Making the criminal addict: Subjectivity and social control in a strong-arm rehab
| Author | Sarah Whetstone,Teresa Gowan |
| Published date | 01 January 2012 |
| Date | 01 January 2012 |
| DOI | 10.1177/1462474511424684 |
| Subject Matter | Articles |
Article
Punishment & Society
14(1) 69–93
! The Author(s) 2012
Making the criminal
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addict: Subjectivity and
DOI: 10.1177/1462474511424684
pun.sagepub.com
social control in a
strong-arm rehab
Teresa Gowan and Sarah Whetstone
University of Minnesota, USA
Abstract
The mandatory, state-subsidized treatment opened up by drug courts and other jail and
prison diversion programs have massively expanded the numbers of the nation’s poor and
working class who are labeled addicts and sent to rehab, making drug rehabilitation a
primary site for the re-socialization and control of the poor. Drawing on ethnographic and
interview data, this article examines the institutional form at the center of this process:
the ‘strong-arm’ rehabilitation facilities most closely tied to drug courts, probation, and
parole. The therapeutic community tradition’s long-standing practices of moral reform
through intensive behavior modification are now mobilized by the state on a large scale,
transformed into a ‘fuzzy edge’ of the criminal justice system which resocializes far more
intensively than most forms of incarceration. We understand the ‘medicalization’ repre-
sented by strong-arm rehab not as a reprieve from judgment, but instead as a process of
translation and amplification. Translated by staff into therapeutic, moral, and finally cultural
versions, the biochemical ‘diagnosis’ of pathology comes to serve as a neutral, medicalized
front behind which the systemic injuries of race and class disappear. Instead, the strong-
arm process amplifies the taint of addiction into a new biologization of poverty and race.
Keywords
addiction treatment, drug courts, mass incarceration, poverty, race, subjectivity
Anxieties about drug use creating social disorder among the ‘dangerous classes’
have infused American strategies in crime control since the opium scares of the
19th century. Within the current era of hyper-incarceration, though, the
Corresponding author:
Teresa Gowan, University of Minnesota, Room 1080, 909 Social Sciences, 267 19th Ave S, Minneapolis, MN
55455, USA.
Email: tgowan@umn.edu
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Punishment & Society 14(1)
suppression of drug use has taken a far more central role. Since Nixon’s Operation
Intercept of 1969, the US government has spent roughly one trillion dollars to
suppress, punish, or treat illicit substance abuse (Fields, 2009). Government
officials, public health advocates, and mass media have mobilized public anxieties
about drugs as a central threat to social stability, producing a national crusade
which has radically skewed patterns of arrest and sentencing. To date, this strategy
has culminated in a more than 10-fold increase in drug crime incarceration since
1980 (Western, 2007), imprisoning many for the first time, and returning a steady
flow of often-traumatized men and women into poor and working-class areas
(Acker, 2002; Beckett, 1997; Duster, 1997; Macek, 2006; Reinarman, 2005;
Simon, 2007; Tonry, 2011).
The last decades have seen mounting public concern over the ineffectiveness,
high economic cost, and social injuries of mass incarceration. A sense of diminish-
ing returns has persuaded even some hard-line ‘law and order’ proponents to
countenance a larger emphasis on rehabilitation, taking the form of bi-partisan
political efforts to expand alternatives to incarceration (King and Pasquarella,
2009). As a result, probation, parole, and new alternative sentencing procedures
are increasingly channeling offenders out of ‘the system’ and into community-based
correction, the most recent rapidly growing mechanism being the ‘drug courts’
started in 1989 to manage low-level drug or drug-related offences. There are now
over 1600 such courts in the United States (King and Pasquarella, 2009).
Our own research site was one of seven rehab centers contracted by a local
county drug court program. The court provided a steady stream of clientele and
funding, and, as we show below, had shaped the institution’s therapeutic practice
to fit criminal correction goals. The quarter of the clients coming in through drug
court referrals represented only the tip of the iceberg – for every drug court client,
there were two more ‘serving time’ in treatment on a probation-related sentence,
facing sometimes as many as 10 years in prison should they fail to complete the
program.
