Prescriptions and proscriptions: moralising sleep medicines

Abstract

The pharmaceuticalisation of sleep is a contentious issue. Sleep medicines get a ‘bad press’ due to their potential for dependence and other side effects, including studies reporting increased mortality risks for long‐term users. Yet relatively little qualitative social science research has been conducted into how people understand and negotiate their use/non‐use of sleep medicines in the context of their everyday lives. This paper draws on focus group data collected in the UK to elicit collective views on and experiences of prescription hypnotics across different social contexts. Respondents, we show, drew on a range of moral repertoires which allowed them to present themselves and their relationships with hypnotics in different ways. Six distinct repertoires about hypnotic use are identified in this regard: the ‘deserving’ patient, the ‘responsible’ user, the ‘compliant’ patient, the ‘addict’, the ‘sinful’ user and the ‘noble’ non user. These users and non‐users are constructed drawing on cross‐cutting themes of addiction and control, ambivalence and reflexivity. Such issues are in turn discussed in relation to recent sociological debates on the pharmaceuticalisation/de‐pharmaceuticalisation of everyday life and the consumption of medicines in the UK today.

What is wrong with ‘being a pill‐taker’? The special case of statins

“…Pain is an example of a problem whose legitimation of pill-taking is fragilein these interviews, only other people take pills for 'a little niggle'. Another example of fragile legitimacy concerns insomnia; Gabe et al (2015) describe the morally-charged negotiations involved in talk about sleeping pills. Like in the data here, Gabe and colleagues found 'need' was constituted either by having problems which functioned as a condition (in participants they classify as 'deserving' pill-takers), or by 'compliance' with medical advice.…”

‘Sometimes, it's easier to write the prescription’: physician and patient accounts of the reluctant medicalisation of sleeplessness

“…Unlike in the work of Gabe et al . (), ‘normality’ in this sample was commonly linked to the ordinariness of sleep aid use. One patient in her mid‐sixties stated that ‘so many’ people in her age group had issues with sleep.…”

“…Some patients aligned with the moral repertoire of the ‘virtuous’ non‐user’, recently described by Gabe et al . (: 12), wherein sleeplessness is ‘something people should be able to deal with themselves’. One patient whose husband had urged her to seek medical attention for her sleeplessness had secured and filled a prescription, but claimed she'd ‘never used it’.…”

“…Some sociological studies have explored the patient perspective on sleep problems and solutions (Coveney , Gabe and Thorogood , Gabe et al . , Hislop and Arber , Venn and Arber , Zarhin ). Other researchers have solicited the practitioner perspective (Dyas et al .…”

Selling slumber: American neoliberalism and the medicalization of sleeplessness

“…Particularly, innovations in biomedicine have transformed health culture to one that is critically concerned with prevention of illness and risk assessment (Clarke et al, ). Waggoner (, p. 66) explains, “Modern medicine and public health can be understood as grand attempts to tame the future, to contain risk, to exert control where control is not fully possible.” As such, people are increasingly seeking out new ways to maximize their personal health (e.g., Potter et al, ), and despite some patient resistance (see Williams, Gabe, & Martin, ) or physician reluctance (see Moloney, ), they overwhelmingly accept and rationalize pharmaceutical drugs as a viable solution to medicalized conditions (e.g., Gabe, Coveney, & Williams, ; Moloney, Konrad, & Zimmer, ). Indeed, pharmaceutical companies capitalize on this “healthicization” of society by marketing self‐diagnosis to patient‐consumers (Ebeling, ).…”