Appreciating the user's perspective: listening to the "methadonians"

Researchers have long neglected the user's perspective and experiences in assessing drug effects and drug use. With increased interest in Canada directed at prescribing heroin in place of methadone, researchers took the relatively unique approach of gathering data and information from methadone users to determine their views and experiences with methadone programs and alternative treatment choices. The results of that research portrayed very interesting and useful notions of users regarding methadone maintenance and the prescribing of heroin.

Introduction: the need for a multidimensional and multidisciplinary approach

This special issue combines contributions from several disciplines within the social sciences on how to understand long-term use or dependency on various kinds of psychotropics. It emphasizes the need for a multidisciplinary approach in order to understand the complexity of such long-term use. The papers in this issue will base their arguments on psychological, sociological, anthropological, clinical, and social pharmacy perspectives. Different disciplines focus specially on certain topics. For example, psychology can help us to understand what kind of mental processes that are involved in the development of long-term tranquillizer use. Sociology, anthropology and social pharmacy have a particular contribution to make in helping us, in different ways, to understand the social meanings of psychotropic drug use.

Epilogue: drawing together the threads and perspectives on the long-term use of psychotropics

The aims of the epilogue are to draw together the threads in this issue by reviewing some themes presented in the previous chapters and to consider the relationship between the perspectives mentioned. The implications of a multidimensional perspective for future research, treatment and prevention are discussed. It is emphasized that the social sciences have an important part to play in helping us understand long-term use of psychotropics. The social sciences provide insights of importance for research, treatment and prevention of dependency on psychotropics, and also, may help us deal better with these kind of problems in the future.

The Promotion of Medications for Personal and Social Problems

The issue of promoting medications for personal or social problems involves a difficult balance between medical definitions of what constitutes a disease and consumers' perceptions of what they want or need in the way of optimal health and well-being. There are certain symptom states and conditions that are poorly defined in terms of the biomedical model of disease. Other conditions, such as child abuse, ordinary stress and tension (“pressures of life”), small breasts, thinning hair, mental fatigue, and certain personal and social problems of life are often considered diseases by some (e.g., afflicted consumers, health product manufacturers and promoters), but not by others (e.g., health professionals, health insurance companies). The key concern is who determines what conditions are diseases to be addressed by medical care systems and public health efforts, and what conditions are problems and concerns better addressed by the family unit, social welfare agencies, religious groups, or society in general.