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Linden-Carmichael AN, Stull SW, Lanza ST. Alcohol and cannabis use in daily lives of college-attending young adults: Does co-use correspond to greater reported pleasure? Addict Behav 2024; 159:108130. [PMID: 39178638 PMCID: PMC11381134 DOI: 10.1016/j.addbeh.2024.108130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/23/2024] [Accepted: 08/12/2024] [Indexed: 08/26/2024]
Abstract
Co-use of alcohol and cannabis is prevalent and linked with heightened risk for substance-related harms. The current study investigated the role of substance-related pleasure as a reinforcing factor for co-use relative to alcohol or cannabis use. Specifically, we used data from a 21-day diary study of college students to examine day-level associations between co-use and self-reported substance-related pleasure (any, level of pleasure). Participants were 237 college students (65 % female sex at birth, ages 18-24) who reported 1+ alcohol and cannabis co-use occasion. Participants completed daily surveys across 21 consecutive days about yesterday's substance use and experiences of pleasure, yielding 2,086 daily surveys involving alcohol and/or cannabis use. Multilevel models indicated that odds of substance-related pleasure were higher on days with co-use relative to days with single-substance use, and level of pleasure was higher on co-use days relative to cannabis but not alcohol use days. Pleasure may serve as a reinforcing property of co-use that may be related to continued use despite experience of negative consequences. Intensity of pleasure related to co-use appears to be largely driven by use of alcohol. However, given mixed findings concerning level of pleasure, individuals may report co-use increases feelings of pleasure but do not actually experience more pleasure. Pleasure may serve as a viable target in future prevention and intervention programming targeting co-use.
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Collins RA, Duncanson K, Skinner JA, Hay PJ, Paxton SJ, Burrows TL. Exploring Psychological Constructs in People Receiving Treatment for Addictive Eating Behaviours: "I Hate Loving Food as Much as I Do". Behav Sci (Basel) 2023; 13:817. [PMID: 37887467 PMCID: PMC10604454 DOI: 10.3390/bs13100817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/18/2023] [Accepted: 09/28/2023] [Indexed: 10/28/2023] Open
Abstract
Research into the complexities of addictive eating behaviours continues to develop, as a deeper understanding of this construct beyond self-report diagnostic tools emerges. In this study, we undertook structured interviews with 40 participants engaged in a personality-based management program for addictive eating, to gain insight into what situations lead people with addictive eating behaviours to overeat, and how they believe their lives would be different if they had control over their eating. A phenomenological analysis to explore compulsion and control in the context of food experiences for participants was used to construct two main themes of the addictive eating paradox and striving to transition from 'other' to 'normal'. The addictive eating paradox identified multiple contradictory experiences of a situation, e.g., 'loving food' but 'hating food'. Striving to transition from 'other' to 'normal' encompassed the idea that participants envisaged that by gaining control over their eating they could become 'normal'. This study emphasises the need to provide support and strategies to help people navigate paradoxical thoughts and presents new ideas to increase the effectiveness of interventions for individuals struggling with the complex self-beliefs held by those with addictive eating behaviours.
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Affiliation(s)
- Rebecca A. Collins
- School of Health Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.S.); (T.L.B.)
- Food & Nutrition Program, New Lambton, NSW 2305, Australia;
| | - Kerith Duncanson
- Food & Nutrition Program, New Lambton, NSW 2305, Australia;
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Janelle A. Skinner
- School of Health Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.S.); (T.L.B.)
- Food & Nutrition Program, New Lambton, NSW 2305, Australia;
| | - Phillipa J. Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia;
- Campbelltown Hospital, South West Sydney Local Health District, Sydney, NSW 2560, Australia
| | - Susan J. Paxton
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia;
| | - Tracy L. Burrows
- School of Health Sciences, The University of Newcastle, Callaghan, NSW 2308, Australia; (J.A.S.); (T.L.B.)
