Stephen Snelders

Cultural enthusiasm, resistance and the societal embedding of new technologies: Psychotropic drugs in the 20th century

Abstract The societal embedding of new (medical) technologies involves not only market success, but also regulation and public acceptance. Cultural enthusiasm about their benefits and social concerns about their risks and dangers are in this respect important. Conceptualizing interactions between product championing, cultural enthusiasm and resistance, the article analyses three patterns of societal embedding: (1) hype-cycle, (2) contested embedding, and (3) controversy and stalemate. A fourth pattern of waves of enthusiasm and concern is proposed for technologies with unexpected side effects. This pattern is explored and elaborated with a longitudinal case study of the introduction of a particular form of medical technology: psychotropic drugs such as Veronal and Valium in the period 1900–2000.

Semantic document selection: historical research on collections that span multiple centuries

The availability of digitized collections of historical data, such as newspapers, increases every day. With that, so does the wish for historians to explore these collections. Methods that are traditionally used to examine a collection do not scale up to todays collection sizes. We propose a method that combines text mining with exploratory search to provide historians with a means of interactively selecting and inspecting relevant documents from very large collections. We assess our proposal with a case study on a prototype system.

Managing Double Binds in the Pharmaceutical Prescription Market: The Case of Halcion

The epidemic of serious drug safety problems (e.g., Seroxat/Paxil [paroxetine], Vioxx [rofecoxib], Redux [dexfenfluramide] or Ambien [zolpidem]) in the first decade of the twenty-first century has led to public debate on the integrity of the pharmaceutical industry and the effectiveness of drug regulation (Healy, 2004; Moynihan & Cassels, 2005; Anonymous, 2005; Committee on the assessment of the US drug safety system, 2006; Pray, 2007).1 To improve drug surveillance practices and governance, the various parties participating in the debates proposed a wide variety of changes for processes of international drug development and drug approval. The proposals included the reduction or extension of the patent protection period, abolition of drug patents, strengthening the independence and transparency of regulatory agencies, and incentives for drug development in high-need, high-risk disease areas. But the majority of these proposals failed to address the historical dynamics underlying drug development and use. Employing a historical perspective is a prerequisite to further our understanding of the process of the societal embedding of drugs and the role played by societal concerns and cultural context. Drug trajectories can serve as analytical tool to study the changing scientific, political, and social economies of the prescription drug markets (Pieters, 2005: 3–5; Gaudilliere, 2005; Levy & Garnier, 2007).

Genetic Discrimination in the Doctoring of Cancer and Alcoholism

The genomics revolution of the early twenty-first century has stimulated the need for new appraisals of the risks of genetic discrimination in health care. Historical memories of genetic discrimination have raised serious concerns of the misuse of genetic information in the doctoring of patients. This has led to political action such as federal legislation in the United States to protect patients in both clinical practice and trials. Whether scientific knowledge of the inherited susceptibilities to disease need necessarily translate into new stigmatization and discrimination of specific populations at risk for disease has become an important topic in community genetics. Our study of the historical experiences of the application of genetic knowledge in the doctoring of cancer and alcoholism patients in the past century suggests that not scientific theories and evaluations by themselves lead to genetic discrimination. The crucial factors in determining whether genetic discrimination will occur are the social perceptions and evaluations of both disease and the specific at-risk population by not only the physicians themselves but the general population embedded in a specific sociohistorical context.

Standardizing psychotropic drugs and drug practices in the twentieth century: paradox of order and disorder

According to ongoing historical research, standardizing the production and consumption of psychotropic drugs is a process fraught with contradictions and inconsistencies. Both the construction and change of drug standards can be highly unsettling events and do not necessarily lead to more order. The balance between order and disorder appears to be rather fragile and paradoxically at all stages in the evolution of standards we see order-disorder transitions.