Framing Drug Use

Bodies, Space, Economy and Crime

J. Fitzgerald

• Publisher: Palgrave Macmillan
• Year: 2015
• Print ISBN: 9781349694273, 9781137482235
• eBook ISBN: 9781137482242
• Topic: Social Sciences
• Subtopic: Criminology
• Index: Social Sciences

This book examines the forces that shape psychoactive drug use. The approach, informed by poststructuralist semiotics, culture, phenomenology and contemporary theories of affect, illuminates the connections between drugs, bodies, space, economy and crime.

1

Introduction: Who Is Responsible?

There is a reason we continue to have drug use problems. Drug use is complicated. Drug use can come to mean many things in different contexts, and how we try to control drug use can vary enormously. From my own policy practice, considerable diversity can be seen in how people approach drug use: drug criminals in rural Indonesia are sometimes chained to trees; until recently, drug users in Ecuador were given the same ‘rehabilitation’ treatment as homosexuals; in the Chinese autonomous region of Xinjiang, methadone was considered only a superficial treatment for opiate addiction because it was a Western pharmaceutical; in Somalia, chewing the leafy pseudoephedrine-containing plant ‘khat’ is considered a part of masculine political culture; and in some parts of Uzbekistan, a good mother learns how to inject her children with drugs, a practice considered abhorrent by many mothers in other parts of the world.

For some, psychoactive drug use is revolting. It makes no sense to ingest, inject or inhale a substance for the purpose of changing how you encounter the world. The drug user who voluntarily chooses to distance themselves from the world around them in search of a pleasurable ‘stone’, ‘fix’ or ‘hit’ is for some people incomprehensible. For others, drug use is a normal part of life. As medical anthropologist Cecil Helman once observed, drugs can be food, a fuel or a tonic (1981); the meaning of a drug should always be considered in the context of its use.

The issue of managing drug use and drug users can polarize populations and fracture politics depending on what forces are in contest. Drug use is considered by some to be a free choice about personal lifestyle. Others believe that the economic and structural violence of the ‘system’ forces marginalized poor people to use drugs. For some users, drug use is foisted upon them by external forces, such as peer pressure. For others, overwhelming internal forces (personality, craving, addiction, depression) coerce them to use drugs. Force, be it internal, external or a combination of both, looms large as a common thread to understanding drug use.

With such complexity come diverse approaches that try to make sense of drug use. A first step in trying to understand drug use is to identify how the problem of drug use is being framed. This book is an analysis of the contesting forces that are involved when people use drugs. Within this broad endeavour, I have taken an empirical approach, where I focus on specific drug use settings and analyse the relevant contest of forces. Sometimes this involves examining the force of economics, sometimes it involves the force of emotion, sometimes the force of physical pleasure and sometimes the force of culture.

In following this approach, I use a set of analytic strategies and a philosophical model of the human subject derived from the work of Gilles Deleuze, Michel Foucault and other theorists for whom force is a central concern. This will be a challenge to readers in disciplines that are not familiar with these writers. Some disciplines (such as criminology and pharmacology) are characterized by their capacity to renew themselves by a voracious ability to take on new ideas (Lippens and van Calster, 2010). Other disciplines may find it difficult to look beyond their own epistemic borders. This book will also challenge those who are firmly located in a specific theory of drug use, not because I attempt to undermine any particular theory, but because I ask people to look at how force operates in their own explanatory frameworks.

The analytic techniques I use could broadly be called poststructuralist, as they are designed to look at how force is mediated through the varied structures inherent in our everyday lives. I examine the spatial practices, streetscapes, languages, signs, photographs, stories, routines, social organizations and frameworks of everyday life, with a keen eye on how the various forces operate and come to shape the way we use drugs. The focus is on the everyday because force is often most imperceptible when it is seemingly a natural part of life.

This focus on force is unusual in drug and alcohol research. Force, however, is a central concern when understanding the strength of emotions in the drug and alcohol arena. One reason drugs evoke strong emotion is because force can be coercive, and most people like to think that they determine their own future. This is a curious and disturbing quality of drugs and the human condition. We are always subject to forces; it is a defining character of being human. What drugs reveal in their action is the degree to which different forces determine our choices. So while the book is notionally about drugs, it is also a book about the human condition.

