Posted by:24 January, 2013
Title: Prescribed: Writing, Filling, Using and Abusing the Prescription in Modern America
Edited by: JA Greene and E Siegel Watkins
Publisher: Johns Hopkins University Press, 2012
Reviewer: Barbara O’Donnell, senior ODP, Whittington Health
What was it like?
Could you imagine visiting your doctor these days and not coming away with some form of prescription? In whatever form it takes, the prescription is the vehicle that carries the cure, or at least, relief from your symptoms. It also has the added benefit that you come away with something tangible to show for your visit. Drawing on historical, political, sociological and anthropological perspectives of the prescription, these ten American medical historians provide a comprehensive history and unique insight into the modern prescription and its many roles in the US.
The prescription has been a staple of medical practice since around 1550 BC, and entered a new phase in the mid-20th century with the advent of prescription-only non-opioid drugs and antibiotics. Drugs went from being a relatively small economic sector to a post-war boom industry fuelled by new technologies, and today is the US’s most profitable business sector. At the same time, the prescription itself gained huge power and medicine underwent major changes.
The prescription is a boundary between the legal and illegal, even though the prescription-only status of some drugs has failed to lower their rates of abuse and addiction.
Along the way we touch on; ownership and control of the prescription; the Latin used to write prescriptions, which helped keep their contents private to all but a privileged few; ready-made speciality medicines that did away with Latin usage and the need for powders normally mixed by pharmacists, thereby changing their role; the rise of the Food and Drug Administration’s regulatory powers to ensure the safety of the public; political inquiries targeting the drug industry; moral panics; surveillance systems used to track doctor’s prescribing habits; resistance of doctors to antibiotic usage restrictions; the blurring of boundaries between the traditional responsibilities of various health care professionals, and the challenges faced by doctors from lay-groups in various aspects of the contraceptive prescribing debates.
What were the highlights?
Stories of patients whose lives were ruled by the prescription and cast in the wrong light by physicians convinced they were abusing their pain medications and the story of feminist healthcare activism. The many different perspectives that were drawn on to create this book add interest.
Strengths & weaknesses:
The number of authors who have clearly done their research in the writing of these pieces is a real strength The addition of case studies makes what can be a wordy book at times, more interesting.
Readers must bear in mind that this book is written entirely about the US. In the US, medicines, drugs in particular, are big business and as such some of the ethical dilemmas outlined here may not necessarily be faced by prescribers in the UK or other countries. However, given that the UK often follows where the US leads, since so much research originates from that similar population, and the current climate of change in the UK; it may be that this book also offers some glimpses of the future.
Who should read it?
All practitioners; medical, nursing, professions allied to medicine, clinical or research based, involved in prescribing, and those who have an interest in this area. I’d recommend this book to anyone with an interest in the history and or politics of medicine, medicine in the US.
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