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Book Review

Prescribed: Writing, Filling, Using, and Abusing the Prescription in Modern America

Scott R. Turkin, MD

Published: July 15, 2013

Prescribed: Writing, Filling, Using, and Abusing the Prescription in Modern America

edited by Jeremy A. Greene and Elizabeth Siegel Watkins. Johns Hopkins Press, Baltimore, MD, 2012, 322 pages, $30.00 (paper).

Whether you accept Edmund Burke’s oft-quoted assertion that those who don’ t know history are destined to repeat it or, like Mark Twain, believe that history doesn’ t repeat itself but it does rhyme, it is incontrovertible that a knowledge of history leads to a richer and more nuanced understanding of the present and may illuminate the way into the future. I also submit that gaining of such knowledge provides simple intellectual fun and that Prescribed provides both useful knowledge and intellectual enjoyment.

The history of the prescription itself, especially from the mid-20th century to date, is the focus of this volume. In 10 separately authored chapters by experts in the history of medicine, the complex interactions among the producers, prescribers, and imbibers of the modern pharmacopoiea are explored. The political, economic, and sociological aspects of the evolution of the prescription make for fascinating reading.

"Together, the 10 chapters reflect a broad range of therapeutic and diagnostic areas, from the heroic treatment of acute infectious disease, to the management of chronic asymptomatic conditions, to psychoactive drugs, to contraception" (from the introduction, p 19). Common themes are the extent and limitations of professionals’ authority, the rights and roles of consumers and their advocates, and the political and economic forces at play in determining them.

Although something akin to the modern prescription dates back at least to the era of the ancient Egyptians, it has changed more in the last century or so than in all of history theretofore. In the United States, the 20th century saw the creation of the Food and Drug Administration through the Pure Food and Drug Act in 1906; the Harrison Narcotic Act of 1914, which for the first time imposed legal restrictions on a category of drugs; the Federal Food, Drug, and Cosmetic Act of 1937 after more than 100 Americans died from the product "Elixir Sulfanilamide"; and the Durham-Humphrey Amendment of 1951, which codified the concept of prescription-only medications. Each of these events and the evolution of such terms as safety, efficacy, indication, and labeling were shaped by many stakeholders and their competing interests and are covered here.

Perhaps the most succinct way to convey the breadth and scope of this work is to simply present the evocative titles of the chapters:

  1. Goofball Panic: Barbiturates, "Dangerous" and Addictive Drugs, and the Regulation of Medicine in Postwar America
  2. Pharmacological Restraints: Antibiotic Prescribing and the Limits of Physician Autonomy
  3. "Eroding the Physician’s Control of Therapy": The Postwar Politics of the Prescription
  4. Deciphering the Prescription: Pharmacists and the Patient Package Insert
  5. The Right to Write: Prescription and Nurse Practitioners
  6. The Best Prescription for Women’s Health: Feminist Approaches to Well-Woman Care
  7. "Safer than Aspirin": The Campaign for Over-the-Counter Oral Contraceptive and Emergency Contraceptive Pills
  8. The Prescription as Stigma: Opioid Pain Relievers and the Long Walk to the Pharmacy Counter
  9. Busted for Blockbusters: "Scrip Mills," Quaalude, and Prescribing Power in the 1970s
  10. The Afterlife of the Prescription: the Sciences of Therapeutic Surveillance

Surely, there will be readers who may have preferred more or less detail in any given chapter/topic, but I found the balance about right in being appropriate for a reader with modest prior knowledge of the subject but still providing enough detail for even a scholar of the history of medicine. The editors’ stated aim "to illuminate the political, cultural, and economic matrix within which various groups of actors have been engaged in the production, regulation, marketing, sale, consumption, and understanding of pharmaceutical products" (p 22) was certainly achieved. My only regret is that there were only 10 chapters.

Scott R. Turkin, MD

Author affiliation: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Potential conflicts of interest: Dr Turkin has been on the speakers or advisory boards for Forest, Sunovion, and Otsuka.

Volume: 74

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