Long-term users of psychotropic drugs: embodying masculinized stress and feminized nerves

Sedative administration in Spanish hospitals in the context of perinatal loss: findings from a mixed-methods study

This article explores the contexts, processes and motivations behind the administration of sedatives (minor tranquilisers) in the time around perinatal loss. Using a mixed methods design, an online survey of 796 women and 13 narrative interviews were conducted. The participants had experienced a stillbirth or termination of pregnancy from 16 weeks or a neonatal death in Spanish hospitals. The quantitative (univariate and CHAID decision-tree) and qualitative (narrative-linguistic) analysis found that sedative administration was pervasive across care contexts and appears to be naturalised despite contradicting practice recommendations. Sedative administration was associated with emotional control and avoidance of loss, lack of accompaniment and on occasion with managing disruptive patients. Lack of informed consent was very common, with little explanation of side-effects prior to administration. In the participants' narratives, health professionals tended to construct sedatives as benign, but for some women the effects were counterproductive to loss and grief and related to persistent regrets about decisions. The study concludes that, in the context of perinatal loss, sedative administration was highly integrated into the fabric of medicalised care. As a socio-political and cultural practice underscored by gender-based care dynamics, there seems to be an imbalance between benefit and risk to women's welfare.

Embodied Subjectivities

Developing an understanding of intoxicated bodily states is important for comprehending why people consume alcohol. This article sets out to investigate the intoxicated subjectivities of women who are in a relationship with another woman. Within the alcohol and other drug (AOD) field, gender, sexuality, and bodily perspectives have become more central objects of attention. While AOD studies have ascribed agency to both alcohol and the human body, how the body and alcohol together produce intoxicated subjective states has not been considered thoroughly. Through an examination of three women’s subjective accounts of intoxication, this study found that conceptualizing phenomena such as alcohol, gender, sexuality, and a predefined body as discrete, independent entities limits our understanding of the complexities of embodied intoxication. To overcome this limitation, the article draws on Karen Barad’s new materialism theory, which proves more sensitive to a range of different agents. This provides a new way of conceiving the onto-epistemological relations between these agents and challenges both common ideas about intoxication among same-sex experienced women and more general understandings of embodied subjectivity.

Unconventional indicators of drug dependence among elderly long-term users of benzodiazepines

A quarter of the elderly population is prescribed benzodiazepines (BZD). This has led to growing concerns about drug dependence and the validity of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for dependence to a substance. This study aimed to understand how dependence was experienced by long-term BZD users. Interviews were conducted with 45 elderly persons who had been using BZDs for an average of nine years. These users' comments suggest six indicators of dependence: self-identifying as a dependent user, invoking multiple stressors to justify BZD use, using BZD to cope with anticipated stressors, trivializing the dangers of BZDs, keeping a supply in reserve, having previously tried and failed to stop, and reducing the dosage. Our results stress the need to take a more elaborate, person-centered view of dependence.

Use of benzodiazepine drugs and perceived job stress in a cohort of working men and women in Belgium. Results from the BELSTRESS-study

The aim of the Belstress Study was to see whether use of benzodiazepines is associated with perceived job stress as measured by Karasek's job-strain model. This model has as its central tenet that the most adverse health outcomes are to be expected in high strain jobs characterized by high job demands and low job control. An extension of the model states that the most noxious combination is high job demands, low control and low social support at work. Sample subjects were recruited from 25 Belgian companies between 1994 and 1998, and cover a wide range of occupations. A 5.6% of 16,094 men and 9.3% of 5012 women aged 35-59 years report use of benzodiazepines during the last month. A clear association is displayed between self-reported use of benzodiazepines and a high strain job compared to a low strain job (men: OR=1.93, 99% CI=1.4-2.6; women: OR=1.66, 99% CI=1.0-2.7), after adjustment is made for socio-demographic confounders (age, level of education, occupational group, employment sector, living situation). The independent association with quartile level of job demands is a striking feature (men: OR of highest quartile compared to lowest quartile group=1.91, 99% CI=1.4-2.6; women: OR=1.99, 99% CI=1.3-3.1). In men, an inverse association with quartile level of job control is observed (OR= 0.65, 99% CI=0.5-0.9) whereas in women a clear tendency in that direction is displayed (OR=0.62, 99% CI=0.4-1.1). The association with low social support is less clear; an independent association between use of benzodiazepines and iso-strain was observed particularly in men.

Men's emotional inexpressivity: advertising for psychotropic drugs in Scandinavian medical journals

Aim

Men's use of psychotropics and the portrayal of men in psychotropic drug advertising have been underresearched and undertheorized in past research on psychotropics. The focus on women's health as the primary target of medicalization and commodification has scanted the same processes for men. This study aims to illuminate the construction of patienthood in the patient portrayals of men's mental health.

Method

A quantitative and qualitative analysis was done of all the advertisements (N=366) for psychotropics that appeared in the national medical journal in Denmark, Finland, Norway, and Sweden in 2000.

Results

In the gender portryal of men in the psychotropic ads two images of men's patienthood were constructed: men's relational problems with family and men as victims of ontological insecurity.