- Food & Nutrition Program, New Lambton, NSW 2305, Australia;
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Chassid-Segin M, Gueta K, Ronel N. Maintaining Normative Functioning Alongside Drug Use: The Recognition of Harms and Adoption of Change Strategies. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:1879-1897. [PMID: 34612066 DOI: 10.1177/0306624x211049180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The current study examined drug users' perspectives on strategies that helped them to maintain normative functioning or resolve impaired functioning. We interviewed 29 drug users who described themselves as functioning normatively while using drugs on a regular basis until they experienced harms or raised concerns of future harms. The content analysis showed that the users maintain their normative functioning through diverse strategies that can be located on a continuum. This continuum was conceptualized as "normative functioning management" based on White et al.'s concept of "recovery management." This study found an ongoing continuum through self-management and social interaction consisting of three regions: the management of normative functioning, the recognition of the harm of drug use to functioning, and the subsequent adoption of change strategies for maintaining normative functioning. This continuum may provide a more nuanced theoretical understanding of the phenomenon of drug users with normative functioning and is therefore relevant for counselors encountering such users in their practice. This study highlights inner resources such as self-awareness and social interaction that help functioning users to maintain their normative functioning and fulfill basic obligations in their normal routines, that is, preserving their professional status, family lives, and relationships.
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Brookfield S, Selvey L, Maher L, Fitzgerald L. ‘Making Ground’: An Ethnography of ‘Living With’ Harmful Methamphetamine Use and the Plurality of Recovery. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426211073911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The trajectories of people attempting to reduce harmful methamphetamine use are frequently understood within a binary framework of transitioning between states of health and disease. This framework can often be reinforced by service interactions informed by these dominant narratives of recovery and addiction. In this paper, we draw on a critical interactionist analysis of ethnographic fieldwork conducted with people who use methamphetamine, to examine how their experiences could undermine this binary, observing the ways participants experienced growth, change, and progress, without necessarily maintaining abstinence. These findings support a more diverse understanding of drug use trajectories, and we explore the concept of ‘living with drug use’, similar to how people live with other chronic conditions by finding ‘health in illness’. Participant experiences are also interpreted within the context of counter public health, arguing for the recognition and integration of values and goals which are divergent from the implicit aims of public health practice.
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Affiliation(s)
- Samuel Brookfield
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Linda Selvey
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Lisa Maher
- Kirby Institute for Infection and Immunity, University of New South Wales, Sydney, Australia
| | - Lisa Fitzgerald
- School of Public Health, The University of Queensland, Brisbane, Australia
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Your diagnosis will not protect you (and neither will academia): Reckoning with education and Dis-Ease. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 98:103450. [PMID: 34531035 DOI: 10.1016/j.drugpo.2021.103450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 11/20/2022]
Abstract
This article is an autoethnographic exploration of institutionalized responses to uncontrolled substance use informed by medical paradigms. Theoretically, it is situated within a lineage of work in critical drug and Mad studies that challenge assumptions about choice, including - and especially - by interrogating the extent to which choice is an apt conceptual tool for making sense of "addiction." Throughout, I focus on two discrete but analogous events, both of which entailed binging on substances, entering altered states, and being rejected from academic spaces through a lens of biomedicine. My objective in doing so is two-fold: First, I hope to incite what I feel is a long overdue conversation between Mad and critical drug studies in service of theoretical cross-pollination. Second, I wish to outline how codifying people as Mad and addicted can amount to a "cutting out" (Smith, 1978) of relevant extraneous factors that motivate one's deviant actions, including within education institutions whose members research these same identities. I conclude by discussing the implications of this "cutting out" for my and possibly others' academic trajectories.
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Brookfield SJ, Selvey L, Maher L, Fitzgerald L. "It Just Kind of Cascades": A critical ethnography of methamphetamine-related pleasure among people in recovery. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 98:103427. [PMID: 34455175 DOI: 10.1016/j.drugpo.2021.103427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/20/2021] [Accepted: 08/09/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite its well documented risks and harms, methamphetamine use can also be experienced as a pleasurable, purposeful, and productive activity. Drug use discourse has historically deemphasised the pleasures of drug use, as they can contradict the expectations of neoliberalism that individuals be moderate, rational consumers. The purpose of this study was to explore the experiences of people trying to reduce or control their methamphetamine use, utilising a critical interactionist approach to excavate the subjugated knowledge of methamphetamine-related pleasure, and construct an understanding of methamphetamine use that incorporated these positive experiences. METHODS Qualitative interviews and ethnographic observation were conducted over an eight-month period with a group of twelve people using methamphetamine and accessing recovery services. Transcripts and fieldnotes were analysed thematically with a critical interactionist lens. RESULTS The pleasures of methamphetamine use were differentiated into pursuing the rush, exploring sociality, self-medication, and desiring productivity. The interwoven nature of these themes presents a multidimensional understanding of methamphetamine use resulting from a cascade of interacting causes and effects, rather than a linear product of individual choice or structural forces. These findings also highlight the complex symbiotic relationship between pleasure, productivity, and risk for people using methamphetamine which can be traced to the broader cultural and economic context in which use occurs. CONCLUSION Interventions and policies responding to harmful methamphetamine use must address the content and nature of the methamphetamine use cascade, acknowledging the diverse needs methamphetamine can meet for contemporary neoliberal citizens, and the sometimes complex and sophisticated purposes for which people may utilise its effects.