My intention with this book is to identify opportunities that bring the reader into a deeper understanding of the complexity of drug use. I do not have a central theorem or barrow to push about the politics of drug use or which research methods are best. I do have one commitment, and that it is to enhance the care, compassion and sense of responsibility we all have in managing drug use. In the same way we are all subject to forces, we all, to some extent, participate in those forces that shape the world around us. The consequence of this new framework I am proposing is that care, compassion and responsibility might come to replace blame and punishment as central terms that define how we approach drug control.

Concerns to control the force of the human ‘appetite’ for intoxicating substances appear as far back as the ancient Platonic dialogues (Rinella, 2010). Central to these texts is the figure of the pharmakos, a criminal character who continues in modern times as an icon in drug policy, philosophy and criminology (Szasz, 1974; Derrida, 1981; Rinella, 2010; Mountian, 2013).

As Mountian (2013) suggests, the pharmakos is one of a series of terms – the pharmaka – that includes the pharmakeus, the pharmakon and the pharmakos. These terms map out ancient Greek relationships between some very old concerns about selfhood, memory, potions, magic, social exclusion and our capacity to manage desires (Derrida, 1981, 1995). The pharmakon is, on the one hand, a simple originary term for drug. It is also a complex term meaning sacrament, remedy and poison. It is from this term that modern pharmacology emerged, and the complexity of the term is retained in the character of how we manage psychoactive substances.

There is a tale attached to the criminal figure of the ancient Greek pharmakos. As Szasz (1974) notes and others have expounded (Derrida, 1981; Mountian, 2013) the pharmakos was a scapegoat. The criminal pharmakos was expelled from the city through a ritual sacrifice in a social and political act where the ills of the city were symbolically cleansed (Rinella, 2010). Subsequently, there has been a long history of punishing both the image and the body of the drug user to alleviate a collective anxiety about social order.

Illegal drug use is often framed as a problem of selfhood, uncontrolled desires and the state (Sulkunen, 2009). Consequently, illegal drug users are often framed as immoral, mad, bad or sad (Shapiro, 1999; Mountian, 2013). Over the past century, drug use has been framed in numerous ways (Musto, 2002): a moral pathology (Mold, 2008); a mental deficiency; a symptom of oppression sickness (Singer, 2001); an economic development problem (Klein, 2008); a chronic relapsing brain disease (Leshner, 1997); even a product of autonomous craving (Childress et al., 2008). The picture is not, however, that simple. The complexity of the pharmakon continues to confound, as singular neurochemical models continue to provide only partial explanations for human drug use behaviours (Hall et al., 2003). As foreshadowed by the ancient taxonomy, drug use and drug users are defined by the forces that shape them.

An indication that this complexity has been recognized can be found in the diverse ways drug use is regulated. There is now, however, widespread recognition that the prohibition of illegal drug use is a historical artefact. It is not necessarily natural or rational to prohibit drugs in the way that we do. The current regulatory arrangements for illegal drugs have emerged as a consequence of the complex social histories and approaches across many different types of state and supra-state conventions, and regional agreements (Musto, 2002). Today, cannabis is regulated differently in different US states. Mandatory sentences for crack cocaine across the United States have been wound back. In different parts of the world, the legal status of psychoactive drugs can differ substantially. For example, the decriminalization of small quantities of illegal drugs has been undertaken in such diverse settings as the Netherlands, Portugal, Australia and Ecuador. It is now acknowledged that many forces are involved in regulating human drug use and that managing illegal drug use is a wicked problem not amenable to simple solutions.

Foucault identified in ancient Greek texts that discussion of the control of appetites were really questions about the control of both individual and social forces (1986; Rinella, 2010). Although Foucault was focused on sexuality, it did not escape his attention that the forces exerted on the self by the self and by the social were essential in establishing the possibility of a subject. This model of the subject as being constituted by force has equivalents in a number of related philosophical traditions.

Henri Bergson (1991), a nineteenth-century vitalist philosopher, believed in a radical humanity, where desire was collective and the human was only human by virtue of a particular configuration of matter or energy that enabled the production of a particular kind of body. Deleuze, following Bergson, was similarly focused on how the modern subject could be understood as an assemblage of forces. There has, however, been confusion regarding the contribution of Deleuzian philosophy in applied settings. Rosi Braidotti (1996) suggests in her application of Deleuze in the feminist arena:

