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The Face of Social Suffering: The Life History of a Street Drug Addict:The Face of Social Suffering: The Life History of a Street Drug Addict
Abstract
The Face of Social Suffering: The Life History of. Street Drug Addict. Merrill Singer. Long Grove, IL: Waveland Press, 2006 (paper). viii + 176 pp.
... In the context of socially imposed distress associated especially in recent years with structural adjustment, the poor seek reprieve and escape from social suffering (Kleinman, Veena, & Margaret, 1997; Singer, 2006). In this, like all people in need, they have three imperatives: what works? ...
Locating development efforts within the context of globalism and global drug capitalism, this article examines the significant health and social impact both legal and illegal drugs have on international development efforts. The paper takes on an issue that is generally overlooked in the development debate and is not much addressed in the current international development standard, the Millennium Development Goals, and yet is one that places serious constraints on the ability of underdeveloped nations to achieve improvement. The relationship between psychotropic or "mind/mood altering" drugs and sustainable development is rooted in the contribution that the legal and illegal drug trade makes to a set of barriers to development, including: (1) interpersonal crime and community violence; (2) the corruption of public servants and the disintegration of social institutions; (3) the emergence of new or enhanced health problems; (4) the lowering of worker productivity; (5) the ensnarement of youth in drug distribution and away from productive education or employment; (6) the skewing of economies to drug production and money laundering. The paper emphasizes the need for new approaches for diminishing the burden placed by drugs on development.
Injection drug users are at high risk for hepatitis B virus infections. Nevertheless, few concerted efforts have been made to provide injectors with access to an available, safe, and effective vaccine. A campaign to screen and vaccinate injectors was conducted at syringe exchange programs in Chicago, Illinois, and Hartford and Bridgeport, Connecticut. Injectors with no evidence of past hepatitis B infection were eligible for vaccination. Eligible injectors were offered the three doses of vaccine and questioned about their past and current drug use, their sociodemographics, their understanding of hepatitis infections, and their motivation for participating in the study. Disease prevalence, vaccination rates, and the answers to study questions were analyzed comparing the sample of Hispanic to non-Hispanic injectors. We screened 1970 injectors, 860 of whom were eligible for vaccination. Of those, 591 received at least one dose of the vaccine. Hispanics comprised 30.9% of those screened, 24.9% of those eligible, and 25.2% of those receiving at least one dose. Hispanics were more likely than non-Hispanic Whites or non-Hispanic Blacks to have already been infected with hepatitis B—55.6% for Hispanics versus 46.5% for non-Hispanics. Although it is impossible to generalize from our study population to Hispanic injectors as a whole, it seems apparent that if greater efforts are made to promote hepatitis B vaccination among Hispanics, high rates of vaccination can be achieved.
Injection drug users are at high risk for hepatitis B virus infections. Nevertheless, few concerted efforts have been made to provide injectors with access to an available, safe, and effective vaccine. A campaign to screen and vaccinate injectors was conducted at syringe exchange programs in Chicago, Illinois, and Hartford and Bridgeport, Connecticut. Injectors with no evidence of past hepatitis B infection were eligible for vaccination. Eligible injectors were offered the three doses of vaccine and questioned about their past and current drug use, their sociodemographics, their understanding of hepatitis infections, and their motivation for participating in the study. Disease prevalence, vaccination rates, and the answers to study questions were analyzed comparing the sample of Hispanic to non-Hispanic injectors. We screened 1970 injectors, 860 of whom were eligible for vaccination. Of those, 591 received at least one dose of the vaccine. Hispanics comprised 30.9% of those screened, 24.9% of those eligible, and 25.2% of those receiving at least one dose. Hispanics were more likely than non-Hispanic Whites or non-Hispanic Blacks to have already been infected with hepatitis B—55.6% for Hispanics versus 46.5% for non-Hispanics. Although it is impossible to generalize from our study population to Hispanic injectors as a whole, it seems apparent that if greater efforts are made to promote hepatitis B vaccination among Hispanics, high rates of vaccination can be achieved.
Aims:
This paper reviews the world anthropology of drugs and alcohol use literature, identifying key issues addressed by anthropologists, methods and theoretical models in use, trends in focus over time and future directions.
