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Multiple Logics: How Staff in Relapse Prevention Interpellate People With Substance Use Problems 多重逻辑:预防复发的工作人员如何将有药物使用问题的人联系起来
Q1 Social Sciences Pub Date : 2021-03-07 DOI: 10.1177/0091450921998077
Mats Ekendahl, Patrik Karlsson
This study analyzes how staff in Swedish alcohol and other drug (AoD) treatment interpellate service users as people who can benefit from relapse prevention. Relapse prevention is a widely used intervention. Research is scarce, however, on how relapse prevention is practiced locally and how treatment staff perceive the relationship between AoD use as a problem and relapse prevention as a solution. Drawing on Actor-Network Theory and critical studies of AoD issues within this tradition, we elucidate how staff through specific interpellative logics enact service users, their individual characteristics, and living conditions. The data derive from interviews with 18 professionals working with assessment, counseling, case-management, therapy, and healthcare at AoD treatment agencies in the Stockholm region. The results show that the participants drew on four interpellative logics, and thereby enacted service users as four different object types. Region and network logics pinpointed that individuals have stable observable characteristics that determine their problems and eligibility for treatment (e.g., living conditions, diagnoses). Fluid and fire logics emphasized that their characteristics also vary depending on context and can be present and absent at the same time (e.g., harms, agency). This flexible interpellation of service users echoes the tendency among treatment staff to embrace sometimes irreconcilable understandings of AoD problems and to enact multiple realities of addiction. This suits a professional field where many factors are thought to cause and help resolve problems, but where the treatment supply is often limited to specific interventions. We conclude that it is easier to create a reasonable match between the service delivered and the potential service user if the characteristics of the latter are considered diverse and flickering. This exemplifies Carol Bacchi’s tenet that problem representations are adjusted to fit the solution at hand.
这项研究分析了瑞典酒精和其他药物治疗机构的工作人员如何将服务使用者宣传为可以从预防复发中受益的人。复发预防是一种广泛使用的干预措施。然而,关于复发预防在当地是如何实施的,以及治疗人员如何将AoD的使用视为一个问题和复发预防视为一种解决方案之间的关系,研究很少。借助行动者网络理论和对这一传统中的AoD问题的批判性研究,我们阐明了员工如何通过特定的质询逻辑来制定服务用户、他们的个人特征和生活条件。这些数据来自对斯德哥尔摩地区AoD治疗机构18名从事评估、咨询、病例管理、治疗和医疗保健工作的专业人员的采访。结果表明,参与者借鉴了四种互问逻辑,从而将服务用户设定为四种不同的对象类型。区域和网络逻辑指出,个体具有稳定的可观察特征,这些特征决定了他们的问题和治疗资格(例如,生活条件、诊断)。流体和火灾逻辑强调,它们的特征也因上下文而异,可以同时存在和不存在(例如,危害、代理)。这种对服务使用者的灵活询问呼应了治疗人员对AoD问题有时不可调和的理解,并形成了成瘾的多重现实。这适合一个专业领域,在这个领域,许多因素被认为会导致并有助于解决问题,但治疗供应往往仅限于特定的干预措施。我们得出的结论是,如果潜在服务用户的特征被认为是多样的和闪烁的,那么在提供的服务和潜在服务用户之间建立合理的匹配会更容易。这体现了Carol Bacchi的原则,即对问题表示进行调整以适应手头的解决方案。
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引用次数: 4
Bleeding Borders and Enemies Within: How Newsmagazine Covers Portrayed Drugs of Abuse, 1979–2019 流血的边界和内部敌人:1979-2019年新闻杂志封面如何描绘滥用药物
Q1 Social Sciences Pub Date : 2021-03-01 DOI: 10.1177/0091450921993835
Bryan E. Denham, S. Cacciatore, Michael Caves
This study examined how the covers of three newsmagazines, Time, Newsweek, and U.S. News & World Report, portrayed drugs of abuse between 1979 and 2019. Findings showed consistency with extant research suggesting that a rigid focus on supply has resulted in a vilification of Latino traffickers from Central and South America. We also saw differences in how newsmagazines portrayed powder cocaine and crack cocaine and observed patterns of “White washing” opioid abuse. Implications and recommendations for future research are provided.
