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药物致死和治疗宿命论:使老龄化队列理论复杂化。

Drug fatalities and treatment fatalism: Complicating the ageing cohort theory.

机构信息

Goldsmiths, University of London, London, UK.

出版信息

Sociol Health Illn. 2021 Jun;43(5):1175-1190. doi: 10.1111/1467-9566.13278. Epub 2021 May 6.

Abstract

Deaths related to drug 'misuse' remain at an all-time high in the United Kingdom (UK). Older heroin consumers are particularly at risk, with the highest rates of deaths among people aged 40-49 and the steepest rises in the over-fifty age bracket. Accordingly, a popular theory for the UK's increase in drug-related deaths, made by the government, and propelled in the media, is that there is an ageing cohort of heroin users with age-related health complications predisposing them to an overdose. However, drawing on in-depth interviews with those people deemed to be most at risk, this article works to complicate this theory, with participants citing a shift in (a) experience and responsibility, (b) route of administration, (c) desired effects, (d) acceptance of their drug use and 'user' status and (e) valuing health. Disrupting age as a given risk factor, this article turns attention away from the individual and these 'natural' processes to what participants describe as a singular, punitive, and inflexible treatment system and its intersecting structures. Approaching life and death as a matter of sociomaterial 'mattering', this article rethinks a reductionist, causal link between age and drug-related death with a treatment despondency and fatalism that could prove fatal.

摘要

在英国(UK),与药物“滥用”相关的死亡人数仍处于历史最高水平。老年海洛因使用者尤其面临风险,40-49 岁人群的死亡率最高,50 岁以上人群的死亡率上升幅度最大。因此,政府和媒体提出了一个流行的理论,即英国因药物相关死亡人数的增加是由于年龄较大的海洛因使用者存在与年龄相关的健康并发症,使他们容易过量用药。然而,本文通过对那些被认为风险最高的人进行深入采访,对这一理论进行了复杂化处理,参与者提到了(a)经验和责任、(b)给药途径、(c)期望效果、(d)对他们的药物使用和“使用者”身份的接受程度以及(e)对健康的重视方面的转变。本文通过将年龄视为既定风险因素的做法,将注意力从个体和这些“自然”过程转移到参与者所描述的单一、惩罚性和僵化的治疗系统及其交叉结构上,从而颠覆了年龄的作用。本文将生活和死亡视为社会物质“重要性”的问题,重新思考了年龄与药物相关死亡之间的简化因果关系,这种治疗的绝望和宿命论可能是致命的。

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