Editor’s Note: Eugene Raikhel and William Garriott, editors of a just-out collection of ethnographic essays titled Addiction Trajectories (Duke University Press, 2013), share their views in response to the Points’ interview’s probes.
William Garriott (WG) and Eugene Raikhel (ER): In Addiction Trajectories we wanted to introduce readers to current anthropological work on addiction, and to propose a conceptual theme which we think unifies much of this new research. So the book does both of these things. First, it presents several ethnographic case studies of addiction in contemporary settings ranging from Puerto Rico to Russia, to southern France, to West Virginia, to Las Vegas. Second, it proposes the concept of addiction trajectories as a framework for understanding these particular cases. We highlight three particular addiction trajectories: epistemic or knowledge trajectories, therapeutic trajectories, and experiential and experimental trajectories. These terms capture three key elements of addiction: the ongoing debate over what, exactly, addiction is; the myriad treatments available for addiction; and the experience of addiction. The term “trajectories” is meant to draw attention both to the different kinds of movement we see taking place in each of these dimensions (change over time, but also movement across social and geographic space) as well as the open-endedness of this movement.
Eugene Raikhel
2. What do you think a bunch of drug and alcohol historians might find particularly interesting about your book?
WG: I hope they will appreciate the authors’ efforts to show, through ethnography, how history is lived. Each chapter in its own way shows how the past is embodied in the present. This may be, in the case of Angela Garcia’s chapter, how a history of land dispossession in New Mexico is implicated in contemporary experiences of heroin addiction, or, in Eugene’s chapter, how the legacy of Soviet-era addiction therapeutics continues to shape treatment of addiction today.
ER: I agree entirely and I hope that the book can build upon and help to continue the very important conversation between historians and social scientists working on drugs, alcohol and addiction in the present day. Our book really highlights the degree to which many anthropologists working on addiction today are deeply invested in thinking about the production, circulation and enactment of knowledge. The broader context here is the profound engagement which medical anthropology has had with science and technology studies over the past two decades—an engagement that has also engendered links with historians of science and medicine. I think that these concerns are present to some degree in all of the chapters, though in different ways. For example, in her largely ethnographic chapter Nancy Campbell follows into the present-day some of the lines of addiction research which she traced across the 20th century in her book Discovering Addiction. Todd Meyers’ ethnography of adolescents in drug rehabilitation treatment in Baltimore is shaped in many ways by his research on historian of medicine Georges Canguilhem and neurologist Kurt Goldstein. Natasha Schüll’s research on video gambling addiction as co-produced by the machines and the people who play them, builds on the work of Bruno Latour and scholars of human-technology interaction. And finally, we’re very lucky to have an afterword to this volume by Emily Martin, who really pioneered the anthropology of science and technology during the 1980s and early 1990s.
3. Now that the hard part is over, what is the thing YOU find most interesting about your book?
William Garriott
WG: As an editor I still find the individual chapters of the book fascinating. Reading them collectively provides a remarkable sense of addiction’s diverse presence in the world today. One of the things we tried to do as editors is not jump immediately to pathologizing addiction. To be sure, addiction is often shrouded in tragedy. However, we felt it was important to also explore other dimensions of addiction, such as its capacity to create and sustain social ties, to open up new and unpredictable political debates, and, of course, its intimate and complicated relationship with the experience of pleasure. All of these elements, as well as the more tragic, appear in diverse and surprising ways throughout the book.
ER: Anthropologists don’t tend to do nearly as much explicitly comparative work today as they once did. There are some significant historical reasons for this, but one of the results is that many edited collections are framed around fairly abstract concepts. While I appreciate many of those edited volumes, I really like that our book is so tightly focused on the topic of addiction. I think that this close thematic focus generates a number of intriguing resonances between the chapters — highlighting parallels and contrasts between numerous ethnographic settings. Some of the chapters are themselves comparative. For example, Helena Hansen’s contribution looks at both evangelical addiction ministries in Puerto Rico and opioid maintenance therapy in New York City. Summerson Carr’s chapter compares Motivational Interviewing – a currently ascendant treatment modality – with the mainstream addiction treatment that draws heavily on the assumptions and logics of the Twelve Step Program. In other cases, we have interesting links between chapters. My contribution focuses on the suggestion and aversion-based treatment methods widely used in Russia and Anne Lovell’s chapter follows a group of Eastern European addicts who have fled precisely this treatment regime for the more tolerant environs of Marseille. And finally, I think that the common theme also brings into contrast conceptual distinctions between each of the contributors.
4. Every research project leaves some stones unturned. What stone are you most curious to see turned over soon?
WG: I am anxious to see how policy surrounding addiction (including drug use, treatment, and so on) develops. My own focus is on drugs in the United States and particularly the legacy of the war on drugs. Anecdotally, it feels as though the conversation is shifting. Attitudes about marijuana appear to be changing, just as the criminal justice system seems to have reached a tipping point with regard to its ability to warehouse large numbers of “drug offenders” the way it has done over the past several decades. Internationally, there seems to be a greater willingness to experiment with alternative forms of drug regulation that do not necessarily reflect the US agenda. I am curious to see where all of this takes us, particularly as policy develops in tandem with new developments in the science and treatment of addiction. It is notable, I think, that many of our book’s chapters include discussions of buprenorphine. Continued development of pharmaceutical treatments alone could have a significant impact on changing the conversation surrounding addiction given the impact of pharmaceuticals on our understanding of conditions such as depression.
Buprenorphine
ER: In addiction to these key questions, I would add that some of the conceptual developments currently taking place in the human sciences are particularly interesting for those of us working on drugs and addiction. Over the past decade or so, the human sciences have seen an increasing concern with issues of “materiality” as well as various attempts to rethink the relationship between the social and the biological. I’m thinking very broadly here and including conceptual approaches and projects ranging from affect theory to “object-oriented ontology” to multispecies ethnography to “critical neuroscience” and “neuroanthropology.” Of course, each of these terms represents a diverse literature in its own right, and each encompasses a wide (and perhaps mutually incommensurable) range of perspectives. But the broader point is that there seems to be an increasing recognition by many scholars in the human sciences that, as Jamie Saris puts it in his contribution to our volume, “ ‘construction’ works at the level of biology as much as it does at any other level,” (p.281) and that this recognition might be a productive basis for new kinds of collaborative research and interdisciplinary engagement on drugs and addiction. At the very least, I think that these conceptual approaches give those of us in the human and social sciences some productive tools for thinking about the relationships between people, psychoactive substances, and environments.
5. BONUS QUESTION: In an audio version of this book, who should provide the narration?
WG: Assuming that the person need not still be living, I would say William S. Burroughs would be an obvious choice. But there is also a strong case to be made for Oprah Winfrey, given that she plays a significant role in one of the chapters of the book.
ER: I’d love to hear Oprah reading about “experimentality.”