这项研究调查了三份新闻杂志《时代》、《新闻周刊》和《美国新闻与世界报道》的封面如何描述1979年至2019年期间的药物滥用情况。调查结果与现有的研究一致,表明对供应的严格关注导致了对来自中南美洲的拉丁裔贩运者的诋毁。我们还看到了新闻杂志对粉末可卡因和快克可卡因的描述方式的差异,并观察到“洗白”阿片类药物滥用的模式。对未来的研究提出了启示和建议。
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引用次数: 0
Toward Community Empowerment: The Puerto Rican Ganchero. 迈向社区赋权:波多黎各的甘切罗。
Q1 Social Sciences Pub Date : 2021-03-01 Epub Date: 2020-10-07 DOI: 10.1177/0091450920964576
C Gelpí-Acosta, H Guarino, E Benoit, S Deren, A Rodríguez

People who inject drugs (PWID) who migrate from Puerto Rico (PR) to New York City (NYC) are at elevated risk for hepatitis C (HCV), HIV and drug overdose. There is an urgent need to identify a sustainable path toward improving the health outcomes of this population. Peer-driven HIV/HCV prevention interventions for PWID are effective in reducing risk behaviors. Additionally, the concept of intravention-naturally occurring disease prevention activities among PWID (Friedman, 2004)-is a suitable theoretical framework to cast and bolster PWID-indigenous risk reduction norms and practices to achieve positive health outcomes. From 2017-2019, we conducted an ethnographic study in the Bronx, NYC to identify the injection risks of migrant Puerto Rican PWID, institutional barriers to risk reduction and solutions to these barriers. Study components included a longitudinal ethnography with 40 migrant PWID (e.g., baseline and exit interviews and monthly face-to-face follow-ups for 12 months), two institutional ethnographies (IEs) with 10 migrants and six service providers, and three focus groups (FGs) with another 15 migrant PWID. Data were analyzed using a grounded theory approach. In this article, we present findings from the IEs and FGs, specifically regarding a promising intravention pathway to promote health empowerment among these migrants that leverages an existing social role within their networks: the PR-indigenous ganchero. A ganchero is a vein-finding expert who is paid with drugs or cash for providing injection services. Ethnographic evidence from this study suggests that gancheros can occupy harm reduction leadership roles among migrant Puerto Rican PWID, adapting standard overdose and HIV/HCV prevention education to the specific experiences of their community. We conclude by noting the culturally appropriate risk reduction service delivery improvements needed to mitigate the health vulnerabilities of migrants and provide a roadmap for improving service delivery and identifying future research avenues.

从波多黎各(PR)移民到纽约市(NYC)的注射吸毒者(PWID)感染丙型肝炎(HCV)、艾滋病毒(HIV)和药物过量的风险较高。迫切需要确定一条可持续的途径来改善这一人群的健康状况。同伴驱动的艾滋病毒/丙型肝炎预防干预措施在减少危险行为方面是有效的。此外,静脉干预的概念-在PWID中自然发生的疾病预防活动(Friedman, 2004)-是一个合适的理论框架,可以塑造和支持PWID土著减少风险的规范和实践,以实现积极的健康结果。从2017年到2019年,我们在纽约市布朗克斯进行了一项人种学研究,以确定波多黎各移民PWID的注射风险,降低风险的制度障碍以及这些障碍的解决方案。研究组成部分包括对40名移民PWID的纵向民族志(例如,基线和退出访谈以及为期12个月的每月面对面随访),对10名移民和6名服务提供者的两项机构民族志(IEs),以及对另外15名移民PWID的三个焦点小组(fg)。数据分析采用扎根理论的方法。在本文中,我们介绍了来自ie和FGs的研究结果,特别是关于一个有希望的静脉干预途径,以促进这些移民的健康赋权,利用其网络中现有的社会角色:PR-indigenous ganchero。ganchero是一名寻找静脉的专家,他们提供注射服务,获得毒品或现金报酬。本研究的人种学证据表明,gancheros可以在移民波多黎各PWID中发挥减少伤害的领导作用,使标准的过量和HIV/HCV预防教育适应其社区的具体经验。最后,我们指出,为减轻移徙者的健康脆弱性,需要在文化上适当地改善减少风险的服务提供,并为改善服务提供和确定未来的研究途径提供了路线图。
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引用次数: 6
Narrative Politics in Policy Discourse: The Debate Over Safe Injection Sites in Philadelphia, Pennsylvania 政策话语中的叙事政治:宾夕法尼亚州费城关于安全注射场所的争论
Q1 Social Sciences Pub Date : 2021-03-01 DOI: 10.1177/0091450921993821
Ryan J. Lofaro, H. Miller
