The countervailing forces behind France's low Ritalin consumption

In recent decades pharmaceutical consumption has skyrocketed, growing from $43 US billion in 1985 to over $1143 billion in 2017. In trying to understand the source of this growth, social scientists have identified the key actors driving medication use and the processes through which they are driving it. However, much less attention has been devoted to understanding the forces that constrain medication consumption. This information is crucial for developing a deeper understanding of medication consumption, one that explains how context mediates the ability of key actors to shape medication consumption. To address this gap, I examine France's low consumption of psychostimulants to treat ADHD symptoms. France is a strategic case to analyze because it diverges dramatically from comparative cases: while 7% of U.S. children are medicated with psychostimulants, the same is true for only 0.2% of French children. To explain the French case I use the theory of countervailing powers. Informed by interviews with key informants, the French medical literature on psychostimulants and secondary sources, I explain how the state, medical experts and consumers have acted as countervailing forces against pharmaceutical interests. In doing so, I provide deeper insight about how context can limit the pharmaceutical industry's power.