Moral Panic Over Meth

‘Making Ground’: An Ethnography of ‘Living With’ Harmful Methamphetamine Use and the Plurality of Recovery

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.

Drug Use During Pregnancy Policies in the United States From 1970 to 2016

As U.S. states legalize marijuana and as governmental attention is paid to the “opioid crisis,” state policies pertaining to drug use during pregnancy are increasingly important. Little is known about the scope of state policies targeting drug use during pregnancy, how they have evolved, and how they compare to alcohol use during pregnancy policies.

Method:

Our 46-year original data set of statutes and regulations in U.S. states covers the entirety of state-level legislation in this policy domain. Data were obtained through original legal research and from the National Institute on Alcohol Abuse and Alcoholism’s Alcohol Policy Information System. Policies were analyzed individually as well as by classification as punitive toward or supportive of women.

Results:

The number of states with drug use during pregnancy policies has increased from 1 in 1974 to 43 in 2016. Policies started as punitive. By the mid- to late 1980s, supportive policies emerged, and mixed policy environments dominated in the 2000s. Overall, drug/pregnancy policy environments have become less supportive over time. Comparisons of drug laws to alcohol laws show that the policy trajectories started in opposite directions, but by 2016, the results were the same: Punitive policies were more prevalent than supportive policies across states. Moreover, there is a great deal of overlap between drug use during pregnancy policies and alcohol/pregnancy policies.

Conclusion:

This study breaks new ground. More studies are needed that explore the effects of these policies on alcohol and other drug use by pregnant women and on birth outcomes.

Framing the Danger of Designer Drugs

Media reporting of drug issues has important ramifications for public opinion of drugs and drug trends. This study was conducted to examine the media coverage of a specific new subcategory of drugs, so-called “designer drugs,” using coverage of a highly publicized attack in Miami as a case study. Broadcast news transcripts were analyzed to both identify themes in coverage of this attack and contextualize this reporting in the clinical literature on bath salts, the drug implicated in the attack. Textual analysis of broadcast coverage produced four major emergent themes: (1) vivid and sensational descriptions of the attack and of the effects of the drug, (2) discussion of bath salts use as an “epidemic,” (3) appeals to tighten legislation related to bath salts, and (4) silence on issues related to mental health. In addition, media reporting of this attack did not take into account potentially salient sources of information such as clinical research on rates of use and commonly reported behavioral effects of the drug to place bath salts use in context of this literature. Together, these findings suggest that media coverage of the Miami Zombie Attack framed a novel drug in incomplete and problematic terms. These framing choices dramatically underrepresented the role of mental health in the attack and led to inadequately informed health legislation.

Survival Tactics and Strategies of Methamphetamine-Using HIV-Positive Men Who Have Sex with Men in San Diego

In this article, two ways that HIV-positive drug users survive under the supervision of law enforcement agencies, community health organizations, and social welfare offices are differentiated. First, strategies are long-ranging and often carefully planned, and they involve conscious utilization and manipulation of bureaucratic processes. Second, tactics are short-ranging and often haphazard, and they are used to survive on daily or weekly bases, with entrenched problems and structural solutions avoided or ignored. Data from three years of ethnographic fieldwork with 14 methamphetamine-using HIV-positive men who have sex with men in San Diego, California is used to expand upon these two categories, explaining the different, often ineffectual, ways these men accessed care, services, shelter, drugs, and companionship. This article also examines the policy implications of taking in consideration these different kinds of survival methods, arguing for intensive client-specific interventions when working with long-term addicts with multiple health problems.

“Meth’s Not My Cup of Tea”

Recent media portrayals of methamphetamine (meth) suggest that its use is relatively rare among Black drug users. Our aim with the current research is to explore the reasons why Black women stimulant users abstain from using meth. We rely on semi-structured interviews with 33 Black women whose drug of choice was cocaine and who had never or rarely used meth. These women said that they did not use meth because they had limited access to the drug, feared the chemicals used in production, disliked the immediate sensations, and feared the long-term consequences on their health. The limited access to meth led these stimulant users to rely on stereotypes of meth that the drug is made from toxic materials and that it causes rapid deterioration in users’ appearances. We argue that these factors contribute to meth use being stigmatized in Black communities, thereby acting as a protective factor in discouraging use among Black stimulant users.

