Australian Research Centre in Sex, Health and Society, La Trobe University, Australia.
National Drug Research Institute, Curtin University, Australia.
Health Sociol Rev. 2021 Jul;30(2):95-110. doi: 10.1080/14461242.2020.1789485. Epub 2020 Jul 9.
The discrimination faced by people understood to have alcohol or other drug addictions has been the subject of extensive research, with many studies documenting experiences of stigma within healthcare services. Building on this literature, we examine the role of stigma in shaping the healthcare expectations of people seen as affected by alcohol and other drug addictions. Our analysis draws on recent theorisations of stigma as a process of social production to analyse in-depth, qualitative interviews with 20 people who had recently attended an inpatient withdrawal management service. Participants describe as exceptional forms of care that are often taken for granted by other members of the community. We argue that routinised experiences of discrimination work to constitute basic care as exceptional. This finding is significant for two reasons: (1) people who consume alcohol and other drugs often have complex healthcare needs and already encounter obstacles to accessing the care they need, and (2) by positioning people who consume drugs outside the purview of healthcare, this dynamic obstructs their fundamental right to care. We conclude by reflecting on the implications of these findings for those who are often positioned as not entitled to high quality healthcare.
人们对有酗酒或吸毒问题的人的歧视一直是广泛研究的主题，许多研究记录了医疗保健服务中污名化的经历。在此基础上，我们研究了污名化在塑造人们对酗酒和吸毒问题的医疗保健期望方面的作用。我们的分析借鉴了最近关于污名化是一种社会生产过程的理论，对最近参加住院戒断管理服务的 20 人进行了深入的定性访谈。参与者将那些被认为受到酗酒和吸毒影响的人的护理描述为特殊形式的护理，而这些护理通常被社区的其他成员视为理所当然。我们认为，例行的歧视经历使基本护理变得特殊。这一发现有两个重要原因：（1）酗酒和吸毒的人通常有复杂的医疗保健需求，并且已经遇到了获得所需护理的障碍；（2）通过将吸毒者置于医疗保健范围之外，这种动态阻碍了他们获得护理的基本权利。最后，我们反思了这些发现对那些经常被认为无权获得高质量医疗保健的人的影响。
