Research Paper
Telling different stories, making new realities: The ontological politics of ‘addiction’ biographies

https://doi.org/10.1016/j.drugpo.2017.05.011Get rights and content

Abstract

Personal narratives of alcohol and other drug addiction circulate widely in popular culture and they also have currency in professional therapeutic settings. Despite this, relatively little research has explored the conventions operating in these narratives and how they shape people’s experiences and identities. While research in this area often proceeds on the premise that addiction biographies are straightforwardly ‘true’ accounts, in this paper we draw on the insights of critical alcohol and other drug scholarship, and the concept of ‘ontological politics’ to argue that biographies produce normative ideas about addiction and those said to be experiencing it. Our analysis compares traditional addiction narratives with the biographies we reconstructed from qualitative interviews with 60 people in Australia who describe themselves as having an ‘addiction’, ‘dependence’ or drug ‘habit’. We track how addiction is variously enacted in these accounts and comment on the effects of particular enactments. By attending to the ways in which people cope, even thrive, with the kind of consumption that would attract a diagnosis of addiction or dependence, the biographies we produced disrupt the classic narrative of increasing drug use, decline and eventual collapse. Doing so allows for consideration of the benefits of consumption, as well as the ways that people carefully regulate it to minimise harms. It also constitutes individuals as active in managing consumption—an important move that challenges dominant understandings of addiction as a disorder of compulsivity. We conclude by considering the implications of our attempt to provide an alternative range of narratives, which resonate with people’s diverse experiences.

Introduction

Personal narratives of addiction circulate widely in popular culture. Indeed the media has long been filled with such stories but they often rely on stereotypes and offer few clues about the variety of experiences people have and the many ways they cope and live rich, meaningful lives. Despite the dominance of addiction biographies in popular culture and in some therapeutic settings, relatively little research has explored the norms operating in these accounts and how they shape people’s experiences and identities. In this paper we build on the insights of the critical addiction literature to analyse biographies produced as part of a qualitative study of personal experiences of alcohol and other drug addiction in Australia. The biographies were reconstructed from in-depth interviews with 60 people who self-identified as having an addiction, dependence or habit, and published on a carefully curated, public website www.livesofsubstance.org. While accounts such as those we developed are often presumed to reflect faithfully ‘real-life’ experiences, we argue that they produce normative ideas about addiction, with implications for people whose drug use would attract this label. In making this argument we draw on the work of science and technology studies theorists Annemarie Mol (1999) and John Law (2004) to challenge the assumption that it is possible to uncover a pre-existing objective reality of addiction. These scholars argue that there is no stable, singular reality that precedes our attempts to know it. Rather, knowledge practices perform what Mol and Law call ‘ontological politics’. The concept of ontological politics theorises realities as neither given nor fixed, but shaped within specific practices. The key point of this insight is that we are active in making realities so which ones we make is a political question. In this article, we are concerned with how the practices of reconstructing personal narratives from interviews with people who identify as having an alcohol or other drug addiction, dependence or habit help to make addiction and those who see themselves as affected by it.

In a previous article (Pienaar et al., 2015) we analysed accounts of addiction in two major Australian alcohol and other drug-related websites, arguing that they shape as much as reflect addiction, also shaping individual experiences. We outlined the planned website mentioned above and briefly considered how it might challenge stereotypes and in so doing, help to remake addiction. Here we build on this work to explore in detail how the biographies we produced for the website intervene in the social production of addiction. Comparing conventional addiction biographies with our alternative biographies, we spell out the different accounts of addiction and the self they generate. In conducting this comparative analysis, the focus is on how the biographies we produced disrupt the classic addiction narratives of trauma, collapse and redemption that tend to dominate the media and public discourse (Fraser and valentine, 2008). By drawing attention to the agency of those usually depicted as lacking it, and positing agency as a relational achievement, our biographies challenge existing accounts of addiction as a disorder of individual compulsivity. Beyond this, they show how people cope, even thrive, with the kind of consumption that would attract an addiction diagnosis. This emphasis on challenging conventional addiction narratives is not an attempt to dismiss people’s struggles or suffering, but rather to draw attention to the ways in which narrating addiction as a disease of compulsivity may actually generate suffering by reinforcing stigma and discrimination.

In the next sections, we provide some background to the Australian alcohol and other drug treatment system, before reviewing the relevant critical social science literature that focusses on addiction (auto)biographies, identifying a need for further work in this area. We then outline our theoretical approach and methods. This is followed by an analysis of traditional addiction autobiographies where we identify their tendency to pathologise and stigmatise regular drug use. Against this backdrop, we then present a range of alternative biographical accounts, which together offer new ways of constituting addiction, or as we will argue, emerge from a different ‘ontological politics’ than currently operates in dominant accounts of addiction. We conclude by exploring the implications of providing these new narratives.

