Staying Together No Matter What: Becoming Young Parents on the Streets of Vancouver

Among young people who use drugs in the context of entrenched poverty and homelessness, pregnancy is often viewed as an event that can meaningfully change the trajectory of their lives. However, youth's desires and decision-making do not always align with the perspectives of various professionals and systems regarding how best to intervene during pregnancies and early parenting. Drawing on longitudinal interviews and fieldwork with young people in Vancouver, Canada, we explore how their romantic relationships powerfully shaped understandings of what was right and wrong and which actions to take during pregnancy and early parenting, and how these moral worlds frequently clashed with the imperatives of healthcare, criminal justice, and child protection systems. We demonstrate how a disjuncture between youth's desires, decision-making and moralities, and the systems that are intended to help them, can further entrench young people in cycles of loss, defeat, and harm. These cycles are powerfully racialized for young Indigenous people in our context.

Improving understandings of trauma and alcohol and other drug-related problems: A social research agenda

Trauma is increasingly understood to shape a range of alcohol and other drug (AOD)-related problems, including addiction, relapse, mental illness and overdose. However, the merits of understanding AOD-related problems as the effect of trauma are uncertain with the nature and implications of such linkages requiring closer scrutiny. Where trauma is linked to AOD-related problems, this relationship is typically treated as self-evident, obscuring the uncertainties in knowledge surrounding the notion of trauma itself. Informed by insights from critical drugs and trauma scholarship that challenge deterministic notions of AOD 'problems' and trauma, this essay identifies key issues for social research in this area that warrant further consideration. We argue that there is a pressing need to acknowledge variation and diversity in the relationship between trauma and AOD-related problems, and the gendered and sexual dynamics shaping the expansion of the trauma paradigm. We then outline how critical Indigenist interdisciplinary work can inform culturally specific knowledge on trauma and AOD-related problems, and also suggest targeted research on the delivery and experience of trauma-informed approaches in the AOD context. To this end, we present several recommendations for a social research agenda underpinned by critical, qualitative research into how people experience and manage trauma and AOD-related problems in their everyday lives.

Self-interpellation in narratives about craving: Multiple and unitary selves

The concept of addiction seeks to explain why people act contrary to their own best interest. At the centre stage of addiction discourse is craving, conceptualised as a strong urge to use substances. This article analyses how talk therapies such as relapse prevention and self-help groups shape identity constructions and understandings of craving among clients. Drawing upon interviews with individuals who have engaged in talk therapies in Sweden, we analyse how craving is made up through 'self-interpellation', that is, personal narratives about past, present or future thoughts, feelings and actions. The main 'self-interpellation' included multiple selves, where craving was elided by the true self and only felt by the inauthentic self. Less dominant were narratives which drew on a unitary self that remained stable over time and had to fight craving. The notion of multiple selves appeared as a master narrative that the participants were positioned by in their identity constructions. We conclude that this multiplicity seems ontologically demanding for people who try to recover from substance use problems. A demystification of craving, in which neither substance effects nor malfunctioning brains are blamed for seemingly irrational thoughts and actions, may reduce the stigmatisation of those who have developed habitual substance use.

A matter of craving-An archeology of relapse prevention in Swedish addiction treatment

This article concerns how craving is approached and handled, how it is 'made up', in the practice of so-called relapse prevention (RP) for addiction problems. There is a lack of research on what RP in general, and craving in particular, 'is' and can become across settings. Drawing upon science and technology studies (STS) and critical addiction research, we analyze how craving is enacted in manuals and training material related to the intervention, and in interviews with professionals in the Swedish treatment system. Adopting an archeological approach, we scrutinize different layers of craving enactments in RP, in search of assumptions that give rise to what John Law refers to as 'collateral realities'. We identified three collateral realities: 1) 'The materialization of craving'; 2) 'The transcendence of the individual' and 3) 'The merging of treatment and everyday life' The data show that the brain, cognition, emotions and behavior are enacted in RP as demarcated targets of intervention that the individual can transcend and control. This approach, in turn, relies on the more foundational tenet that there are no clear-cut boundaries between different identities (I/me/self; body/brain/cognition), between different settings (inside/outside treatment; real/imagined situations) or between different points in time (now/then/before). We discuss the relevance and usefulness of addiction treatment realities where craving is approached as a stable object that can be effectively treated, and where interventions inaugurate neoliberal governance of responsibilized individuals.

Visualizing a Calculus of Recovery: Calibrating Relations in an Opioid Epicenter

This article uses participatory photography to explore the relationships animating efforts towards recovery from opioid use disorder (OUD) in the Dayton, Ohio area, an epicenter of illicit opioid use and overdose death. A photo-elicitation project was conducted with thirteen people who met the DSM-5 criteria for OUD. Photographs were used as prompts during qualitative interviews, which were thematically analyzed. Analysis of both visual and textual data demonstrated the ways in which recovery became an unfolding process of calculation as participants made strategic choices to navigate relations and encounters with things, people, and places. Relationships across each of these domains could, under some circumstances, serve as supports or motivators in the recovery process, but, in alternate settings, be experienced as "triggers" prompting a resumption of problematic drug use or, at the very least, a reckoning with the feelings and emotions associated with painful or problematic aspects of personal histories and drug use experiences. Findings highlight the importance of understanding recovery as a calibration of the ambiguous relations animating experiences of everyday life. We argue for continued emphasis on recovery as an active performance and ongoing practice of calculation-of risks and benefits, of supports and triggers, of gratification and heartbreak-rather than a goal or static state.