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Affiliation(s)
- Samuel J Brookfield
- School of Public Health, University of Queensland, 266 Herston Road, Herston, QLD 4006, Australia.
| | - Linda Selvey
- School of Public Health, University of Queensland, 266 Herston Road, Herston, QLD 4006, Australia
| | - Lisa Maher
- Kirby Institute, Level 6, Wallace Wurth Building, High Street, University of New South Wales (UNSW), Kensington, NSW 2052, Australia
| | - Lisa Fitzgerald
- School of Public Health, University of Queensland, 266 Herston Road, Herston, QLD 4006, Australia
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Askew R, Williams L. Rethinking enhancement substance use: A critical discourse studies approach. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 95:102994. [PMID: 33272772 DOI: 10.1016/j.drugpo.2020.102994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/25/2020] [Accepted: 09/30/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND We draw on both interdisciplinary enhancement substance use research and critical drug studies scholarship to reconceptualise enhancement substance use. Our critical discourse approach illuminates how a variety of substances are positioned as tools for self-improvement. In reconceptualising enhancement substance use, we ask what different substances can be positioned as providing enhancement? How are they positioned as tools for achieving enhancement or self-improvement goals? What discursive repertoires are employed to achieve these aims? METHODS Forty interviews were conducted with people who use substances, such as ayahuasca, psilocybin, cocaine, alcohol, nootropics and non-prescription pharmaceuticals, including Adderall and modafinil. To explore the meanings of and motivations for substance consumption, we apply the sociocognitive approach (SCA) pioneered by Teun van Dijk (2014; 2015) and examine language through the triangulation of cognition, discourse and society. We analyse how different substances are positioned as tools for achieving enhancement or self-improvement goals. RESULTS We identify three distinct discursive repertoires that frame substance use as enhancement: the discourse of transformation, the discourse of healing and the discourse of productivity. When accounting for enhancement substance use, our participants employ a number of discursive strategies, including ideological polarisation or 'othering', analogies, examples, maxims, metaphors and figurative speech. We also find evidence of interdiscursivity with most participants drawing on more than one discourse when speaking about how substances are positioned as providing enhancement. CONCLUSION We conclude that the concept of enhancement has wider applicability than current understandings allow. We argue that if we reframe all substance use as providing enhancement or achieving a self-improvement goal, we have the potential to destigmatise substance use and eliminate the over-simplistic binaries that surround it.
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Affiliation(s)
- Rebecca Askew
- Manchester Metropolitan University, Department of Sociology, All Saints Campus, Geoffrey Manton Building, Rosamond Street West, M15 6LL.
| | - Lisa Williams
- University of Manchester, Department of Criminology, School of Social Sciences, Williamson Building, Oxford Road, Manchester, M13 9PL
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Sultan A, Duff C. Assembling and diversifying social contexts of recovery. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 87:102979. [PMID: 33096366 DOI: 10.1016/j.drugpo.2020.102979] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 09/08/2020] [Accepted: 09/17/2020] [Indexed: 11/30/2022]
Abstract
Recovery from drug use is receiving increased attention in critical drug studies. Researchers point out the importance of scrutinizing the term and its meanings anew in order to better understand drug use treatment policies and their effects on the individuals they target. Informed by relational ontological thinking, this article analyses a series of empirical accounts of recovery experiences, and offers a critical assessment of the social contexts of recovery. Qualitative data collected in Azerbaijan and Germany provide distinctive reports of the differentiated experiences of youth as they make and re-make sense of their recovery within specific recovery contexts. Discussions reveal how recovery advances in relations between human and nonhuman actors including spaces, bodies, affects, and practices. On the basis of this analysis, we argue that recovery may be framed as an emergent and dynamic context that becomes with and from drug use.
