Telling different stories, making new realities: The ontological politics of ‘addiction’ biographies

Personal narratives of alcohol and other drug addiction circulate widely in popular culture and they also have currency in professional therapeutic settings. Despite this, relatively little research has explored the conventions operating in these narratives and how they shape people's experiences and identities. While research in this area often proceeds on the premise that addiction biographies are straightforwardly ‘true’ accounts, in this paper we draw on the insights of critical alcohol and other drug scholarship, and the concept of ‘ontological politics’ to argue that biographies produce normative ideas about addiction and those said to be experiencing it. Our analysis compares traditional addiction narratives with the biographies we reconstructed from qualitative interviews with 60 people in Australia who describe themselves as having an ‘addiction’, ‘dependence’ or drug ‘habit’. We track how addiction is variously enacted in these accounts and comment on the effects of particular enactments. By attending to the ways in which people cope, even thrive, with the kind of consumption that would attract a diagnosis of addiction or dependence, the biographies we produced disrupt the classic narrative of increasing drug use, decline and eventual collapse. Doing so allows for consideration of the benefits of consumption, as well as the ways that people carefully regulate it to minimise harms. It also constitutes individuals as active in managing consumption—an important move that challenges dominant understandings of addiction as a disorder of compulsivity. We conclude by considering the implications of our attempt to provide an alternative range of narratives, which resonate with people's diverse experiences

Challenging the addiction/health binary with assemblage thinking: An analysis of consumer accounts

Critical analyses of drug use and 'addiction' have identified a series of binary oppositions between addiction and free will, independence, self-control, responsibility, productivity and autonomy. This critical work has also examined how science, policy and popular discourses frequently characterise addiction as antithetical to health and well-being. Furthermore, those diagnosed with addiction are often understood as indifferent to health and well-being, or as lacking the knowledge or desire required to maintain them. In this article, we draw on data from 60 qualitative interviews with people who self-identify as living with an 'addiction', 'dependence' or 'habit', to argue that the binary opposition between addiction and health struggles to attend to their rich and varied health perspectives and experiences. We explore three themes in the interview data: reinscribing the binary opposition between addiction and health/well-being; strategies for maintaining health and well-being alongside addiction; and alcohol and other drug consumption as aiding health and well-being. Perhaps because addiction and health have been so thoroughly understood as antithetical, such perspectives and experiences have received surprisingly little research and policy attention. Yet they offer fertile ground for rethinking the strengths and capacities of those who self-identity as living with an addiction, dependence or habit, as well as untapped resources for responding to the harm sometimes associated with alcohol and other drug use

Iterating ‘addiction’: Residential relocation and the spatio-temporal production of alcohol and other drug consumption patterns

Addiction is generally understood to be characterised by a persistent pattern of regular, heavy alcohol and other drug consumption. Current models of addiction tend to locate the causes of these patterns within the body or brain of the individual, sidelining relational and contextual factors. Where space and place are acknowledged as key factors contributing to consumption, they tend to be conceived of as static or fixed, which limits their ability to account for the fluid production and modulation of consumption patterns over time. In this article we query individualised and decontextualised understandings of the causes of consumption patterns through an analysis of accounts of residential relocation from interviews undertaken for a large research project on experiences of addiction in Australia. In conducting our analysis we conceptualise alcohol and other drug consumption patterns using Karen Barad's notions of intra-action and spatio-temporality, which allow for greater attention to be paid to the spatial and temporal dimensions of the material and social processes involved in generating consumption patterns. Drawing on 60 in-depth interviews conducted with people who self-identified as experiencing an alcohol and other drug addiction, dependence or habit, our analysis focuses on the ways in which participant accounts of moving enacted space and time as significant factors in how patterns of consumption were generated, disrupted and maintained. Our analysis explores how consumption patterns arose within highly localised relations, demonstrating the need for understandings of consumption patterns that acknowledge the indivisibility of space and time in their production. In concluding, we argue for a move away from static conceptions of place towards a more dynamic conception of spatio-temporality, and suggest the need to consider avenues for more effectively integrating place and time into strategies for generating preferred consumption patterns and initiating and sustaining change where desired

Addiction stigma and the biopolitics of liberal modernity: A qualitative analysis

Definitions of addiction have never been more hotly contested. The advance of neuroscientific accounts has not only placed into public awareness a highly controversial explanatory approach, it has also shed new light on the absence of agreement among the many experts who contest it. Proponents argue that calling addiction a 'brain disease' is important because it is destigmatising. Many critics of the neuroscientific approach also agree on this point. Considered from the point of view of the sociology of health and illness, the idea that labelling something a disease will alleviate stigma is a surprising one. Disease, as demonstrated in that field of research, is routinely stigmatised. In this article we take up the issue of stigma as it plays out in relation to addiction, seeking to clarify and challenge the claims made about the progress associated with disease models. To do so, we draw on Erving Goffman's classic work on stigma, reconsidering it in light of more recent, process oriented, theoretical resources, and posing stigmatisation as a performative biopolitical process. Analysing recently collected interviews conducted with 60 people in Australia who consider themselves to have an alcohol or other drug addiction, dependence or habit, we explore their accounts of stigma, finding experiences of stigma to be common, multiple and strikingly diverse. We argue that by treating stigma as politically productive - as a contingent biopolitically performative process rather than as a stable marker of some kind of anterior difference - we can better understand what it achieves. This allows us to consider not simply how the 'disease' of addiction can be destigmatised, or even whether the 'diseasing' of addiction is itself stigmatising (although this would seem a key question), but whether the very problematisation of 'addiction' in the first place constitutes a stigma process

Lives of Substance: a mixed-method evaluation of a public information website on addiction experiences

The Lives of Substance (LoS) website presents personal experiences of drug use and ‘addiction’ in people’s own words as part of a larger project of complicating public discourses of addiction, countering stigmatising misconceptions and acting as an intervention in the social production of addiction. This article presents the findings of a mixed-method evaluation of the website, and comments on some of the methodological and practical challenges of evaluating health-related online information resources. Method: Three data sources were used to examine such as the reach of the website (website analytics); experiences of the website audience (responses to an evaluation survey on the website); and other indicators of use and impact (including social media referrals and organisational links). Results: In the 10-week evaluation period, 3970 unique users visited the website. Comments provided via the online survey endorsed the website as a means of challenging stereotypes and as presenting drug use as only a ‘part of a person’s whole life’. Twenty-four organisations had linked to the website and 987 social media referrals were recorded. Conclusion: These data indicate that the LoS website is having some success as a resource for countering addiction-related stigma and offering more holistic and inclusive social understandings of addiction

Sexualities and Intoxication: “To Be Intoxicated Is to Still Be Me, Just a Little Blurry”—Drugs, Enhancement and Transformation in Lesbian, Gay, Bisexual, Transgender and Queer Cultures

Despite evidence that drug use is higher among lesbian, gay, bisexual, transgender and queer (LGBTQ) populations, research that explores the gendered and sexual dynamics of LGBTQ substance use is limited. Responding to this opening in the literature, and drawing on 32 qualitative interviews from an Australian study, we consider how LGBTQ consumers pursue particular drug effects to change their experience of gender and/or sexuality. Our analysis suggests that for many consumers, drug use and the experience of intoxication enhances sexual pleasure. In the context of gender variance, intoxication can facilitate free gender expression and, in some cases, palliate bodily discomfort. Acknowledging the generative effects of drug use for gender and sexual transformation, we conclude by commenting on the implications of our analysis for LGBTQ health policy and practice