Kiran Pienaar

The future of drugs: recreational drug use and sexual health among gay and other men who have sex with men

There are complex historical connections between sexual minoritisation and desires to chemically alter bodily experience. For gay men, drug and alcohol use can be a creative or experimental response to social marginalisation - and not necessarily a problematic one in every instance. Numerous studies have found that infection with HIV and other sexually transmissible infections (STIs) is more likely among gay and men who have sex with men (MSM) who use recreational drugs than those who do not, but the causal nature of these relations is uncertain. Sexualised drug use is associated with a range of other problems, including dependence, mental health issues, accident and overdose. A growing body of work in the Alcohol and Other Drugs (AOD) field demonstrates the action of drugs and their purported effects to be a product of their relations with various other actors, contexts and practices. Given these contingencies, it is impossible to predict the future of drugs or their effect on the sexual health of gay and MSM with any degree of certainty. This article outlines some of the conditions most likely to mediate such futures in the medium term. Public funding for lesbian, gay, bisexual, transgender and queer drug issues should not remain restricted to questions of HIV prevention and sexual health. It should be expanded to equip sexual health and AOD service providers with the cultural and sexual literacy to mitigate stigma and allow them to respond constructively to drug problems among sexual and gender minorities as a matter of priority.

New narratives, new selves: Complicating addiction in online alcohol and other drug resources

Abstract Within the expansive qualitative literature on alcohol and other drug (AOD) use, knowledge of lived experiences of AOD addiction is limited. Much of the existing scholarship reifies addiction as a calamitous state, and pathologises those believed to be experiencing it. Such research discounts the many ways people live with regular AOD use and is unable to tell us much about how addiction emerges through, rather than precedes, people’s experiences and understandings of it. This article draws on the theoretical literature on the production of social problems and the concept of “ontological politics” to introduce an innovative approach to understanding lived experiences of AOD addiction. Applying this literature to a critical analysis of personal narratives from two Australian AOD websites, we demonstrate how addiction is conceived narrowly in these narratives as a disorder of compulsion, amenable to treatment. Not only does this conception reproduce unhelpful assumptions about addiction, it also reifies it as a stable, unified entity, the boundaries of which are fixed. Against this familiar account, we conceive addiction as an emergent, fiercely contested phenomenon, constituted in part through the very measures designed to treat it. This shift in focus allows an innovation in engaging with addiction, which is being pursued in a new Australian research project: the development of a public website presenting lived experiences of addiction that will be (1) a means of challenging existing public discourses, and (2) an intervention in the social production of addiction. The article concludes by considering the politics of this approach and how it might reshape addiction.

Diffracting addicting binaries: An analysis of personal accounts of alcohol and other drug ‘addiction’

Associated with social and individual harm, loss of control and destructive behaviour, addiction is widely considered to be a major social problem. Most models of addiction, including the influential disease model, rely on the volition/compulsion binary, conceptualising addiction as a disorder of compulsion. In order to interrogate this prevailing view, this article draws on qualitative data from interviews with people who describe themselves as having an alcohol or other drug ‘addiction’, ‘dependence’ or ‘habit’. Applying the concept of ‘diffraction’ elaborated by science studies scholar Karen Barad, we examine the process of ‘addicting’, or the various ways in which addiction is constituted, in accounts of daily life with regular alcohol and other drug use. Our analysis suggests not only that personal accounts of addiction exceed the absolute opposition of volition/compulsion but also that the polarising assumptions of existing addicting discourses produce many of the negative effects typically attributed to the ‘disease of addiction’.

The body as a site of struggle: oppositional discourses of the disciplined female body

This article presents the results of a study on the discursive construction of one aspect of gender identity, namely the female physical ideal. It reports on an analysis of the discourses of the disciplined female body, as these are drawn upon in two conversations between a group of young, Western female university students. The conversations were elicited in August 2005 using a stimulus exercise designed to encourage discussion on issues relating to female body image, such as the notion of the ideal female body, dieting and plastic surgery. Using the tools of Critical Discourse Analysis (CDA) (Fairclough, 2001) the article analyses four related discourses, namely the pro-diet discourse, the discourse of the healthy body, the discourse of studied indifference and the discourse of the sexually attractive female body, in terms of how these discourses encode different, sometimes contradictory ideologies of the Western female body ideal. The article concludes that the discourse of the sexually attractive female body emerges as dominant in these conversational extracts and that, by colonising the other discourses, it legitimates its ethic of compulsory heterosexuality, which positions women as erotic objects of the male gaze.