The large-scale mandatory, state-subsidized treatment opened up by drug courts
and other jail and prison diversion programs has expanded the numbers of the
nation’s poor and working class who are labeled addicts and sent to rehab (Tiger,
2011). Indeed, the criminal justice system is now the largest single referral source to
publicly funded drug treatment (SAMHSA, 2008, 2010). ‘Strong-arm rehab’ – as we
are calling it – has become a primary site for the re-socialization and control of the
poor.
Drawing on ethnographic and interview data, this article examines the institu-
tional form at the center of this process; the rehab facilities with strong ties to drug
courts, probation, and parole. By labeling these institutions as ‘strong-arm rehab’,
we identify a particular type of court-mandated rehabilitation emphasizing long
residential stays, high structure, mutual surveillance, and an intense process of
character reform. Strong-arm rehab also tends to be a highly racialized form,
consistently linked to poor African American drug offenders. The black overrep-
resentation in criminal corrections in our state was pointed – in 2010, blacks
Gowan and Whetstone
71
comprised one-third of all drug offenders, incarcerated at a rate eight times their
portion of the population. Over half of the drug offenders defined by the drug court
as ‘high-risk, high-need’ and subsequently ‘sentenced’ to treatment in a strong-arm
facility were African American. Racial disparities in drug court conviction were
reinforced by economic inequality – unlike many of the white offenders, none of the
African Americans sentenced to drug court were able to use private insurance to
opt for outpatient rehab. The disparities persisted inside the strong-arm rehab
itself, where African Americans were strongly overrepresented, comprising
two-thirds to three-quarters of the clientele at different points in our two-year
study.
This article first contextualizes the development of strong-arm rehab within
modern punishment policy, drawing out the institutional and discursive conditions
surrounding its development. Then we turn to the questions driving our own case
study. What does the shift toward drug-treatment-as-crime-control mean for the
definition and practice of both rehabilitation and criminal corrections? Does rehab
as an ‘alternative’ to incarceration mitigate the severity of penal policy in an era of
mass incarceration, or merely shift the expression of punitive control to a new
setting? If strong-arm rehab is a large-scale resocialization process, what kinds of
ideas, practices, and ultimately people are they producing? How do staff members
understand and manage the combination of therapeutic diagnosis and criminal
culpability? How does criminal justice backup actually get translated and exercised
in these satellite custodial institutions? How might we understand the broader
implications of this hybrid therapeutic-punitive form for cultural understandings
of personal responsibility, citizenship, and the moral order?
The recent turn to rehabilitation can be read as a predictable swing of the
US crime control pendulum back from repression to reform (Garland, 1990,
2001; Hutchinson, 2006; Rothman, 1980). Yet the pendulum inevitably swings
‘back’ to a different moment of rehabilitation. The Progressive era’s emphasis on
curing moral vice through public health and neighborhood improvement returned
transformed in the early 1970s with a deeper therapeutic emphasis and a radical
deinstitutionalization rhetoric propelled by the critiques of 1960s-era prisoners and
activists. The current impulse toward reform and rehabilitation also has its new
and peculiar specificities. At once medicalized and deeply authoritarian, riven with
anxiety about self-control and ‘choice’ – the rise of drug courts and strong-arm
rehab reflects the peculiar prominence of addiction within the current American
Zeitgeist.
Mainstreaming the therapeutic?
Some have argued that the increasing centrality of the notion of addiction in US
culture reflects post-Second World War paranoia about the agency of the modern
individual (Melley, 2002, 2008; Sedgwick, 1994). The proliferation of ‘addiction’
into the realms of gambling, sexual behavior, hoarding, and even shopping does
suggest a generalized ‘agency panic’. As Ehrenreich (1990) suggested in Fear of
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Falling, the anxieties of the white middle-class about their own habits tend to get
projected on to the despised and the poor in outsize proportions. No wonder it has
come to seem commonsensical to many progressive public servants that the roots
of most crime and antisocial behavior should lie in addiction.
These enthusiastic supporters of drug courts – public health advocates, liberal
lawyers, and treatment professionals – believe that court-mandated treatment has
the potential to address the roots of anti-social behavior far more directly and
effectively than incarceration. Yet traditionalist proponents of punitive policy
have also fostered these drug-related sentencing alternatives, looking to manage
the drain of incarceration on state budgets (Marlowe et al., 2003). Strong-arm
rehabilitation has...
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