INDICES> Metamizole in your country? (10)

["Vladimir S. Shoukhov" <shoukhov@cityline.ru>]

INDICES> Metamizole in your country? (10)
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Dear Professor B. Vrhovac,

I slightly doubt that we need to be so deep in thoughts of possible
ethnic
differences/peculiarities inside Europe.
Taking care of people suffering from pain as usual have a
social-cultural
and/or ideological roots. Once we mentioned (1998) that attitudes to
physical pain and its treatment in the USSR had a large basis in
Soviet
ideology. One of the idealized qualities of strong and healthy "Soviet
man"
(same as for Aryan's!) was the ability to resist pain, an image that
was in
every way sustained.  This emphasis on creating an ideology of
personal
fortitude was reinforced by medical training and practice in the USSR
(and
others communist-coalition countries of Eastern Europe) that focused
on
providing care for acute medical conditions. This policy neglected the
population suffering from chronic, geriatric and terminal medical
conditions
that require sustained care as well as amenably treatable common
ailments
(including adverse reaction to drugs) which could be maintained by a
primary
care system, the latter being largely absent under existing medical
system.
The weakness (or lack) of a strong and functioning prescription only
medicine system and availability of state funding for drugs leads to a
situation where the role of the prescribe in the system is undermined
and
further encourages high self medicating behavior (it is estimated that
over
70% of pharmaceutical expenditure in Russia is paid for privately).
Advice
on self medication is typically provided by close friends and
relatives and
advertising as opposed to advice from the doctor and the inadequate
control
of pharmacy dispensing allows the purchase of practically all
non-narcotic
analgesics without prescription. Moreover the weakness of existing
pharmacovigilance system leads to unconscious missing or simply
ignoring of
adverse reaction cases.

Faithfully yours,
Prof. Vladimir S. Shoukhov, M.D., D.Sci (Med)
+7 (095) 930 4105
shoukhov@yahoo.com



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