing information with advertising (Spain et al, 2001).…”