Injecting ATS/NPS use and drug abjection in Romania

Drugs and Alcohol Today, 2021

This paper explores multiple problematisation processes through a former needle exchange programme run by Kék Pont (a nongovernmental organisation) in the 8th district of Budapest. By presenting a collage of ethnographic stories, we attempt to preserve tacit knowledges associated with the programme and thereby keep its office alive as a ‘drug place’, the operation of which was made impossible in 2014. Drawing on the insights of Foucauldian governmentality studies and Actor-Network Theory, this paper focuses on drug use as a problem in its spatial-material settings. Based on ethnographic fieldwork, our contribution traces multiple problematisation processes and related infrastructures. From the needle exchange programme’s perspective, drug use is not a singular problem but the effect of multiple problematisation processes. Although those processes are often in conflict with each other, the question is not which one is right, but how social workers manage to hold them together. It is a fragile achievement that requires years of training and ongoing negotiation with local actors. By eliminating Kék Pont’s 8th district office, the Hungarian Government did not only hinder harm reduction in the area; it had also rendered tacit knowledges associated with the needle exchange programme as a ‘drug place’ inaccessible. Our paper is a melancholy intervention – an attempt to preserve tacit knowledges that had accumulated at the needle exchange programme. Our retelling of ethnographic stories about this ‘drug place’ is our way of ensuring that other drug policies remain imaginable.

Addiction Research & Theory, 2008

This article reports on the ethnographical study carried out among an opiate consumer community in Barcelona (Spain) and analyses the meanings that those consumers build and handle around the substances that they consume. Our approach emphasises the point of view of the consumers in their understanding of drugs and the type of relationships that they maintain between themselves and with their social environment.

Drugs: Education, Prevention and Policy, 2016

Aims-To understand how perceived law enforcement policies and practices contribute to the low rates of utilization of opioid agonist therapies (OAT) among people who inject drugs (PWIDs) in Ukraine. Methods-Qualitative data from 25 focus groups (FGs) with 199 opioid-dependent PWIDs in Ukraine examined domains related to lived or learned experiences with OAT, police, arrest, incarceration, and criminal activity were analyzed using grounded theory principles. Findings-Most participants were male (66%), in their late 30s, and previously incarcerated (85%) mainly for drug-related activities. When imprisoned, PWIDs perceived themselves as being "addiction-free". After prison-release, the confluence of police surveillance, societal stress contributed to participants' drug use relapse, perpetuating a cycle of searching for money and drugs, followed by re-arrest and re-incarceration. Fear of police and arrest both facilitated OAT entry and simultaneously contributed to avoiding OAT since system-level requirements identified OAT clients as targets for police harassment. OAT represents an evidence-based option to 'break the cycle', however, law enforcement practices still thwart OAT capacity to improve individual and public health. Conclusion-In the absence of structural changes in law enforcement policies and practices in Ukraine, PWIDs will continue to avoid OAT and perpetuate the addiction cycle with high imprisonment rates.

This chapter offers a short history of ‘drugs’ as a policy object and a governance tool that reveals some of the contradictions behind the emergence of modern capitalism in the liberal age. It situates the freedom-addiction binary at the foundation of moralising prohibition discourses and the ideal of the ‘drug-free world’. It emphasises the preservation of the choice-making liberal self as the main function of the medico-legal institutional assemblages designed to monitor and control the non-therapeutic consumption and distribution of psychoactive agents. It further seeks to follow this paradigm in the scientific field by knocking at the door of a ‘science of intoxication’ that predominantly understands and explains habits of substance use as deviant paths of flawed minds and bodies. This is weighed against sociological and ethnographic accounts that challenge pathological definitions of addiction by placing drugs at the core of culturally meaningful lifestyles and power relations. Finally, this first chapter looks at harm-reduction, the main reform movement that challenges the ‘war on drugs’ by invoking ideals of pragmatic public health provision. If prohibition discourses are thus critiqued for restricting human freedom, contrary to the ideals they were meant to serve, harm-reduction is also critiqued for its risk management ethos that positions ‘problematic users’ as crippled rational subjects. NB: This extract from my doctoral thesis can be used and referenced as an introductory literature review to the field of critical drug studies.

Journal of Social Work Practice, 2011

This qualitative study analyses the construction of a subject who uses drugs (injected drugs) so as to offer psychosocial proposals for social healthcare interventions within this collective, and thereby contribute to social healthcare policies that optimise treatment for drug use. The results indicate that identity is connected to positions that are activated in interactions and relationships between users and professionals in various day-to-day contexts of healthcare and treatment. We have labelled these activated positions: therapeutic, drug-sensory, consumerist, legal-repressive and group-community. Understanding them provides clues that may improve interventions in health and legal contexts. These clues include understanding the tensions between the subject and the substance, considering the stigmatised image and identity, and supporting the idea of the existence of dilemmas in users and professionals, as this may allow transformations to occur in the mutual relationships that are established.

2012

Harm Reduction Journal

Background This study examines the use of new psychoactive substances (NPS) and the harm reduction response in six Eurasian countries: Belarus, Moldova, Serbia, Kazakhstan, Kyrgyzstan, and Georgia. The aim is to identify current patterns of NPS use and related harms in each country through recording the perspectives and lived experience of people who use drugs and people who provide harm reduction services in order to inform the harm reduction response. Methodology The study involved desk-based research and semi-structured interviews/focus groups with 124 people who use drugs and 55 health and harm reduction service providers across the six countries. Results People who use drugs in all countries were aware of NPS, primarily synthetic cathinones and synthetic cannabinoids. NPS users generally reflected two groups: those with no prior history of illicit drug use (typically younger people) and those who used NPS on an occasional or regular basis due to the lack of availability of thei...

Critical Public Health, 2017

Since the 1980s, the primary public health response to injecting drug use in the UK has been one of harm reduction. That is, reducing the harms associated with drug use without necessarily reducing consumption itself. Rooted in a post-Enlightenment idea of rationalism, interventions are premised on the rational individual who, given the right means, will choose to avoid harm. This lies in stark contrast to dominant addiction models that pervade popular images of the 'out of control' drug user, or worse, 'junkie'. Whilst harm reduction has undoubtedly had vast successes, including challenging the otherwise pathologising and often stigmatising model of addiction, I argue that it has not gone far enough in addressing aspects of drug use that go beyond 'rational' and 'human' control. Drawing on my doctoral research with people who inject drugs, conducted in London, UK, this paper highlights the role of the injecting 'event', which far from being directed or controlled by a pre-defined individual or 'body' was composed by a fragile assemblage of bodies, human and nonhuman. Furthermore, in line with the 'event's' heterogeneous and precarious make-up, multiple ways of 'becoming' through these events were possible. I look here at these 'becomings' as both stabilising and destabilising ways of being in the world, and argue that we need to pay closer attention to these events and what people are actually in the process of becoming in order to enact more accountable and 'response-able' harm reduction.

This paper uses the UK as a vehicle through which to argue that a dominant reductionist drugs discourse exists which simplifies understandings of drug use and drug users leading to socio-cultural misrepresentations of harm, risk and dangerousness. It contends that at the centre of this discourse lies the process of othering - the identification of specific substances and substance users as a threat to UK society. Interestingly, within the wider context of global drug policy reform this othering process appears to be expanding to target a wider variety of factors and actors - those policies, research findings and individuals which contest normative notions, resulting in the marginalisation of ‘alternative voices’ which question the entrenched assumptions associated with drug prohibition. The paper concludes that there is a need for collective action by critical scholars to move beyond the other, calling for academics to be innovative in their research agendas, creative in their dissemination of knowledge and resolute despite the threat of being othered themselves.