Beyond addiction: the medicalization of poverty in the treatment of chronic pain

Our team conducted an Institutional ethnography, including qualitative interviews, observations, and textual analysis of relevant documents, of physicians’ work in managing patients with chronic pain in Ontario Canada. We interviewed over 60 participants, including primary care providers (physicians, nurses, nurse practitioners, and allied health professionals). We applied the theoretical lens of medicalization of poverty to analyze our findings. The concept of medicalization has been used to refer to the process by which problems, experiences or issues become defined as primarily medical in nature, thus requiring the skill and expertise of medicine to correct. The known problems associated with poverty – poor health outcomes, mental health issues and addiction, to name but a few – are now increasingly managed by physicians and more importantly are viewed as being within the purview of physicians to “treat”. This medicalization of poverty is problematic because it is based on a model of individual responsibility for one's health.