What's Normal? An Ethnographic Account of Heroin Users in Methadone Treatment
The use of harm reduction interventions as more feasible alternatives to the complete drug abstinence approach of conventional biomedical paradigms of opiate treatment begs an account of how the goals of heroin recovery are defined, negotiated, and contested between service providers and users. This ethnographic study of discursive constructions of "normalcy" by staff and clients at two harm reduction centres in Toronto, Canada found a diversity of narratives of heroin recovery, which illustrates the need for health services that address the different needs of heroin users. In examining staff's conceptions of "normalcy" that rely on the control and normalization of bodies, or what Foucault calls "biopower", contradictions are revealed in the ways staff put into practice the theory of harm reduction. In turn, a close examination of client responses to institutional goals of treatment reveals that they are not merely "passive" or "docile" subjects of caregivers' "biopower". Rather, their ambiguous strategies for asserting personal identity, challenge staff's taken-for-granted dichotomies such as addiction/recovery, use/abstinence, self-control/out of control, street/straight life.
Keywords: Harm Reduction, Heroin Recovery, Staff and Clients, Normalcy, Methadone Treatment, Toronto
Assistant Professor, Department of Sociology