National Drug Research Institute, Faculty of Health Sciences, Curtin University, NDRI Melbourne Office, 6/19-35 Gertrude St., Fitzroy, Victoria, 3065, Australia.
National Drug Research Institute, Faculty of Health Sciences, Curtin University, NDRI Melbourne Office, 6/19-35 Gertrude St., Fitzroy, Victoria, 3065, Australia.
Int J Drug Policy. 2017 Jun;44:192-201. doi: 10.1016/j.drugpo.2017.02.005. Epub 2017 Mar 30.
Definitions of addiction have never been more hotly contested. The advance of neuroscientific accounts has not only placed into public awareness a highly controversial explanatory approach, it has also shed new light on the absence of agreement among the many experts who contest it. Proponents argue that calling addiction a 'brain disease' is important because it is destigmatising. Many critics of the neuroscientific approach also agree on this point. Considered from the point of view of the sociology of health and illness, the idea that labelling something a disease will alleviate stigma is a surprising one. Disease, as demonstrated in that field of research, is routinely stigmatised. In this article we take up the issue of stigma as it plays out in relation to addiction, seeking to clarify and challenge the claims made about the progress associated with disease models. To do so, we draw on Erving Goffman's classic work on stigma, reconsidering it in light of more recent, process oriented, theoretical resources, and posing stigmatisation as a performative biopolitical process. Analysing recently collected interviews conducted with 60 people in Australia who consider themselves to have an alcohol or other drug addiction, dependence or habit, we explore their accounts of stigma, finding experiences of stigma to be common, multiple and strikingly diverse. We argue that by treating stigma as politically productive - as a contingent biopolitically performative process rather than as a stable marker of some kind of anterior difference - we can better understand what it achieves. This allows us to consider not simply how the 'disease' of addiction can be destigmatised, or even whether the 'diseasing' of addiction is itself stigmatising (although this would seem a key question), but whether the very problematisation of 'addiction' in the first place constitutes a stigma process.
成瘾的定义从未像现在这样备受争议。神经科学解释的出现不仅使一种极具争议性的解释方法引起了公众的关注，也让那些对该方法持反对意见的众多专家之间缺乏共识的问题变得更加凸显。支持者认为，将成瘾称为“脑部疾病”很重要，因为这样做可以消除污名化。许多神经科学方法的批评者也同意这一点。从健康与疾病的社会学角度来看，将某事物贴上疾病标签会减轻污名化的观点令人惊讶。正如该研究领域所表明的那样，疾病通常会被污名化。在本文中，我们将探讨污名化问题在成瘾问题上的表现，试图阐明和挑战与疾病模型相关的进展所提出的主张。为此，我们借鉴了欧文·戈夫曼（Erving Goffman）关于污名的经典著作，结合最近的、面向过程的理论资源对其进行重新思考，并将污名化视为一种表现性的生物政治过程。通过分析最近对澳大利亚 60 名自认为患有酒精或其他药物成瘾、依赖或习惯的人进行的访谈，我们探讨了他们对污名化的看法，发现污名化的经历很常见、多样且截然不同。我们认为，将污名化视为政治产物——一种偶然的、生物政治表现性的过程，而不是某种先前差异的稳定标志——我们可以更好地理解其作用。这使我们不仅可以考虑成瘾的“疾病”如何能够去污名化，甚至可以考虑成瘾的“疾病化”本身是否具有污名化（尽管这似乎是一个关键问题），而是可以考虑首先将“成瘾”问题化本身是否构成了一个污名化过程。