Methods:
Papers and books that comprise the literature were identified through computer search using the keywords: ethnography of drug use (and variants, e.g. drug ethnography, qualitative approaches in drug research), ethnography of drinking, anthropology and drug use, and anthropology and drinking. Search engines included Google Scholar, EBSCOHost, AnthroSource and PubMed. Identified sources were read and integrated into the review.
Results and conclusions:
The literature search identified a rich and growing literature on the anthropology of drinking and drug use. The research and published literature on the anthropology of drug use has grown and diversified since the 1970s, found acceptance in the wider multi-disciplinary domain of alcohol and drug studies and developed beyond the socio-cultural model to include life-style, critical medical anthropology and experiential explanatory models. Anthropological research has helped to shape the field of addiction science, e.g. ethnographic studies show that the lived worlds and self-identities of drug users have cultural order and socially constructed purpose and meaning, and experiential research shows that some addictions or aspects of addictions can be affirmative, creative and sustainable, at least at the individual level. The human immunodeficiency virus/acquired immune deficiency syndrome pandemic has significantly increased anthropological research on drug-related issues world-wide.
Romantic partnerships between drug-using couples, when they are recognized at all, tend to be viewed as dysfunctional, unstable, utilitarian, and often violent. This study presents a more nuanced portrayal by describing the interpersonal dynamics of 10 heroin and cocaine-using couples from Hartford, Connecticut.
These couples cared for each other similarly to the ways that non-drug-using couples care for their intimate partners. However, most also cared by helping each other avoid the symptoms of drug withdrawal. They did this by colluding with each other to procure and use drugs. Care and collusion in procuring and using drugs involved meanings and social practices that were constituted and reproduced by both partners in an interpersonal dynamic that was often overtly gendered. These gendered dynamics could be fluid and changed over time in response to altered circumstances and/or individual agency. They also were shaped by and interacted with long-standing historical, economic and socio-cultural forces including the persistent economic inequality, racism and other forms of structural violence endemic in the inner-city Hartford neighborhoods where these couples resided. As a result, these relationships offered both risk and protection from HIV, HCV and other health threats (e.g. arrest and violence).
A more complex and nuanced understanding of drug-using couples can be tapped for its potential in shaping prevention and intervention efforts. For example, drug treatment providers need to establish policies which recognize the existence and importance of interpersonal dynamics between drug users, and work with them to coordinate detoxification and treatment for both partners, whenever possible, as well as provide additional couples-oriented services in an integrated and comprehensive drug treatment system.
BALTIMORE — Black men in the United States face a far more dire situation than is portrayed by common employment and education statistics, a flurry of new scholarly studies warn, and it has worsened in recent years even as an economic boom and a welfare overhaul have brought gains to black women and other groups. Focusing more closely than ever on the life patterns of young black men, the new studies, by experts at Columbia, Princeton, Harvard and other institutions, show that the huge pool of poorly educated black men are becoming ever more disconnected from the mainstream society, and to a far greater degree than comparable white or Hispanic men. Especially in the country's inner cities, the studies show, finishing high school is the exception, legal work is scarcer than ever and prison is almost routine, with incarceration rates climbing for blacks even as urban crime rates have declined. Although the problems afflicting poor black men have been known for decades, the new data paint a more extensive and sobering picture of the challenges they face. "There's something very different happening with young black men, and it's something we can no longer ignore," said Ronald B. Mincy, professor of social work at Columbia University and editor of "Black Males Left Behind" (Urban Institute Press, 2006). "Over the last two decades, the economy did great," Mr. Mincy said, "and low-skilled women, helped by public policy, latched onto it. But young black men were falling farther back." Many of the new studies go beyond the traditional approaches to looking at the plight of black men, especially when it comes to determining the scope of joblessness. For example, official unemployment rates can be misleading because they do not include those not seeking work or incarcerated. "If you look at the numbers, the 1990's was a bad decade for young black men, even though it had the best labor market in 30 years," said Harry J. Holzer, an economist at Georgetown University and co-author, with Peter Edelman and Paul Offner, of "Reconnecting Disadvantaged Young Men" (Urban Institute Press, 2006). In response to the worsening situation for young black men, a growing number of programs are placing as much importance on teaching life skills — like parenting, conflict resolution and character building — as they are on teaching job skills.