Disciplining addictions: the bio-politics
of methadone and heroin in the United States

Bourgois P Department of Anthropology,
History and Social Medicine,
University of California,
San Francisco 94143-0850, USA.
Cult Med Psychiatry 2000 Jun; 24(2):165-95


Biomedical understanding of methadone as a magic-bullet pharmacological block to the euphoric effects of heroin is inconsistent with epidemiological and clinical data. An ethnographic perspective on the ways street-based heroin addicts experience methadone reveals the quagmire of power relations that shape drug treatment in the United States. The phenomenon of the methadone clinic is an unhappy compromise between competing discourses: A criminalizing morality versus a medicalizing model of addiction-as-a-brain-disease. Treatment in this context becomes a hostile exercise in disciplining the unruly misuses of pleasure and in controlling economically unproductive bodies. Most of the biomedical and epidemiological research literature on methadone obscures these power dynamics by technocratically debating dosage titrations in a social vacuum. A foucaultian critique of the interplay between power and knowledge might dismiss debates over the Swiss experiments with heroin prescription as merely one more version of biopower disciplining unworthy bodies. Foucault's ill-defined concept of the specific intellectual as someone who confronts power relations on a practical technical level, however, suggests there can be a role for political as well as theoretical engagement with debates in the field of applied substance abuse treatment. Meanwhile, too many heroin addicts who are prescribed methadone in the United States suffer negative side effects that range from an accentuated craving for polydrug abuse to a paralyzing sense of impotence and physical and emotional discomfort.
OTC cough syrups
LAAM v methadone
Methadone: structure
Opioids and depression
Methadone and cocaine
Methadone maintenance
Rapid opioid detoxification
Buprenorphine v methadone
Methadone, LAAM and the rush
Methadone: pharmacokinetics/pharmacodynamics

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