Placing precarity: access and belonging in the shifting landscape of UK mental health care

This paper engages with the notion of 'embodied belonging' through an ethnography of the social and material aspects of accessing mental health care in the UK. I focus on moments of access and transition in a voluntary sector organisation in London: an intercultural psychotherapy centre, serving a range of im/migrant communities. Whilst both 'belonging' and 'place' are often invoked to imply stability, I explore how material contexts of access and inclusion can paradoxically be implicated in the ongoing production of precarity-of unstable, uncertain, and vulnerable ways of being. A sociomaterial analysis of ethnographic material and visual data from two creative mapping interviews attends to material and spatial aspects of the centre and its transitory place in the urban environment. It demonstrates how these aspects of place became entangled in client experiences of access: uncertainties of waiting, ambivalence towards belonging to a particular client group, and questions around deservingness of care. This engendered an embodied and situated experience of 'precarious belonging'. I therefore argue that precarity should be 'placed', both within the concept of embodied belonging, and ethnographically, within the material constraints, impermanence, and spatial politics of projects to include the excluded in UK mental health care.

Mapping the Drugged Body: Telling Different Kinds of Drug-using Stories

Drugged bodies are commonly depicted as passive, suffering and abject, which makes it hard for them to be known in other ways. Wanting to get closer to these alternative bodies and their resourcefulness for living, I turned to body-mapping as an inventive method for telling different kinds of drug-using stories. Drawing on a research project with people who inject heroin and crack cocaine in London, UK, I employed body-mapping as a way of studying drugged bodies in their relation to others, human and non-human, in the injecting event. I invited participants to draw their bodies in describing these otherwise hard-to-articulate experiences. Following Donna Haraway, I conceptualise body-mapping as a more-than-human mode of storytelling where different kinds of bodies can be known. Here, I look at three such bodies - sensing-bodies, temporal-bodies and environment-bodies - and argue that it is through being able to respond to such bodies that more hospitable ways of living with drugs can become possible.

Connections built and broken: The ontologies of relapse

'Relapse prevention' has become a familiar concept and practice for those engaged with drug treatment services. The ways that 'relapse prevention' is currently practised and talked about departs primarily from research produced within the discipline of psychology, and especially by researchers and practitioners adopting cognitive behavioural (Marlatt & Donovan, 2005; Witkiewitz & Marlatt, 2009) and neurocognitive approaches (Tapert et al., 2004). The outcome has been the production of 'tools' and 'mechanisms', put in place to 'prevent' people from relapsing. This way of thinking about relapse has generated the assumption that once access to these 'tools' has been granted, relapse becomes a problem of the individual, a personal 'success' or 'failure', depending on how these tools are used, a measurement of how much one 'really' wants to recover. This system of thought reproduces longstanding discourses of blame against AOD users and fuels the discussion on the 'revolving doors' of recovery (White & Kelly, 2010), holding treatment services accountable for 'failing' to produce and maintain 'recovered' bodies. In this paper my aim is to challenge the production of relapse as a 'threat' and to rethink it as a desire to connect, a desire that can be either enhanced, or broken. Drawing on empirical data produced in two recovery services, one in Liverpool (UK) and one in Athens (Greece), analysed through a Deleuzo-Guattarian system of thought, I discuss relapse in two different ways: (a) as part of the temporality of recovery, a way to start building connections with services; as the expression of an emerging desire under exploration, and(b) as the consequence of broken and interrupted connections when policy fails to support the encounters emerging in the recovery space, disrupting thus the recovery process.

The becoming-methadone-body: on the onto-politics of health intervention translations

In this paper, we reflect on health intervention translations as matters of their implementation practices. Our case is methadone treatment, an intervention promoted globally for treating opioid dependence and preventing HIV among people who inject drugs. Tracing methadone's translations in high-security prisons in the Kyrgyz Republic, we notice the multiple methadones made possible, what these afford, and the onto-political effects they make. We work with the idea of the 'becoming-methadone-body' to trace the making-up of methadone treatment and its effects as an intra-action of human and nonhuman substances and bodies. Methadone's embodied effects flow beyond the mere psycho-activity of substances incorporating individual bodies, to material highs and lows incorporating the governing practices of prisoner society. The methadone-in-practice of prisoner society is altogether different to that imagined as being in translation as an intervention of HIV prevention and opioid treatment, and has material agency as a practice of societal governance. Heroin also emerges as an actor in these relations. Our analysis troubles practices of 'evidence-based' intervention and 'implementation science' in the health field, by arguing for a move towards 'evidence-making' intervention approaches. Noticing the onto-politics of health intervention translations invites speculation on how intervening might be done differently.

