- People who experience oppression, marginalization, criminalization, vulnerabilization, and vilification, are frequently discussed by the bureaucrats who are paid to manage them, the researchers who are paid to study them, and the social services who are funded to better them.
- All of these people—the bureaucrats, researchers, and social service workers—operate under the more-or-less sincere belief that they approach the populations they manage, the cases they study, and the clients they support, in a caring manner.
- Because of this, the people doing the talking are always coming up with new ways to talk about people that appear to be more sensitive or woke or humanizing, and less judgemental or derogatory. However, because the oppression, marginalization, criminalization, vulnerabilization, and vilification all continue despite the deployment of new labels, stigmas and biases then attach themselves to new seemingly-more-value-neutral terms. This cycle creates an ever-expanding market for new terms.
- Folks like Peter Conrad and Joseph Schneider have tracked some of this in their explorations of how hegemonic social discourses moved from speaking about deviance to speaking in medical terms in the mid-to-late twentieth century. Things previously considered badness under the Christian morality that dominated Canadian society were rebranded as sickness in the post-Christian secular state. Thus, the immoral, vice-ridden sinner was rebranded as the “alcoholic” and the same became true of the “drug addict.”
- The transition from the language of sin and vice to the language of addiction resonated a great deal with kind-hearted people who were trying to emphasize the human dignity and worth of the people they cared for and about. Instead of being a value judgment about a person’s character, addiction became a medical condition requiring the same kind of sensitive care and treatment as other medical conditions.
- However, the medicalization of deviance was, simultaneously, the medicalization of social control. The transition from Christianity to secularism (ever-always an incomplete transition and one that may yet prove to be a temporary blip in Western statecraft) created a crisis for state power. Previously, Christian morality provided the moral underpinnings required to justify the use of force on the bodies of those who were considered problematical to the trajectory of the racial-capitalist state. The police, and other violence workers of the state, were justified in using force upon deviant bodies. After Christendom, the discursive apparatus of health replaced that of Christianity to justify forcing those considered deviant (now sick or ill or addicted) to do what they did not want to do, to go where they did not want to go, and to be where they did not want to be.
- What vanishes from the now hegemonic dispositif of health is any kind of serious analysis of or engagement with oppression. Hence, also, its model of care lacks any truly liberatory praxis. I don’t want to overstate this—there is, of course, a continual process of subversion, co-optation, and hybridity (as per Homi Bhabha), taking place here. Nonetheless, it remains true that healthcare replaced Christianity as the moral discourse justifying the use of force on others, and the structures of oppression more generally, because it was more not less effective.
- As a result, the same stigma began to accumulate around the language of “addiction” and “the addict” that had previously accreted around the terms used to describe “sinners,” “boozehounds,” and “junkies.” Consequently, “addiction” language quickly and easily became the discourse deployed by carceral Christianity and the forces of state violence.
- As stated above (point #3), this inevitably occurs when people change their words but do not change their praxis. Social service organizations that have proven beneficial to maintaining the trajectory of the racial-capitalist status quo are particularly adept at constantly changing their language to reflect whatever cotemporary “evidence-based best practices” are trending—without modifying their polices, procedures, and actual practices in a meaningful way. Here, Gramsci’s notion of the “passive revolution” is relevant. Apparatuses are transformed due to pressure from below, but they are transformed in such a way that the power and priorities of the ruling classes are maintained or strengthened.
- Research into the dynamics of what we call “addiction” have highlighted how much of our response to “addiction,” is unhelpful or even actively harmful. We now know that “the opposite of addiction is connection,” that harm reduction approaches are more successful than abstinence-based programs, and so on.
- Therefore, instead of speaking about “drug addicts” or “drug addiction,” a lot of healthcare-oriented service providers began to use the language of “substance abuse.” This raises the odd philosophical question regarding if it is possible for a substance, like Adderall, to be “abused” but, more to the point, it still makes care-providers view the people they claim to care for as abusers. Consequently, healthcare providers now speak of “substance misuse” and “people who misuse substances.” They do this to try and avoid the not-so-subtle hint of moral condemnation that keeps creeping back into their language (because it turns out that a lot of what people thought was Christian morality is simply the bourgeois morality of racial capitalism).
- Speaking of “people who misuse substances” raises the not-so-easily answered ethical question of what counts as the proper use of a substance and inevitably requires us to examine the power dynamics that determine who has the authority to decide what counts as use or misuse (the violence workers of the state? The doctors who prescribe medications under the law? people with lived and living experience?).
- Is it misusing a substance to purchase and then smoke fentanyl because you have chronic pain and used to receive a prescription for Oxy-80s from your family doctor but now doctors will not prescribe narcotics like that for your pain and you have been flagged as “pill-seeking” because you continued to try and receive that medication (on which you now have a biochemical dependency—see point #18 below—which was created by a family doctor)?