I see a real danger that the complex and highly articulate structure of Deleuze’s redefinition of subjectivity becomes split between, on the one hand, a more ‘socio-economic’ angle, which inscribes the French master alongside other leading thinkers of the ‘post-industrial’ or ‘post-fordist’ economic system, and on the other, a more ‘aesthetic’ aspect, which inscribes Deleuze in a continuum with the cultural and literary generation who invented ‘the linguistic turn’. This would be in my eyes a reductive reception of Deleuze’s work and one which would spectacularly miss the point of his complex re-articulation of subjectivity as an assembled singularity of forces. (p. 305)

There are a number of points to be drawn from this observation. First, what Braidotti is referring to here is the misconception of Deleuze as simply a ‘postmodernist’. Deleuze was, foremost, a poststructuralist philosopher. There is a growing academic literature on the philosophy of Deleuze, and as always some is valuable and some less so. Deleuze’s writings are not easy to understand, but the benefits of grasping the full consequences of his analytical approach are well worth the time. By putting Deleuze’s analytic tools to work on empirical materials, I hope to explain this Deleuzian philosophy. It should be noted, however, that I don’t always use Deleuzian analyses in each chapter of this book.

The most significant contribution made by Deleuze to this work is his basic model of the subject as an assemblage of forces. Rather than the subject being a conscious, autonomous sovereign individual, Deleuze suggests the individual is better understood as a kind of meeting point of social and abstract forces that together form a body that still makes choices, albeit in a highly contested context.

This is the key political ‘so what’ in this book. By using a range of analytic tools that demonstrate the links between drugs, bodies, space and capital, we come to know how central drugs are to our everyday. Each chapter shows a series of connections. These ontological connections will, I hope, come to form the basis of our care, compassion and collective responsibility. With this greater sense of connection to the world around us, we should find ourselves implicated in that world, and as a consequence take more responsibility for it. This is not just an intellectual exercise. There is an ethical and moral dimension to this kind of analysis.

Mountian (2013) suggests that we should try to avoid morality when examining drug discourse (p. 10). I do not believe we can escape morality when thinking about drug use. This work should bring you closer to drug use by making clear how connected we are to those forces that insert drugs into the many different aspects of our lives. It is only through seeing our proximity to drugs that we can act with compassion and care for the world around us.

2

Navigating a Pharmacoanalysis

There have been numerous attempts to provide a comprehensive account of the relationships between drugs, bodies, culture, economy and the everyday. Popular books such as Griffith Edwards’ Matters of Substance (2005) and Jim Orford’s Excessive Appetites (2001) emerged from psychological medicine and have focused on rationality and evidence. Mariana Valverde’s Diseases of the Will (1998) demonstrated that the larger systems of knowledge through which we understand drug use, such as those from psychology and medicine, achieve their effects through historically contingent processes and sometimes through the simple ‘piling up of rationalities’. The dominance of moral discourse in the late nineteenth century was overtaken by pharmaceutical science in the mid-1900s, then by the social sciences in the 1970s, then by psychology, neuroscience and most recently through the ubiquitous ‘bio-psycho-social’ model of drug use. This final, all-encompassing system of knowledge about drug use has attempted to be all things to all people, to account for many of the complexities of drug use through its inclusive framework. Valverde’s metaphor of the ‘piling up of rationalities’ sums up the bio-psycho-social approach to understanding drug use and also highlights its pitfalls.

The encyclopaedic character of the bio-psycho-social approach to drugs has its place, but while it flourishes in terms of its broad descriptive capacities, it often falls down when it comes to analysing the cultural and economic specificities of drug use. Because the bio-psycho-social model has emerged from psychological medicine and positivist science, it has some significant blind spots when it relates to core concerns in the humanities. While it is helpful to note that biological, psychological and social factors contribute to drug effects, it is another thing to try and use this framework to examine how power is deployed, how risk is constructed and how value is derived from drug experiences. Core concerns of humanities research such as power, knowledge, capital, space and the body are left under-explained in this model.

With this book I move away from the bio-psycho-social model. It does not try to provide an expansive account of drug use through a single set of positivist knowledges. Rather, it has as its starting point a toolbox approach to knowledge-making, drawn from a different set of theories and analyses. The toolbox contains analytical tools derived from poststructuralist theorists ranging from Michel Foucault, Jacques Derrida, Gilles Deleuze, Avital Ronell and Alphonso Lingis. This toolbox also includes empirical tools. The empiricism has its roots in the anthropological writing tradition of theoretically informed methods of ethnography or TIME (Willis and Trondman, 2000), where theoretical work draws from the messiness of engaging with empirical methods through a practice of writing the world.