Making problems: The inventive potential of the arts for alcohol and other drug research

The arts and arts-based methods are rare in critical studies of alcohol and other drugs. This article explores the potential role of the arts for allowing alcohol and other drug problems to develop in more collaborative (with participants, broadly conceived) and thus more generative ways. Following turns in the field toward the performativity of alcohol and other drug realities, this article instead asks: what happens if we take the 'experimentality of social life' (Marres, Guggenheim & Wilkie, 2018) as our starting point for research rather than our object? That is to say, how can we work with our already inventive alcohol and other drug worlds to know and intervene with them in closer, more intimate ways? Through ethnographic engagement with a community theatre group for people who identify has having experiences of dependency or addiction, the article looks at how they 'set up' and 'stage' the problem they seek to research and enact through embodied, sensorial and relational modes of knowing that are created speculatively together and with the audience and environment. As we now accept that our methods in critical drug studies are entwined with the realities they make, this article intends to awaken our methodological imagination and attentiveness to the arts as the discipline that has always made things to know things, in order to enable problems to not only be known in new ways but to emerge in new ways.

Drug dog affects: Accounting for the broad social, emotional and health impacts of general drug detection dog operations in Australia

BACKGROUND

Drug detection dogs are increasingly being deployed by policing agencies in Australia and elsewhere to home in on people carrying illicit drugs in a broad range of social contexts including at music festivals, on public transport and in a range of everyday urban spaces. Significant concerns have been raised about their limited deterrence and detection efficacy and tendency to increase drug-related health harms including overdose. Yet the complex ways in which these effects play out, and the broader impacts they have on social and emotional wellbeing, are not yet well documented. This study builds on a growing body of poststructural critical drug studies research to explore the complex social, emotional and health impacts of drug dog use in these broad social contexts.

METHODS

Semi-structured in-depth interviews were conducted with 22 people who had been searched by drug detection dogs at or near music festivals and events, licensed venues and public transport spaces in Australia. Participants were asked about their experiences of being searched, how it impacted upon them in the short and long term, and how it shaped their drug use behaviours, sense of self and social relations, including relations with police.

RESULTS

This study supports previous findings that these drug dog operations do not tend to deter people from consuming illicit substances, but instead encourage a range of adaptations that increase the likelihood of health harms including overdose. The rationalities underpinning responses to drug dogs, and the impacts of those responses, are shown to be deeply spatial, temporal, social and embodied. More specifically, drug dog deployment is shown to have significant short and long term impacts on social and emotional wellbeing and can produce deep embodied trauma.

CONCLUSION

These findings suggest that the use of drug dogs in these broad social contexts is based on untenable assumptions about the rationalities of deterrence, is producing substantial harm without evidence of benefit, and should be urgently reconsidered.

Psychedelic pleasures: An affective understanding of the joys of tripping

BACKGROUND

This paper considers the pleasures of psychedelic drugs and proposes a Deleuzian understanding of drugged pleasures as affects. In spite of a large body of work on psychedelics, not least on their therapeutic potentials, the literature is almost completely devoid of discussions of the recreational practices and pleasures of entheogenic drugs. Yet, most people do not use psychedelics because of their curative powers, but because they are fun and enjoyable ways to alter the experience of reality.

METHODS

In the analytical part of the paper, I examine 100 trip reports from an internet forum in order to explore the pleasures of tripping.

RESULTS

The analyses map out how drugs such as LSD and mushrooms - in combination with contextual factors such as other people, music and nature - give rise to a set of affective modifications of the drug user's capacities to feel, sense and act.

CONCLUSION

In conclusion it is argued that taking seriously the large group of recreational users of hallucinogens is important not only because it broadens our understanding of how entheogenic drugs work in different bodies and settings, but also because it may enable a more productive and harm reductive transmission of knowledge between the scientific and recreational psychedelic communities.

Risky pleasures and drugged assemblages: Young people's consumption practices of AOD in Madrid

BACKGROUND

Drawing on a research project that we carried out on the functionality of "excessive" consumption practices in the lifestyles of young people in Madrid, this article aims to understand how (dis)pleasurable states emerge during young people's consumption of alcohol and other drugs.

METHODS

This article claims that these states derive from "drugged assemblages," that is, a set of (human and non-human) actants that intra-act to produce different effects. Although pleasure can be one of these effects, it is not always guaranteed: consumption practices are assemblages that fluctuate between pleasure and displeasure, and the former can be reached or not depending on the characteristics acquired by the assemblage. It is this fluctuation that makes pleasures "risky." Drugged assemblages also configure and are configured by specific spatial-temporal and material apparatuses or dispositifs. We will analyse botellones, night-clubs and raves as examples of this kind of dispositif, focusing on how they work as a holistic frame where drugged assemblages emerge.

RESULTS

Finally, we will focus on the different strategies and practices that young people, in constant intra-action with other agencies, develop in order to achieve and keep a "controlled loss of control" within the limits and potentials offered by these contexts, in a constant effort to avoid the risks that may result from the blurred line that divides pleasure and displeasure.

CONCLUSION

In this sense, we will argue that, despite the criticisms it has received, it is possible to make Measham's concept of "controlled loss of control" compatible with a post-humanist theoretical framework.