- More to the point raised above (see point #10), is it misusing a substance to take it to soothe your pain and briefly experience the kind of comfort, reprieve, and feelings of self-confidence or belovedness you have not been able to experience anywhere else? Perhaps there is a cost to seeking a reprieve via that substance… but does that mean I am misusing that substance? After all, most everything under the regime of racial capitalism comes at a cost to us (something sex workers have continually reminded us about when they have highlighted how sex work is work).
- Therefore, care providers who are also more engaged with anti-oppressive practices (although see #7 above for how even this language is deployed in social services), have stopped using the language of “addiction” and instead speak of “self-soothing behaviours,” or “compulsively self-soothing behaviours.”
- At this point, it’s important to observe that we all engage in self-soothing behaviours and do so, more-or-less compulsively, depending on what other supports and avenues we have to being adequately soothed by other people or a diverse number of things or activities.
- To say that “the opposite of addiction is connection” is to highlight how much more compulsive our self-soothing becomes when we not only experience loneliness but are also abandoned by others—and most especially by those who should have cared for us or who explicitly profess to care for us (see point #2 above) but who fail to do so or who actively harm us instead.
- To highlight this now is not to take away from the fact that biochemical dependencies can develop in very material, embodied ways, in relation to what we refer to as “addiction.” However, the language of “addiction” is selectively employed in such matters. I do not, for example, speak about being addicted to my anti-depressant, although a biochemical dependency exists in relation to this chemical intervention. I am urged to take my medication regularly to (amongst other things) avoid a painful, difficult, and mentally distressing withdrawal process; but people “who take drugs” are said to be addicts in the throes of addiction because they, too, seek to maintain regular doses of their meds. In my case, regular use is mandated by a doctor. In the second case, the use is said to be a compulsive craving. Often, it should be noted, for the very same chemical.
- To this point, it is interesting when we speak of chemical interventions as “medications” and when we speak of them as “drugs” or, more generically, as “substances.” What often makes a chemical a “drug” instead of a “medication” is not the actual substance of the drug but whether it has been produced or acquired in a criminalized manner. For example, Adderall and Vyvanse, being virtually indistinguishable from crystal meth, are regularly acquired via both legal and criminalized channels. But if I get them from my doctor, I am taking medications. If I get them outside the Salvation Army, I am using drugs. Why are medications things that are “taken” but drugs are things that are “used”? I believe this subtle linguistic difference reveals a moral judgment.
- Furthermore, the study of how our biochemistry changes in relation to our compulsive forms of self-soothing tends to focus almost entirely on matters related to chemically-induced forms of self-soothing and have less to say about other forms (although diet may be an exception—we know, for example, that our gut microbiome can learn to crave high-fat and high-sugar foods—foods regularly consumed as a form of self-soothing—so that we, ourselves, end up craving more and more food of that sort once we eat a certain amount of it because the bacteria in our gut craves those foods and tells us to crave it, too).
- This is largely because some forms of compulsive self-soothing are socially accepted, sanctioned, and encouraged, while other forms are not. Workaholics, for example, are generally rewarded not only with wealth and power but also with high status. They accumulate both goods and goodness.
- In 2000, The Onion published an editorial with the headline, “I’m Like A Chocoholic, But For Booze,” and this satire succeeds, like other brilliant forms of satire, because it reveals something true that we often overlook.
- Whether or not a compulsive form of self-soothing is considered an “addiction,” has a lot to do with how that form of self-soothing impacts a person’s ability to function in ways that are deemed appropriate for them within the place they have inherited in racial capitalism.
- In fact, our society has a high tolerance for compulsive forms of self-soothing that may cause problems for someone in their personal life, but which don’t interfere with that person’s ability to contribute to, or not interfere with, the trajectory of our status quo. Workaholics and Chocoholics have already been mentioned (points 21 and 22 above), but one can also think of people who compulsively watch pornography, or “wine moms,” or hardcore fitness freaks, or, more generally, our cultural dependence on caffeine (capitalism makes me wake-up feeling like shit… caffeine helps me perk up and makes me more functional as a wage-labourer).
- Porn and alcohol are good examples that illustrate this point. Porn viewing, no matter how compulsive, is accepted if it doesn’t interfere with your work time and your ability to pay your bills. But if it interferes with those things, then it becomes an “addiction.” Same for drinking alcohol. Drink as much as you want, as long as you contribute to the system and don’t become dependent on the system. If you become dependent, well, now you’ve got a drinking problem.
