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Life in Pain pp 107–137Cite as

Over the Counter (OTC) Pain Relief and the Self-treatment of Pain

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Abstract

The use of over-the-counter (OTC) analgesics reflects the degree to which the population is allowed to engage in the self-treatment of pain. Regulation of the advertising practices for OTC analgesics is usually the remit of a government agency tasked to assess the efficacy and safety of medicines, and to respond to complaints about false or misleading advertising. Following the opioid epidemic in the United States, greater attention has been placed on reducing access to OTC opioid analgesics such as codeine. In 2018, the Australian Therapeutic Goods Administration (TGA) “up-scheduled” codeine, such that it is now only available by prescription. Reducing access to codeine was argued to be necessary because of the addictive qualities of codeine and the risk it poses for both codeine mortality and the development of demand for stronger opioid analgesics such as oxycodone. This regulatory move was seen as a necessary preventive intervention to avoid a North American-style opioid epidemic in Australia. The pain of the North American opioid epidemic was somehow contagious. In this chapter the consequences of contagious pain are explored in terms of what happens when the self-management of pain is curtailed, for fear that a segment of the population will abuse pain relievers. The impacts are mapped, not in terms of alternative analgesic consumption (both legal or illegal), but in terms of the vulnerability of this segment of pain sufferers to cultural pain neurosignatures created by big pharma through market mechanisms. The chapter will begin with an analysis of the rationale for codeine up-scheduling, and then develop through an analysis of a cultural pain neurosignature—a marketing campaign for paracetamol—and conclude with an explication of the deployment of biopower through leaving this segment of pain sufferers to the mercy of some of the world’s most powerful marketing forces. This chapter illustrates the deeper problems caused by codifying pain in narrow objectivist terms. Regulation of OTC opioid analgesics is not an evidence-based rational process. This chapter reveals how affective contagion produces an evidential ellipsis, leaving the door open for the cannabis markets to emerge as the big winners from pain.

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Authors and Affiliations

  1. School of Social and Political Sciences, University of Melbourne, Parkville, VIC, Australia

    John L. Fitzgerald

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Correspondence to John L. Fitzgerald .

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Fitzgerald, J.L. (2020). Over the Counter (OTC) Pain Relief and the Self-treatment of Pain. In: Life in Pain. Springer, Singapore. https://doi.org/10.1007/978-981-10-5640-6_5

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  • DOI: https://doi.org/10.1007/978-981-10-5640-6_5

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