Section snippets

Background

Addiction is by no means a simple issue and the term itself is heavily contested. In Australia, the official term in medical and public health circles is ‘dependence’ (Ministerial Council on Drug Strategy, 2011) and in other contexts, terms such as ‘compulsive behaviour’ or ‘drug problem’ dominate. Treatment for alcohol and other drug dependence is delivered via a range of government funded services, including counselling, pharmacotherapy, residential treatment and withdrawal management (

Approach

To conduct our analysis, we draw on the concept of ‘ontological politics’ first coined by science and technology studies theorist Annemarie Mol (1999) and later elaborated by Mol’s close collaborator John Law, 2004, Law, 2009a. The term refers to an approach that treats materiality as constantly in the making, rather than given in nature and fixed. Underpinning the notion of ontological politics is the recognition that practices, including those associated with research, produce particular

Method

The qualitative research project on which this article is based was designed to gather personal accounts of drug use for presentation on a web-based resource on addiction experiences [www.livesofsubstance.org]. The project is a collaboration with Healthtalk Australia, an Australian research consortium that conducts qualitative research into personal experiences of health and illness. Healthtalk Australia collaborative projects use a research methodology developed by Oxford University’s Health

Narrating addiction as a disorder of compulsion

We begin with a classic addiction narrative taken from the US website, drugfree.org:

My name is Sofia and I am a recovering addict and alcoholic. I started using when I was 12 years old. What started out as drinking alcohol and smoking weed quickly escalated into regular use of narcotics, and by the age of 13 I was abusing cocaine and prescription pills on a regular basis […]

My life was out of control […] After an incident in which I threatened to commit suicide, I was forced into a long-term

Beyond pathology: Remaking addiction

A key decision informing the composition of our participant biographies relates to how each account opens.2 Consider, for example, the openings to the biographies of 43-year old Bill and 53-year old Helen:

Bill works part time in retail and enjoys spending time doing outdoor activities with his wife and two children. He goes camping and bush walking,

Suffering, trauma and drug use

One of the risks in critiquing addiction discourse as we attempt to do here is that it can appear to dismiss or minimise suffering and struggles. This, of course, is not our aim. Rather, in narrating lived experiences, we have sought to present these struggles and difficulties in the context of people’s lives. Doing so draws attention to the ways in which addiction is bound up with other social and political issues, such as marginalisation, poverty, violence, isolation, stigma and institutional

Articulating pleasures and benefits

While the biographies communicate the struggles and difficulties people face, they do so without eclipsing or discounting the pleasures and benefits of drug use. Consider, for example, this extract from 32-year old Dean’s biography:

Dean (32) began taking ice [methamphetamine] and GHB in his early twenties, primarily with sexual partners. He says ice reduced his ‘inhibitions’ and gave him ‘a lot more energy’ and a ‘sense of empowerment’. He also took GHB as ‘an expansion’ on ice as he says their

Conclusion

Where much alcohol and other drug research takes for granted the status of addiction as a pre-existing problem that precedes our actions, we have sought to draw attention to the ways in which addiction takes shape through our attempts to understand it and, importantly for our purposes, through the process of narrating lived experiences. In developing the personal narratives for publication on a website, our aim has been to give voice to a diverse range of experiences that exceed the

Acknowledgments

The research reported in this paper was conducted in the Social Studies of Addiction Concepts (SSAC) Research Program, based in the National Drug Research Institute, Faculty of Health Sciences, Curtin University, in collaboration with Healthtalk Australia, Monash University, the University of New South Wales’ Centre for Social Research in Health and the Hunter New England Local Health District. The research was funded by the Australian Research Council (Discovery Project DP140100996). Suzanne

References (50)

  • S.J. Bright et al.

    What can we say about substance use? Dominant discourses and narratives emergent from Australian media

    Addiction Research & Theory

    (2007)
  • E.S. Carr

    Scripting addiction: The politics of therapeutic talk and American sobriety

    (2010)
  • C. Duff

    Governing drug use otherwise: For an ethics of care

    Journal of Sociology

    (2008)
  • R. Dwyer et al.

    Making addictions in standardised screening and diagnostic tools

    Health Sociology Review

    (2016)
  • C. Fabre

    Ideological tropes of contemporary addiction narratives. Challenging addiction in Canadian literature and classrooms

    (2016)
  • J. Fitzgerald

    Syringes, metonymy, global fear and news

    Framing drug use: Bodies, space, economy and crime

    (2015)
  • S. Fraser et al.

    Substance and substitution: Methadone subjects in liberal societies

    (2008)
  • S. Fraser et al.

    The drug effect: Constructing drugs and addiction

  • S. Fraser et al.

    Habits: Remaking addiction

    (2014)
  • J.B. Germov

    Second opinion: An introduction to health sociology

    (2014)
  • Health Experiences Research Group (HERG)

    Researcher’s handbook for producing HealthTalkOnline and YouthHealthTalk websites

    Health Experiences Research Group

    (2014)
  • H. Keane

    Public and private practices: Addiction autobiography and its contradictions

    Contemporary Drug Problems

    (2001)
  • H. Keane

    What’s wrong with addiction?

    (2002)
  • H. Keane et al.

    Addiction and dependence: Making realities in the DSM

    Addiction

    (2011)
  • J. Law

    After method: Mess in social science research

    (2004)
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