Safe injection sites are spaces where people who inject drugs can do so under the supervision of staff at the sites who attempt to revive them if they overdose. Public officials in Philadelphia, Pennsylvania, have proposed the sites as a means to reduce opioid overdose deaths in the city, a policy proposal that has been politically and legally contested. This article uses the Narrative Politics model to elucidate the concerns, values, and aspirations of the competing narratives in the public discourse over safe injection sites in Philadelphia. Despite the aspirations expressed within the Harm Reduction narrative to open such a site, opposition from the Nimby (not in my backyard) narrative has, at the time of this research, successfully precluded such a step. Other narratives in the discourse include the Abstinence narrative opposing safe injection sites and the Social Justice narrative opposed to incarceration but also hesitant to wholeheartedly endorse the Harm Reduction narrative for its delayed advocacy of compassionate treatment of people who use drugs now that the face of the person who uses opioids is a white one. In addition to juxtaposing competing narratives against one another and considering their alignments, disagreements, and interactions, the authors consider absences and shared presuppositions. The social construction of the purported drug addict varies in some ways between and among the prevailing narratives; in other ways, all the narratives problematize “addiction” as an affliction that justifies techniques of discipline aimed at caring for and controlling the population.
安全注射场所是注射毒品的人可以在场所工作人员的监督下进行注射的场所,如果他们过量注射,工作人员会试图救活他们。宾夕法尼亚州费城的公职人员提议,将这些场所作为减少该市阿片类药物过量死亡的一种手段,这一政策提议在政治上和法律上都存在争议。本文使用叙事政治模型来阐明在费城安全注射地点的公共话语中竞争叙事的关注点,价值观和愿望。尽管在减少伤害的叙述中表达了开放这样一个站点的愿望,但在本研究进行时,来自邻避(不是在我的后院)叙述的反对已经成功地阻止了这一步骤。话语中的其他叙述包括反对安全注射地点的禁欲叙述和反对监禁的社会正义叙述,但也不愿全心全意地支持减少伤害叙述,因为它延迟了对吸毒者的同情治疗的倡导,因为使用阿片类药物的人的脸是白人的脸。除了将相互竞争的叙述并置,并考虑它们的一致性、分歧和相互作用之外,作者还考虑了缺席和共同的预设。在不同的主流叙事中,所谓的吸毒者的社会建构在某些方面有所不同;在其他方面,所有的叙述都将“成瘾”问题化为一种痛苦,为旨在照顾和控制人口的纪律技术辩护。
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引用次数: 10
Toward a “Post-Legalization” Criminology for Cannabis: A Brief Review and Suggested Agenda for Research Priorities 迈向“后合法化”的大麻犯罪学:简要回顾和建议的优先研究议程
Q1 Social Sciences Pub Date : 2020-12-10 DOI: 10.1177/0091450920977976
B. Fischer, D. Daldegan-Bueno, P. Reuter
Cannabis control policies in a few countries have recently shifted from criminal prohibition-based regimes to legalization of use and supply. While cannabis’ newly emerging status of legality may suggest a coming “end” for criminology-based interest in the drug, these fundamental changes rather open a window to a new set of criminological research issues and questions, mostly focusing on cannabis use and related behaviors, and their relation to crime and justice. Based on a joint, personal record of several decades of criminological research on cannabis, we briefly review the rationale for five fundamental topics and issues of cannabis-related research associated with legalization. These include: 1) the deterrent effect of prohibition; 2) illicit production, markets and supply in a legalization regime; 3) use enforcement; 4) cannabis-impaired driving; 5) cannabis and crime. This constitutes an—albeit subjectively selective—“post-legalization” research agenda for a cannabis-focused criminology. Other possible areas of research focus or interest within fundamentally different paradigms of criminology (e.g., “critical criminology”) are identified and encouraged for development. Overall, the proposed research agenda for a post-legalization cannabis criminology should both contribute discipline-specific knowledge to improved cannabis-related public health and safety as well as allow for important debate and development in this evolving and important research field while entering a new (“post-legalization”) era.