- This is also why the very same drugs, even when they are criminalized, are treated very differently depending on if people who hoard wealth or if impoverished people use them. Rich people take massive amounts of cocaine but, for the most part, this does not interfere with their ability to accumulate capital and advance the trajectory of the status quo. However, when impoverished people take the same amount of cocaine, this can genuinely disrupt their ability to work for wages, pay their bills, and accumulate credit-debt via the designated channels. Thus, the police focus on impoverished cocaine use and the rich are, by and large, left alone.
- In other words, under racial capitalism, “substance misuse” or “addiction” more generally, is taken to be a form of compulsive self-soothing that interferes with one’s ability to perform the role one is expected to take in relation to one’s race, class, gender, ability, culture, and nationality.
- More specifically, “addiction” and “substance misuse” are labels that are applied liberally to forms of compulsive self-soothing that transform a person into a real or potential obstacle to the smooth functioning of the trajectory of the status quo of racial capitalism.
- This is part of the reason why, on the ground, people frequently choose to proudly claim labels that sensitive workers avoid. They recognize that the prettier sounding names that care providers give them are just masks covering the same old oppression. And so, just as feminists sometimes reclaim the “B” word and Black folks sometimes reclaim the “N” word, sometimes those whose medications or means of producing and procuring their medications have been criminalized, reclaim names like “junkie” or “crackhead,” or “waste case.”
- Ultimately, this reminds us, liberation is less about labels and more about praxis. Which isn’t to say that words don’t matter—words, after all make worlds—but if the world that those words are making or remaking is the exact same world that abandoned us to die in the first place, well, that’s a problem that we can’t just talk our way out of.
- In summary, the language of addiction (just like the language that came before and after it) is morally judgmental language deployed in an inconsistent, selective, and biased manner. It masquerades as a form of care but, in actual practice, further strengthens the hold of racial capitalism over our lives. But, just as the opposite of addiction is not abstinence but connection, so also the road to wellness is not recovery but liberation.
- A good first step on that road to liberation is decriminalization. As the Adderall/crystal meth example reminds us (see point #19 above), most of the harms we try to reduce in relation to “street drugs,” are produced not by the substances themselves, but by criminalization. This has also been demonstrated in countries that have decriminalized drugs that are criminalized in Canada (Switzerland, Portugal), and it has also been demonstrated in innumerable studies, including several that have taken place in Canada.
- The opposition to decriminalization, despite the overwhelming amount of evidence that supports it, reveals the extent to which “addiction science” and abstinence-based programs are still rooted in bourgeois Christian notions of “right” and “wrong.” The transition from “badness” to “sickness” (point #4 above), did not change anything fundamental about how oppressed people are treated, viewed by others, and made to feel about themselves. It did not change anything fundamental about how they are disciplined, punished, oppressed, and abandoned unto death.
- This abandonment unto death is explicitly encouraged in abstinence-based programs that deliberately withdraw support from people so that they can “hit rock bottom.” For many people, rock bottom is six feet underground in a pauper’s grave. This is a vivid example of how the language of care is applied to death-dealing practices.
- If our way of caring for people is killing them or exacerbating their suffering and contributing to them dying premature and preventable deaths, then we need to find other ways to care for people.
- If I am trying to understand how to engage in a truly liberatory praxis, then I need to understand why I think the way I do about morality, about ethical issues, and about what I consider to be “right” and “wrong,” “okay” and “not okay.”
- If I am trying to understand how to engage in a truly liberatory praxis, then I need to ask others (and myself!): What gives you life and affirms the life that is within you? What contributes to your sense of self-worth and belovedness? What eases your pain? What comforts you? What do you know that I don’t? (And what do I know that others don’t?) Where do you feel like you can relax? Where do you feel connection and belonging? Where do you feel at home? How have you been betrayed? What can I do that would make a meaningful difference to you? How can we get through this together?
- Asking these questions doesn’t mean I cede my own agency to others. It doesn’t mean I just agree with everything that anyone says to me. It doesn’t mean that I refuse to set any boundaries. It just means that I come to others with a genuine openness, with a transparency about my own values and preconceived notions, with a willingness to learn and be transformed in ways that sometimes feel uncomfortable (or even wrong!) to me, with a faith in others and their abilities to identify their own areas of need, and with a genuine desire to be useful in ways that others identify as useful.
- Note that this is very different than coming to people and saying, “You have (or are) a problem and I have (or am) the solution!” (The view expressed by countless White saviours and addiction workers.) The fact of the matter is that the oppression manufactured by and for racial capitalism is a problem for all of us. Mutually liberating solidarity—which is something we can only create together—is, in my opinion, the most hopeful way out of the mess that we all find ourselves in.
- If this feels like I have drifted rather far from my thesis question (what do we talk about when we talk about “addiction”?), that’s kind of the point. Go and do likewise.