Iterating 'addiction': Residential relocation and the spatio-temporal production of alcohol and other drug consumption patterns

Addiction is generally understood to be characterised by a persistent pattern of regular, heavy alcohol and other drug consumption. Current models of addiction tend to locate the causes of these patterns within the body or brain of the individual, sidelining relational and contextual factors. Where space and place are acknowledged as key factors contributing to consumption, they tend to be conceived of as static or fixed, which limits their ability to account for the fluid production and modulation of consumption patterns over time. In this article we query individualised and decontextualised understandings of the causes of consumption patterns through an analysis of accounts of residential relocation from interviews undertaken for a large research project on experiences of addiction in Australia. In conducting our analysis we conceptualise alcohol and other drug consumption patterns using Karen Barads notions of intra-action and spatio-temporality, which allow for greater attention to be paid to the spatial and temporal dimensions of the material and social processes involved in generating consumption patterns. Drawing on 60 in-depth interviews conducted with people who self-identified as experiencing an alcohol and other drug addiction, dependence or habit, our analysis focuses on the ways in which participant accounts of moving enacted space and time as significant factors in how patterns of consumption were generated, disrupted and maintained. Our analysis explores how consumption patterns arose within highly localised relations, demonstrating the need for understandings of consumption patterns that acknowledge the indivisibility of space and time in their production. In concluding, we argue for a move away from static conceptions of place towards a more dynamic conception of spatio-temporality, and suggest the need to consider avenues for more effectively integrating place and time into strategies for generating preferred consumption patterns and initiating and sustaining change where desired.

Invoking the feminine physical ideal: bitch-slapping, she-men and butch girls

This paper presents the results of research on the discursive construction of one aspect of gender identity: the female physical ideal. Applying Butlers (1993) theory of performativity to a real-life local context, it critically analyses how a group of young South African women discursively construct and perform the notion of the ideal feminine body in conversation with their female friends. Furthermore, it uses elements of the Critical Discourse Analysis (CDA) framework (Fairclough, 1992; 2001) to provide a linguistic analysis of the ideologies which underlie this construction. Recognising that ideologies are unstable and dynamic, it seeks to account for the ideological tensions and ambiguities in the discourses surrounding the feminine body.

Rethinking the Poverty-disease Nexus: the Case of HIV/AIDS in South Africa

While it is well-established that poverty and disease are intimately connected, the nature of this connection and the role of poverty in disease causation remains contested in scientific and social studies of disease. Using the case of HIV/AIDS in South Africa and drawing on a theoretically grounded analysis, this paper reconceptualises disease and poverty as ontologically entangled. In the context of the South African HIV epidemic, this rethinking of the poverty-disease dynamic enables an account of how social forces such as poverty become embodied in the very substance of disease to produce ontologies of HIV/AIDS unique to South Africa.

Lives of Substance: a mixed-method evaluation of a public information website on addiction experiences

Abstract Aims: The Lives of Substance (LoS) website presents personal experiences of drug use and ‘addiction’ in people’s own words as part of a larger project of complicating public discourses of addiction, countering stigmatising misconceptions and acting as an intervention in the social production of addiction. This article presents the findings of a mixed-method evaluation of the website, and comments on some of the methodological and practical challenges of evaluating health-related online information resources. Method: Three data sources were used to examine such as the reach of the website (website analytics); experiences of the website audience (responses to an evaluation survey on the website); and other indicators of use and impact (including social media referrals and organisational links). Results: In the 10-week evaluation period, 3970 unique users visited the website. Comments provided via the online survey endorsed the website as a means of challenging stereotypes and as presenting drug use as only a ‘part of a person’s whole life’. Twenty-four organisations had linked to the website and 987 social media referrals were recorded. Conclusion: These data indicate that the LoS website is having some success as a resource for countering addiction-related stigma and offering more holistic and inclusive social understandings of addiction.