一些国家的大麻管制政策最近已从基于刑事禁令的制度转向使用和供应的合法化。虽然大麻新出现的合法地位可能意味着基于犯罪学的对该药物的兴趣即将“终结”,但这些根本性的变化为一系列新的犯罪学研究问题打开了一扇窗户,主要集中在大麻的使用和相关行为,以及它们与犯罪和司法的关系。基于几十年来大麻犯罪学研究的联合个人记录,我们简要回顾了与合法化相关的大麻相关研究的五个基本主题和问题的基本原理。其中包括:1)禁令的威慑作用;2) 合法化制度下的非法生产、市场和供应;3) 使用强制执行;4) 大麻障碍驾驶;5) 大麻和犯罪。这构成了以大麻为重点的犯罪学的“后合法化”研究议程,尽管主观上是有选择性的。在根本不同的犯罪学范式(例如“批判性犯罪学”)中,确定并鼓励发展其他可能的研究重点或兴趣领域。总体而言,大麻合法化后犯罪学的拟议研究议程既应为改善大麻相关的公共健康和安全贡献特定学科的知识,也应在进入新的(“后合法化”)时代的同时,允许在这一不断发展的重要研究领域进行重要的辩论和发展。
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引用次数: 11
Biopower, Disciplinary Power and Surveillance: An Ethnographic Analysis of the Lived Experience of People Who Use Drugs in Vancouver’s Downtown Eastside 生物权力、纪律权力和监督:温哥华市中心东区吸毒者生活经历的民族志分析
Q1 Social Sciences Pub Date : 2020-12-01 DOI: 10.1177/0091450920955247
Benjamin Scher
Focusing on the role of police as primary actors in the arena of citizen safety, this article examines the impact of policing practices on the daily lived experience of people who use drugs in accessing a supervised consumption site in Vancouver, Canada. The site is located in the heart of Vancouver’s Downtown Eastside (DTES) neighborhood at a community center that I refer to as the Hawthorne Resource Centre. The method of data collection for this study comprised five months of ethnographic fieldwork, including focus groups and one-on-one interviews with community members accessing the site, site staff and management. Drawing on Foucauldian conceptualizations of power, the findings of this research suggest that governmental modes of power, including biopower and disciplinary power, are pervasively operative in various realms of the day to day lives of the Hawthorne Resource Centre clients. Evidence of the scalable nature of these modes of power are seen within the internal functioning of the Supervised Consumption Site, outside in the methods of community policing in the DTES and in weekly police practices in Oppenheimer Park. As such, this study represents a multiscalar assessment of how these Foucauldian power structures work at multiple levels and locations in the DTES. Driven by the narratives of the Hawthorne Resource Centre clients, the findings of this research illustrate not only the importance of understanding power relations within specific policy interventions, but further, highlight how specific tactics mobilized within “harm reduction policing” would be relevant and applicable to the context of the DTES.
