The pharmaceuticalisation of society? A framework for analysis

Abstract

Drawing on insights from both medical sociology and science and technology studies this article provides a critical analysis of the nature and status of pharmaceuticalisation in terms of the following key dimensions and dynamics: (i) the redefinition or reconfiguration of health 'problems' as having a pharmaceutical solution; (ii) changing forms of governance; (iii) mediation; (iv) the creation of new techno-social identities and the mobilisation of patient or consumer groups around drugs; (v) the use of drugs for non-medical purposes and the creation of new consumer markets; and, finally, (vi) drug innovation and the colonisation of health futures. Pharmaceuticalisation, we argue, is therefore best viewed in terms of a number of heterogeneous socio-technical processes that operate at multiple macro-levels and micro-levels that are often only partial or incomplete. The article concludes by drawing out some broader conceptual and reflexive issues this raises as to how we might best understand pharmaceuticalisation, based on our analysis, as a framework for future sociological work in this field.

Pharmaceuticals and society: Power, promises and prospects

“…She acknowledges the role of physician and patient expectations in the use of these medicines but suggests that the pharmaceutical companies' control over the organisation and funding of research and its ability to shape the information landscape is a key factor. On this basis she argues that pharmaceuticalization should not just be restricted to cases involving a re-designation of a condition as suitable for pharmaceutical intervention with a new or existing drug, as implied in the literature (Abraham 2009, Williams et al 2011a. Rather it should encompass any instance of medicines expansion in use, including the increasing application of existing drugs to meet the established need of an existing patient population.…”

“…Which sources are used depends on how individual students think and feel about their non-medical drug usage. On this basis it is argued that prescription stimulant diversion is characterised by a significant degree of complexity and heterogeneity, a key point made by Williams et al (2011a) in their discussion of pharmaceuticalization. This is important in pointing to limits in the extent of non-medical enhancement use.…”

“…In addition, Williams et al (2011a) suggest that pharmaceuticalization is a dynamic sociotechnical process that is part of a `pharmaceutical regime'. That is to say it can be understood as a network of institutions, organisations, actors and artefacts, alongside those cognitive structures and affective processes associated with the creation, production and use of therapeutics.…”

Desvendando sexos, produzindo gêneros e medicamentos: a promoção das descobertas científicas em torno da ocitocina

“…Note that on this list, in addition to prevention and treatment of possible disease, we find an opportunity to improve conditions that, in principle, can be considered as part of the normal course of life but that have been medicalized, as many studies have shown (Rosenberg, 2002;Martin, 2006;Conrad, 2007;Rose, 2007;Clarke et al, 2010;Dumit, 2012;Marshall, 2010;Williams et al, 2011).…”

The drugs don't sell: DIY heart health and the over-the-counter statin experience

“…Though lay activism and consumerism are described as playing a part in the expansion of pharmaceutical use (Abraham 2010b, Bell and Figert 2012, Williams, Martin and Gabe 2011, there is more to do to understand pharmaceutical consumers and consumerism.…”