(In)dependence and addictions: Governmentality across public and private treatment discourses
| Author | Emma C Frieh,Alaina C Iacobucci |
| Published date | 01 February 2018 |
| DOI | 10.1177/1362480616667808 |
| Date | 01 February 2018 |
| Subject Matter | Articles |
https://doi.org/10.1177/1362480616667808
Theoretical Criminology
2018, Vol. 22(1) 83 –98
© The Author(s) 2016
Reprints and permissions:
sagepub.co.uk/journalsPermissions.nav
DOI: 10.1177/1362480616667808
journals.sagepub.com/home/tcr
(In)dependence and addictions:
Governmentality across
public and private treatment
discourses
Alaina C Iacobucci
University of Colorado-Boulder, USA
Emma C Frieh
Indiana University—Bloomington, USA
Abstract
In light of the current spike in opioid addiction in upper middle-class white populations,
we examine addiction treatment discourses on the webpages of public methadone
clinics and private rehabilitation facilities through a critical theoretical lens. While
both discourses exercise social control over opioid-addicted clients by regulating their
everyday practices, we find classed differences in these discourses when they are aimed
at differently socially located populations. Private treatment discourses trust clients to
be led to a state of self-governance through a holistic transformation of ‘mind, body,
and spirit’, while public clinics’ websites frame patients as unruly bodies that must be
chemically rendered docile through medication before they can return to everyday life.
Keywords
Addiction, discourse, governmentality, neoliberalism, rehabilitation
Introduction
As horror stories, cautionary tales, and calls to policy changes about addiction flood
news media and popular discourse, addiction treatment rises to the forefront of focus for
Corresponding author:
Alaina C Iacobucci, Department of Sociology, University of Colorado-Boulder, UCB 327 Ketchum 195,
Boulder, CO 80309, USA.
Email: alaina.iacobucci@colorado.edu
667808TCR0010.1177/1362480616667808Theoretical CriminologyIacobucci and Frieh
research-article2016
Article
84 Theoretical Criminology 22(1)
medical professionals, laypeople, and researchers alike. Drawing from the work of
Michel Foucault and his concepts of normalization and governmentality, we argue that
‘addicts’ are subject to the disciplinary gazes of both the criminal justice system and
medicine and as such, must constantly self-police their behaviors and desires. Addicted
subjects are governed by medical, psychiatric, and legal discourses. They are framed as
both precariously ill and morally responsible for their actions before, during, and after
recovery. Addiction to opioid-type substances like heroin is typically associated with
poverty and racial minority status, and the raced and classed undertones of addiction
discourse for these populations are well documented (e.g. Acker, 2002; Room, 2003).
However, rates of opioid addiction and treatment are rising among higher socioeconomic
status whites, and parallel differences in how addiction treatment discourses operate are
emerging. We explore how these differently socially located populations are subject to
regulation of behavior, and from whom this regulation is expected to come.
We conducted a content analysis of website data from 40 addiction treatment centers
and facilities in New York, dividing our attention between public clinics and private
rehabilitation services. Despite different approaches to framing the individual seeking
treatment, both private and public treatment centers’ websites exposed explicit or implicit
emphases on normalization, either through self-governance or via the effect of docilizing
drugs. We present our theoretical analysis alongside empirical findings to argue that
addiction treatment discourse seeks to return addicted persons to a state of independence,
in which recovery from addiction includes normalized patterns of behavior. However,
this discourse is mobilized differently along class lines, and ‘independence’ takes on dif-
ferent meanings for differently socially located groups.
Literature review and theoretical framework
The historically shifting definition of addiction reflects an ongoing power struggle
between medicine, law enforcement, social science, and politics to control how addicts
are defined and treated throughout the 19th and 20th centuries (Courtwright, 2010;
Hickman, 2004). The adoption of a disease model of addiction epitomises the medicali-
zation of deviance (Conrad, 2010) as medical practitioners attempt to regulate and trans-
form the bodies and subjectivities of their patients. Through the standardization of minute
physical practices of everyday life and the reformation of thought processes regarding
one’s self and behavior, powerful medical discourses inscribe themselves on the bodies
and subjectivities of ‘addicts’. Though it follows from this theoretical framework that all
people who seek treatment from addiction are subject to this form of social control, race,
class, and access to health services impact the deployment of these discourses.
Neoliberalism and late modernity complicate a full acceptance of addiction as a dis-
ease outside of the control of the individual. Addiction, particularly in the western world,
is constructed within a society that stresses individualism, self-control, and responsibil-
ity, and which has historically connected individual self-governance with moral good-
ness (Room, 2003; Weber, 1930). To be a good citizen in a neoliberal society is to attain
individual achievement through hard work, demonstrating one’s goodness as measured
through financial independence (Wacquant, 2009). Independence is directly threatened
by substance abuse because of its threat to a person’s ability to ‘carry out major
To continue reading
Request your trial