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Commentary
OxyContin and the McDonaldization of chronic pain therapy in the USA
  1. Jordan Hughes1,
  2. Neelima Kale2 and
  3. Philip Day2
  1. 1 University of Texas Southwestern Medical Center, Dallas, Texas, USA
  2. 2 Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
  1. Correspondence to Dr Neelima Kale; Neelima.Kale{at}utsouthwestern.edu

Abstract

Principles and practices gleaned from successful business enterprises have been used to transform the practice of medicine for decades. McDonaldization is the process in which principles which govern fast-food businesses, are applied to the practice of medicine. When left unchecked, the application of these principles can have devastating consequences, as in the treatment of chronic, non-malignant pain with OxyContin. At a time when there was growing concern about the under treatment of pain, Purdue Pharma introduced OxyContin, providing an efficient, predictable way of treating chronic pain. The liberal prescription of this drug contributed, and continues to contribute, to the opioid epidemic we see today. So, in confronting this epidemic, we must first understand the process of McDonaldization that has brought us here and then provide safe and effective chronic pain therapies even if they are expensive, time-consuming to deliver, difficult to measure, and unpredictable in their outcomes—all things we’ve grown to detest in our McDonaldized healthcare system.

  • opioids
  • chronic pain
  • McDonaldization

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0

https://doi.org/10.1136/fmch-2018-000069

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    Footnotes

    • Contributors JH, NK and PD contributed to the conceptualisation, drafting, reviewing, editing, revising and final approval of the content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The content presented in this article is not regulated human subjects research and does not require approval by an Institutional Review Board (IRB).

    • Provenance and peer review Not commissioned; internally peer reviewed.