“The Meth Factor”: Group Membership, Information Management, and the Navigation of Stigma

Methamphetamine (or “meth”), a central nervous system stimulant, has been constructed as a dangerous drug with certain and extreme consequences. Incomplete and sometimes inaccurate portrayals, while aimed at preventing the initiation of use, stigmatize those who do use. Using data from in-depth, qualitative interviews with eight Northern Colorado women who are active meth users, this article explores how female meth users navigate this stigma through negotiation of group membership and management of information. The women in this study internalize and challenge the stigma: They identify as meth users and addicts yet view their own practices as distinguishing them from other users; and, they carefully control the extent to which they tell others of their use, even when contradictory to their sense of self and desirable relationships. These findings support the need for increased recognition and further examination of the role and enactment of agency among drug users and other oppressed groups.

Moral Panics and Morality Policy

The United States recently focused on the methamphetamine “epidemic,” but little research has examined policies resulting from this increased attention. This study explores influences of state-level methamphetamine legislation during 2000-2007, with the goals of understanding themes of legislative responses, and assessing political, social, and media-related predictors on legislation. Nine themes of methamphetamine legislation were identified through a legal database: pharmacy precursor regulations, precursor sentencing, manufacturing/trafficking, possession, research/task force, prevention or treatment, law enforcement, environmental cleanup, and child protection. Logistic regression results largely support the moral panic literature by finding media’s influence and methamphetamine manufacturing on legislation. Findings also suggest that law enforcement agencies participate in constructing the drug problem, which then drives legislation. Moreover, the drug problem is defined in terms of methamphetamine manufacturing rather than use and treatment, which are largely nonsignificant. Surprisingly, conservative political ideology predicted decreased legislation, suggesting that liberal candidates also raise concerns over methamphetamine.

Enacting multiple methamphetamines: the ontological politics of public discourse and consumer accounts of a drug and its effects

Over the last decade in Australia, methamphetamine has come to be seen as a significant issue for drug research, policy and practice. Concerns have been expressed over its potency, the increasing prevalence of its use and its potential for producing greater levels, and more severe forms, of harm compared to amphetamine or other drugs. In this article, we critically examine some of the ways in which methamphetamine and its effects are produced and reproduced within and through Australian public discourse, focusing in particular on the associations made between methamphetamine and psychosis. We show how public discourse enacts methamphetamine as an anterior, stable, singular and definite object routinely linked to the severe psychological 'harm' of psychosis. We contrast the enactment of methamphetamine within public discourse with how methamphetamine is enacted by consumers of the drug. In their accounts, consumers perform different methamphetamine objects and offer different interpretations of the relationships of these objects to psychological problems and of the ontological nature (i.e. relating to what is real, what is, what exists) of these problems. In examining public discourse and consumer accounts, we challenge conventional ontological understandings of methamphetamine as anterior, singular, stable and definite, and of its psychological effects as indicative of pathology. In line with recent critical social research on drugs, we draw on social studies of science and technology that focus on the performativity of scientific knowledge and material practices. We suggest that recognising the ontological contingency, and therefore the multiplicity, of methamphetamine offers a critical counterpoint to conventional research, policy and practice accounts of methamphetamine and its psychological effects.

The OxyContin crisis: problematisation and responsibilisation strategies in addiction, pain, and general medicine journals

BACKGROUND

OxyContin(®) (Purdue Pharma, L.P., Stamford, CT) is now widely regarded as a drug of abuse fueling a larger opioid health crisis. While coverage in the North American press about OxyContin overwhelmingly focused upon the problems of related crime and addiction/misuse and the perspectives of law enforcement officials and police, coverage in those fields of medicine most intimately concerned with OxyContin-pain medicine and addiction medicine-was more nuanced.

METHODS

In this article, we draw upon the constructivist social problems tradition and Hunt's theory of moral regulation in a qualitative analysis of 24 medical journal articles. We compare and contrast pain medicine and addiction medicine representations of the OxyContin problem, the agents responsible for it, and proposed solutions.

RESULTS

While there are some significant differences, particularly concerning the nature of the problem and the agents responsible for it, both pain medicine and addiction medicine authors 'take responsibility' in ways that attempt to mitigate the potential appropriation of the issue by law enforcement and regulatory agencies.

CONCLUSIONS

The responses of pain medicine and addiction medicine journal articles represent strategic moves to recapture lost credibility, to retain client populations and tools necessary to their jobs, and to claim a seat at the table in responding to the OxyContin crisis.