本文聚焦于警察在公民安全领域的主要角色,探讨了在加拿大温哥华的一个受监管的消费场所,警察实践对吸毒者日常生活体验的影响。场地位于温哥华市中心东侧(DTES)社区中心的中心,我称之为Hawthorne资源中心。本研究的数据收集方法包括五个月的民族志实地调查,包括焦点小组和对访问该站点的社区成员、站点工作人员和管理人员的一对一访谈。借鉴福柯式的权力概念,本研究的结果表明,政府权力模式,包括生物权力和纪律权力,在霍桑资源中心客户日常生活的各个领域普遍存在。这些权力模式的可扩展性的证据可以在监督消费网站的内部功能中看到,在DTES的社区警务方法和奥本海默公园的每周警察实践中看到。因此,本研究代表了对福柯式权力结构如何在DTES的多个层次和位置上工作的多标量评估。在霍桑资源中心客户的叙述的推动下,本研究的结果不仅说明了在具体政策干预中理解权力关系的重要性,而且进一步强调了在“减少伤害警务”中动员的具体策略如何与DTES的背景相关并适用。
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引用次数: 7
Social Stigma and Perinatal Substance Use Services: Recognizing the Power of the Good Mother Ideal 社会耻辱和围产期物质使用服务:认识到好母亲理想的力量
Q1 Social Sciences Pub Date : 2020-10-30 DOI: 10.1177/0091450920969200
Tracy R. Nichols, A. Welborn, Meredith R Gringle, Amy Lee
People who are diagnosed with a substance use disorder can experience stigmatizing interactions with health and social service providers, which may decrease both quality and continuity of care. For women with a substance-exposed pregnancy (SEP), this stigma can increase exponentially. Stigmatizing interactions can be difficult to identify due to social sanctions against expressing stigmatizing attitudes, beliefs, and behaviors and because stigma often resides in accepted cultural norms. Examining discourses around care provision can serve to identify instances of social stigma as well as illuminate the cultural norms in which they are embedded. Using data from a seven-year grounded theory study on perinatal substance use service provision, this paper reports on the perceptions and experiences of service providers working with mothers who have an SEP and illustrates complexities behind stigmatizing patient-provider interactions. Data collected included observations at meetings, workshops, and conferences addressing best practices across the continuum of care for perinatal substance use as well as interviews and focus groups with providers. The construct of “good mothering,” or hegemonic motherhood, was identified as an important cultural norm that supported social stigma and was embedded in providers’ interactions with mothers with an SEP. Discursive elements found in providers’ descriptions of perinatal substance use service work are presented and highlight the role of hegemonic motherhood as a stigmatizing agent.
被诊断为药物使用障碍的人可能会经历与卫生和社会服务提供者的污名化互动,这可能会降低护理质量和连续性。对于有物质暴露妊娠(SEP)的妇女来说,这种耻辱感会呈指数级增加。由于对表达污名化态度、信仰和行为的社会制裁,以及污名化往往存在于公认的文化规范中,污名化互动可能很难识别。研究围绕护理提供的话语可以有助于识别社会污名的例子,并阐明它们所嵌入的文化规范。利用一项为期七年的围产期药物使用服务提供基础理论研究的数据,本文报告了服务提供者与患有SEP的母亲合作的看法和经历,并说明了污名化患者与提供者互动背后的复杂性。收集的数据包括在会议、研讨会和会议上发表的关于围产期药物使用连续护理最佳实践的意见,以及与提供者的访谈和焦点小组。“好母亲”或霸权母亲的概念被确定为一种重要的文化规范,支持社会污名化,并嵌入提供者与患有SEP的母亲的互动中。提供者对围产期药物使用服务工作的描述中发现了话语元素,并强调了霸权母亲作为污名化媒介的作用。
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引用次数: 22
Tough Times and the Ethnography of State Intimacies 艰难时期与国家亲密关系的民族志
Q1 Social Sciences Pub Date : 2020-09-03 DOI: 10.1177/0091450920956395
N. Campbell