The toolbox also includes a commitment to locate reflections about the nature of knowing, being and becoming in the stories of the banal and the everyday. This style of engagement, exemplified through the work of Lingis (1994, 2000, 2004, 2007), tries to position larger commentaries on the nature of discourse through its interpenetration in the character, experience and complexity of bodies, spaces and desires. The focus of this work is the transformation of phenomenological terrains into cultural and philosophical landscapes. I draw on early interactionist and sociological accounts; on the work of subcultural analysts such as Jock Young and later on the anthropological work of Avril Taylor, Lisa Maher and Phillippe Bourgois. The core focus is on how the structures of the world relate to drug use through culture, economy and discourses of gender and otherness.

This book also has links to a small but distinct hybrid literature that has emerged in recent times from the areas of cultural studies, women’s studies, philosophy and the humanities. Characterized by the work of Richard Klein (Cigarettes Are Sublime, 2003), Helen Keane (What’s Wrong with Addiction?, 2002), Richard Grandpre (Ritalin Nation, 2006) and Anna Alexander (High Culture, 2003), this literature takes as its objects the epistemological and ontological character of drug discourse.

Central to each of the chapters is an understanding of drug use borne out of the philosophy of Gilles Deleuze (1994), and Gilles Deleuze and Felix Guattari (1987). Although not known as drug scholars, they nonetheless use drug use as an exemplar in their philosophy. Their construction of drug use poses an alternative philosophical framework for thinking about how drug use relates to the matter-energy of the world. The orthodox Western narrative of drug use, best understood as a mythical story of wilful subjects on a journey of suffering and redemption, casts drug use as pathological pleasure-seeking arising from of a loss of will. This is only a partial account. Deleuze and Guattari (1987) suggest that drug use per se is not necessarily pathological. Drugs, like meditation, are one way to encounter the world. It is the continued quest for drugs as a mechanism to ‘become-other’ that is problematic.

A key to understanding Deleuze’s contribution to thinking about drug use is to appreciate the ontology he proposes, as it stands in stark contrast to that used in orthodox drug research. Deleuze comes from a vitalist tradition with origins in Bergson’s work in the late nineteenth century (Bergson, 1991). For Deleuze, the world is matter-energy. All objects (organic and non-organic) are composed of the same material. We are formed through processes or ‘machines’ that ‘individualize’ us into our familiar forms. Individual bodies connect with each other to form ‘assemblages’ of desire (Deleuze and Guattari, 1987). These assemblages can be between humans, organic and non-organic objects. There are no sovereign individuals with a discrete consciousness or subjectivity. For Deleuze, we are collective. Desire is not an attribute of the individual, rather it is a flow of energy through an assemblage. Drug use, for Deleuze, is a means through which individual bodies alter their speed of perception, not unlike meditation, so that they can see the world in its de-individualized state. When intoxicated, the boundaries of the world collapse and meld into each other. The familiar world disappears and the world becomes ‘other’. When we ‘become-other’ we plug into the matter-energy of the world and see it for what it is. This experience is beautiful, dangerous and horrific (Deleuze, 1994, p. 237).

According to this framework, the spaces of drug use may not be pathological sites, but rather phase shifts in the world as it becomes-other. These are not shifts in time, but in dimension. Deleuze alone, and with Guattari (and later Massumi), posits that becoming-other is a ‘desire to escape bodily limitation’ (Massumi, 1992, p. 94), a liminal state, a movement between forms. From this viewpoint encountering drug use is a little like changing the coordinates of the perceptible world. In Deleuzian terms, we begin to see the world become-other and encounter the limits of the sensible world. These limits are made visible through an encounter with the drug user’s body. The limits of the sensible world are exposed when the body of the drug user beco...

Table of contents

• Cover
• Title Page
• Copyright
• Contents
• List of Figures
• Preface
• Acknowledgements
• 1. Introduction: Who Is Responsible?
• 2. Navigating a Pharmacoanalysis
• 3. The Image of Drug Desire
• 4. Syringes, Metonymy, Global Fear and News
• 5. The Rave Assemblage
• 6. Faciality and Drug Photography
• 7. The Spatial Economies of Drug Dealing
• 8. Drinking as a Global ‘Mo’-vement Assemblage
• 9. Drugs and the Abject
• 10. Drugs and Transitional Economies
• 11. Neuroenablement and Hope
• 12. Pharmacological Omnipotence and Sexual Violence
• 13. Drug Epistemologies
• Bibliography
• Author Index
• Subject Index