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New deviancy theory and the healthcare system's role in creating, labeling, and facilitating unauthorized prescription drug “abuse”

Levin, David and Shiner, Michael (2016) New deviancy theory and the healthcare system's role in creating, labeling, and facilitating unauthorized prescription drug “abuse”. Pain Practice, 16 (7). pp. 791-793. ISSN 1530-7085

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Identification Number: 10.1111/papr.12458

Abstract

Background: ‘New’ deviancy theories came to prominence during the 1960s and presented a significant challenge to established ways of thinking about crime, delinquency and other forms of rule-breaking. These theories dismissed the idea that there is a distinct, unambiguously deviant minority whose behavior can be explained as a result of individual pathology or social dysfunction. Instead, it was argued that deviance involves meaningful and goal-oriented behavior, which can only be understood through an appreciative stance that is committed to faithful understanding of the world as seen by the subject. Methods and Aims: This paper focuses on the application of ‘new’ deviancy theories to the progression from medically appropriate prescription drug use to extra-medical ‘abuse’. Special consideration is given to the role of the prescribing physician and the medical institution. Conclusions: ‘New’ deviancy theories lend valuable insights into contemporary patterns of unauthorized prescription drug use. They bring to light the role of the physician-patient interaction as a mechanism to diagnose ‘misuse’ by searching for use of neutralization techniques, and for its function in facilitating future ‘abuse’ by guiding a patient through the learned steps to become a regular user. They highlight the importance of values in a patient’s choice to accept medications with psychoactive side effects, and they reinforce the subjectivity in diagnosis and labeling misuse. These theories illustrate the complexities of the interplay between social welfare support, disability, societal norms and self-identity, which are all critical parts of the patient experience. Finally, these concepts help generate hypothesis about the development of meaningful subcultural groups based around this type of behavior. An appreciation of drug ‘abuse’ through this historical framework can inform new approaches for drug policy aimed at reducing narcotic drug abuse.

Item Type: Article
Official URL: http://onlinelibrary.wiley.com/journal/10.1111/(IS...
Additional Information: © 2016 World Institute of Pain
Divisions: Social Policy
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RM Therapeutics. Pharmacology
Sets: Departments > Social Policy
Date Deposited: 19 Sep 2016 14:01
Last Modified: 20 Jul 2019 02:18
URI: http://eprints.lse.ac.uk/id/eprint/67787

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