Backlit by the flickering nightly display of #NYTough, a beacon projected onto the massive Empire State Government Plaza in Albany, New York, I read these two ethnographic encounters during the COVID-19 lockdown, a surreal experience for a scholar of drug policy, treatment, and science. Meant to showcase New Yorkers’ resilience, the slogan beamed its polysemic “tough love” signal across one of former New York State Governor Nelson Rockefeller’s monumental architectural follies. Far more consequential a folly has been the 1973 Rockefeller Laws, “get tough” drug laws mimicked throughout the United States’ “little Rockefeller laws” (Maggio, 2006). The Rockefeller Laws fueled mass incarceration with lengthy mandatory minimum sentences, and went unreformed until 2009 (Office of the New York State Governor, 2009). These laws provoked a particularly masculinist style of #NYTough law enforcement over more than 40 years’ existence, ensnaring a wide swath of New Yorkers—particularly poor persons of color—within the purview of the criminal justice system (Kohler-Hausman 2010, 2017). Reform set in motion an “evolving process in which a shift from punishment to treatment is occurring alongside a growing demand for treatment providers to meet the requirements of the criminal justice system” (Riggs et al., 2014). While the distinctly nontherapeutic criminalization process—which the Rockefeller Laws exemplify—will remain with the disunited states for a long time to come, experiments in therapeutic jurisprudence have yielded a system of “drug courts,” in which judges may exercise a degree of autonomy in sanctioning, while fostering relationships of emotional dependency with “participants” into whose lives they intrude deeply (Kaye, 2020, p. 66). This essay considers two recent U.S.-based books that reveal the inner workings of drug courts and prison-based treatment programs, situating each within the larger stakes of feminist drug ethnography and historiography. The scope of this review essay widened beyond the contribution each book makes to the ethnographic record to encompass the broader question of how states—those “coldest of all cold monsters” (Nietzsche, 1892/1930, p. 56)—respond to “unloved” subjects who use drugs. My purpose is to
在每晚闪烁的#NYTough(投射在纽约奥尔巴尼大型帝国政府广场上的灯塔)的衬托下,我读到了新冠肺炎封锁期间的这两次人种学遭遇,对于一位研究药物政策、治疗和科学的学者来说,这是一次超现实的经历。为了展示纽约人的韧性,这句口号在前纽约州州长纳尔逊·洛克菲勒(Nelson Rockefeller)的一个不朽建筑愚蠢行为中传递了其多义的“坚韧的爱”信号。更重要的是1973年的洛克菲勒法律,该法律模仿了整个美国的“小洛克菲勒法律”(Maggio,2006)。洛克菲勒法律以冗长的强制性最低刑期助长了大规模监禁,直到2009年才得到修改(纽约州州长办公室,2009年)。这些法律在40多年的存在中引发了一种特别男性化的#NYTough执法风格,将大量纽约人——尤其是有色人种穷人——困在刑事司法系统的管辖范围内(Kohler Hausman 20102017)。改革启动了一个“从惩罚到治疗的不断演变的过程,同时对治疗提供者的需求不断增长,以满足刑事司法系统的要求”(Riggs等人,2014)。虽然洛克菲勒法律所体现的明显的非治疗性刑事定罪程序将在未来很长一段时间内继续存在于分裂的各州,但治疗法学的实验已经产生了一个“毒品法庭”系统,在这个系统中,法官可以在制裁方面行使一定程度的自主权,同时培养与“参与者”的情感依赖关系,他们深深地侵入了他们的生活(Kaye,2020,第66页)。本文考虑了美国最近出版的两本书,这两本书揭示了毒品法庭和监狱治疗项目的内部运作,将每一本书都置于女权主义毒品民族志和史学的更大利害关系中。这篇评论文章的范围超出了每本书对民族志记录的贡献,涵盖了更广泛的问题,即国家——那些“所有冷怪物中最冷的”(尼采,1892/1930,第56页)——如何应对吸毒的“不受欢迎”的受试者。我的目的是
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引用次数: 0
Rethinking “Change”: Introduction to a Special Focus 反思“改变”:一个特殊焦点的介绍
Q1 Social Sciences Pub Date : 2020-09-01 DOI: 10.1177/0091450920943446
D. Moore
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引用次数: 1
Change in Editorship of Contemporary Drug Problems 《当代毒品问题》编辑的变化
Q1 Social Sciences Pub Date : 2020-09-01 DOI: 10.1177/0091450920944002
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引用次数: 0
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Contemporary Drug Problems
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