"Just Advil": Harm reduction and identity construction in the consumption of over-the-counter medication for chronic pain
"Just Advil": Harm reduction and identity construction in the consumption of over-the-counter medication for chronic pain
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DOI：
10.1016/j.socscimed.2015.10.033
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发表时间：
2015-12-01
影响因子：
5.4
通讯作者：
Eaves, Emery R.
中科院分区：
文献类型：
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作者：
Eaves, Emery R.
直接面向消费者的营销引发了持续的争论，即广告是否让消费者成为自己护理的代理人，或者将更大的控制权转移给制药行业。非处方 (OTC) 药物的广告尤其预示着将提供简单、无害的解决方案来满足社会生活的需求。我没有加入药品广告中消费者代理与社会控制之间长期存在的争论，而是以减少危害为框架，使用非处方 (OTC) 镇痛药进行自我治疗。从这个角度来看，慢性疼痛患者服用非处方止痛药是寻求一定程度缓解的一种手段，同时也避免了与处方止痛药相关的耻辱。定性方法用于分析来自两个来源的数据：(1) 2006 年至 2011 年在亚利桑那州图森和俄勒冈州波特兰开展的一项试验中对 95 名参与者进行半结构化定性访谈，该试验检查了中医药治疗颞下颌关节紊乱病 (TMD) 的有效性； (2) 三大非处方止痛药品牌的印刷、在线和电视广告。参与者表示，他们对非处方药的使用是最少的、负责任的，并且根据疼痛的严重程度证明是合理的。非处方药广告虽然表面上模棱两可，针对所有形式的疼痛，但实际上为慢性疼痛患者自我计划的一部分提供了对这些药物消费的支持，使他们能够调和缓解疼痛的相互冲突的需求，同时保持坚忍和保持积极的道德认同。患者将非处方药描述为“只是非处方药”或“不是真正的止痛药”，他们致力于减少意识形态伤害，将自己与“那些喜欢服用止痛药的人”区分开来，同时仍寻求缓解。无论摄入量如何，将非处方药的使用视为最低限度和“正常”的合理性，可以避免与处方止痛药的成瘾潜力联系起来，并使慢性疼痛患者的身份与文化认可的坚忍疼痛承受者的身份保持一致。 (C) 2015 Elsevier Ltd. 保留所有权利。
Direct-to-consumer marketing has sparked ongoing debate concerning whether ads empower consumers to be agents of their own care or shift greater control to the pharmaceutical industry. Ads for over-the-counter (OTC) medications in particular portend to offer simple, harmless solutions for meeting the demands of social life. Rather than join the longstanding debate between consumer agency and social control in pharmaceutical advertising, I approach self-medication with over-the-counter (OTC) analgesics using Harm Reduction as a framework. From this perspective, consumption of OTC analgesics by chronic pain sufferers is a means of seeking some level of relief while also avoiding the stigma associated with prescription pain medication. Qualitative methods are used to analyze data from two sources: (1) semi-structured qualitative interviews with 95 participants in a trial examining the effectiveness of Traditional Chinese Medicine for Temporomandibular Disorders (TMD) from 2006 to 2011 in Tucson, AZ and Portland, OR; and (2) print, online, and television advertisements for three major brands of OTC pain medication. Participants described their use of OTC medications as minimal, responsible, and justified by the severity of their pain. OTC medication advertising, while ostensibly ambiguous and targeting all forms of pain, effectively lends support to the consumption of these medications as part of the self-projects of chronic pain sufferers, allowing them to reconcile conflicting demands for pain relief while being stoic and maintaining a positive moral identity. Describing OTC medication as "just over-the-counter" or "not real pain medication," sufferers engage in ideological harm reduction, distinguishing themselves from "those people who like taking pain medication" while still seeking relief. justifying one's use of OTC medication as minimal and "normal," regardless of intake, avoids association with the addictive potential of prescription pain medications and aligns the identity of the chronic pain sufferer with a culturally sanctioned identity as stoic bearer of pain. (C) 2015 Elsevier Ltd. All rights reserved.