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Affiliation(s)
- Aysel Sultan
- Postdoctoral researcher, University of Haifa, Minerva Center on Intersectionality in Aging, Haifa, Israel; Frankfurt University of Applied Sciences, Institute for Addiction Research, Frankfurt, Germany.
| | - Cameron Duff
- Associate Professor, Fellow, Future Social Services Institute, College of Business and Law, RMIT University, Melbourne, Australia
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Critical studies of harm reduction: Overdose response in uncertain political times. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 76:102615. [PMID: 31837567 DOI: 10.1016/j.drugpo.2019.102615] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 11/14/2019] [Accepted: 12/02/2019] [Indexed: 12/20/2022]
Abstract
North America continues to witness escalating rates of opioid overdose deaths. Scale-up of existing and innovative life-saving services - such as overdose prevention sites (OPS) as well as sanctioned and unsanctioned supervised consumption sites - is urgently needed. Is there a place for critical theory-informed studies of harm reduction during times of drug policy failures and overdose crisis? There are different approaches to consider from the critical literature, such as those that, for example, interrogate the basic principles of harm reduction or those that critique the lack of pleasure in the discourses surrounding drug use. Influenced by such work, we examine the development of OPS in Canada, with a focus on recent experiences from the province of Ontario, as an important example of the impacts associated with moving from grassroots harm reduction to institutionalised policy and practice. Services appear to be most innovative, dynamic, and inclusive when people with lived experience, allies, and service providers are directly responding to fast-changing drug use patterns and crises on the ground, before services become formally bureaucratised. We suggest a continuing need to both critically theorise harm reduction and to build strong community relationships in harm reduction work, in efforts to overcome political moves that impede collaboration with and inclusiveness of people who use drugs.
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Kiepek N, Van de Ven K, Dunn M, Forlini C. Seeking legitimacy for broad understandings of substance use. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 73:58-63. [DOI: 10.1016/j.drugpo.2019.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 04/04/2019] [Accepted: 07/02/2019] [Indexed: 12/27/2022]
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Pleasure and HIV biomedical discourse: The structuring of sexual and drug-related risks for gay and bisexual men who Party-n-Play. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 74:181-190. [PMID: 31627160 DOI: 10.1016/j.drugpo.2019.09.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/21/2019] [Accepted: 09/23/2019] [Indexed: 11/23/2022]
Abstract
Party-n-Play (PNP) is a social practice that refers to sex that occurs under the influence of drugs. This study critically examined the risk and pleasure discourses of gay and bisexual men who PNP to explore how epistemic shifts associated with advancements in HIV biomedical sciences influence gay and bisexual men's perceptions of HIV risks and their sexual and drug-related practices. This study also aims to provide a more nuanced understanding of how sexual and drug-related risk practices of gay and bisexual men are entangled with their search for pleasure. The study was framed within poststructural Critical Discourse Analysis (CDA) methodology. In-depth one-hour interviews were conducted with 44 self-identified gay, bisexual, queer, or Two-Spirit men, who lived in Toronto, and who reported using drugs before or during sex with another man. The findings from this study demonstrated the capacity of biomedical discourses to affect respondents' HIV risk perceptions and practices. The transition from condom-centered prevention to today's context where new highly effective biomedical tools for HIV prevention are available created possibilities for greater intimacy, increased pleasure, and less anxiety about HIV tranmission, while challenging many years of preventive socialization among gay and bisexual men. However, this new context also rekindled deep-seated fears about HIV risk and viral load verifiability, reinforced unequal forms of biomedical self-governance and citizenship, and reproduced practices of biopolitics. While discourses on risk and pleasure were interwoven within complex PNP assemblages, the notion of pleasure was mobilized as a discursive tactic of self-control, and the division between normative and non-normative pleasures highlighted the consequence of biopolitical forces governing the production of discourses on sex and drugs. Future HIV social science research needs to attend to the fluid nature of the discursive environments of HIV prevention science, and consider how both the material context of PNP and its social/discursive elements operate together.
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