National Drug Research Institute, Curtin University, Perth, Western Australia, Australia.
Qual Health Res. 2013 Jul;23(7):916-23. doi: 10.1177/1049732313487027. Epub 2013 May 3.
In this article, we argue that the "problem" of addiction emerges as an effect of treatment policy and practice as well as a precursor to it. We draw on the work of Marrati to analyze interviews with policy makers and practitioners in Australia. The interviews suggest that the episode-of-care system governing service activity, outcomes, and funding relies on certain notions of addiction and treatment that compel service providers to designate service users as addicts to receive funding. This has a range of effects, not least that in acquiring the label of "addict," service users enter into bureaucratic and epidemiological systems aimed at quantifying addiction. Rather than treating pre-existing addicts, the system produces "addicts" as an effect of policy imperatives. Because addiction comes to be produced by the very system designed to treat it, the scale of the problem appears to be growing rather than shrinking.
在本文中,我们认为成瘾问题是治疗政策和实践的结果,也是其前兆。我们借鉴了马拉蒂的研究成果,对澳大利亚政策制定者和从业者的访谈进行了分析。这些访谈表明,管理服务活动、结果和资金的“疗程”系统依赖于某些成瘾和治疗概念,迫使服务提供者将服务使用者指定为瘾君子以获得资金。这产生了一系列影响,其中最主要的是,在获得“瘾君子”的标签后,服务使用者会进入旨在量化成瘾的官僚和流行病学系统。该系统不是治疗已经存在的瘾君子,而是将瘾君子作为政策要求的结果制造出来。由于成瘾问题是由旨在治疗成瘾的系统本身产生的,因此问题的规模似乎在不断扩大,而不是缩小。