London School of Hygiene and Tropical Medicine, UK.
Centre for Social Research in Health, University of New South Wales, Sydney, Australia.
Sociol Health Illn. 2019 Nov;41(8):1618-1636. doi: 10.1111/1467-9566.12978. Epub 2019 Jul 16.
In this paper, we reflect on health intervention translations as matters of their implementation practices. Our case is methadone treatment, an intervention promoted globally for treating opioid dependence and preventing HIV among people who inject drugs. Tracing methadone's translations in high-security prisons in the Kyrgyz Republic, we notice the multiple methadones made possible, what these afford, and the onto-political effects they make. We work with the idea of the 'becoming-methadone-body' to trace the making-up of methadone treatment and its effects as an intra-action of human and nonhuman substances and bodies. Methadone's embodied effects flow beyond the mere psycho-activity of substances incorporating individual bodies, to material highs and lows incorporating the governing practices of prisoner society. The methadone-in-practice of prisoner society is altogether different to that imagined as being in translation as an intervention of HIV prevention and opioid treatment, and has material agency as a practice of societal governance. Heroin also emerges as an actor in these relations. Our analysis troubles practices of 'evidence-based' intervention and 'implementation science' in the health field, by arguing for a move towards 'evidence-making' intervention approaches. Noticing the onto-politics of health intervention translations invites speculation on how intervening might be done differently.
在本文中，我们反思健康干预翻译的实施实践。我们的案例是美沙酮治疗，这是一种在全球范围内推广的干预措施，用于治疗阿片类药物依赖和预防注射吸毒者中的 HIV。通过追踪吉尔吉斯斯坦共和国高度安全监狱中美沙酮的翻译，我们注意到了多种美沙酮的可能性，以及这些可能性所带来的好处，以及它们产生的政治影响。我们使用“美沙酮身体的形成”这一概念来追踪美沙酮治疗的形成及其作为人类和非人类物质和身体相互作用的影响。美沙酮的具体影响不仅体现在物质对个体身体的精神活性上，还体现在包含囚犯社会治理实践的物质高低起伏上。囚犯社会中的美沙酮实践与作为 HIV 预防和阿片类药物治疗干预措施的翻译中的想象完全不同，它具有作为社会治理实践的物质代理。海洛因在这些关系中也成为一个参与者。我们通过主张转向“证据制造”干预方法，对健康领域的“基于证据的干预”和“实施科学”实践提出质疑，从而扰乱了这些实践。注意到健康干预翻译的政治影响，让人猜测可以以不同的方式进行干预。
