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Chapter 3

ANTA02 Chapter 3: Chapter 3.doc

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Bianca Dahl

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Chapter 3 – A Community of Addicted Bodies
The Moral Economy
-protection from full-blown heroin withdrawal symptoms drives the moral economy of heroin sharing
-it is considered unethical to leave a person stranded when he or she is dopesick unless one is openly feuding with that person
-the best protection from withdrawal symptoms is to maintain a generous reputation, because everyone is eager to help someone who will reciprocate in the future
-the moral economy generates frequent expressions of solidarity, but the logic of the gray zone imposes greed, deceit, and opportunism onto generosity
-everyday is “a state of emergency”, and aid to others must be meted out selectively as a zero-sum calculation
-inevitably, under conditions of scarcity, the help given to one person is at the expense of another who is also in desperate need
-furthermore, no plea for help can be taken at face value, because hustling for heroin by any means necessary is the defining attribute of a righteous dopefiend
Drug Consumption as Racialized Habitus
-heroin injectors often brag about the size of their habit, exaggerating how many “grams of dope” they inject per day
Techniques of the Body
-Bourdieu would have called these distinct ways of injecting and experiencing heroin “techniques of the body”
-they are complex, historically grounded sets of innumerable cultural practices that contribute to the perception of radical ethnic difference
-countless other routine interactions and markers naturalize such ethnic distinctions into an everyday “common sense” that casts them as genetico-cultural differences infused with
moral judgment
-patterns of cultural diversity are a banal fact of social organization and are not necessarily significant in and of themselves
-what is significant about the ethnic distinctions in behaviours that we describe among the homeless is that they are “misrecognized” by most people as the “natural order of things”
-most dramatically, as seen in the injection process, ethnic distinctions become inscribed onto bodies as scars and infections and are acted out in postures that become associated
with racial characteristics
Masculine Sexual Performance
-sexuality was another visibly embodied ethnic marker that followed the same overall pattern as drug preference, clothing style, masculine dignity, mood, and hygiene
Accessing the Emergency Room
-ethnically distinct techniques of the body resulted in very different patterns of interaction with medical institutions
Iatrogenic Pathology
-when one’s veins are scarred by a lifetime of daily injection and when one’s priority is to consume heroin by any means necessary, an abscess is a convenient and effective site for
-the body is pumping blood to the area in order to combat the infection
-when heroin is injected into this especially vascular site, it provides a rush of exhilaration that is almost as intense as that of a direct deposit into a functional vein
-furthermore, poking a needle into an abscess is not particularly painful because much of the tissue is already dead
-many doctors in the United States consider it “unadvisable” to give painkiller prescriptions to addicts when releasing them from the hospital, even when their pathologies are
objectively painful
Symbolic Violence of Public Health Outreach
-abscesses are merely the tip of the iceberg of the crisis facing health care for the homeless in the United States
-most patients with abscesses are also infected with hepatitis C, smoke cigarettes, drink large quantities of alcohol, and eat poorly
-consequently, they are at risk for a panoply of chronic conditions as they age, including, malnutrition, liver disease, emphysema, tuberculosis, depression, and dementia, not to
mention gunshot and knife wounds
-injection drug users constituted one of the epicenters of the outbreak of HIV in the industrialized world during the 1980s
-epidemiologists identified injectors as a potential vector for spreading HIV into heterosexual populations, and this threat raised the stakes of inadequate health care for the indigent
-harm reduction operates within the limits of a middle-class public health discourse committed to educating “rational clients…free to choose health”
-in pursuit of knowledge and progress, medicalized discourses promote disciplined subjectives that self-impose responsible behaviour
-in short, harm reduction became the gentle strand in the disciplinary web that seeks to rehabilitate the lumpen
-the cross-class effects of this form of “positive” biopower, however, are often contradictory
-knowledge may be empowering to the middle class, but prevention and outreach messages that target the decision-making processes of drug users fail to address the constraints on
choice that shape need, desire, and personal priorities among the indigent
-arguably, many of the outreach programs designed to empower vulnerable injectors and to treat them as rational actors shame them as much as, or more than, they help them
-medical social services predicated on “empowering individuals” to make “informed choices” to misrecognize the power relations that constrain socially vulnerable populations and
that shape subjectivities
-epidemiological infection patterns from the 1990s and 2000s suggest that ancillary paraphernalia sharing is probably not responsible for transmitting HIV in the United States
-most likely, in order for enough blood-to-blood contact to occur and to transmit HIV, one would have to reuse a syringe that has not been rinsed with anything
Pathogenic Law Enforcement
-the criminalization – not just of heroin but also of syringes – as well as the enforcement of local city ordinances against public intoxication, urination, and sleeping outside, pushes
drug users into the farthest margins of public space
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