Trauma, Damage and Pleasure

8/18/2019 Trauma, Damage and Pleasure

1/7

Available online at www.sciencedirect.com

International Journal of Drug Policy 19 (2008) 410–416

Research paper

Trauma, damage and pleasure: Rethinking problematic drug useKylie valentine a , ∗ , Suzanne Fraser b

a Social Policy Research Centre, University of New South Wales, Sydney 2052, Australiab Centre for Women’s Studies and Gender Research School of Political and Social Inquiry, Monash University, Clayton 3800, Australia

Received 5 April 2007; received in revised form 26 June 2007; accepted 8 August 2007

Abstract

Background: While the pleasures of drug use are sometimes acknowledged, they are normally limited to those who are socially privileged.The drug use of those who are impoverished and marginalised is linked instead to crime, social misery and addiction. Studying poverty in

connection with drug use enriches our understanding of both poverty and drugs, but there are limitations to these connections, including theirneglect of pleasure. Method: This paper draws on 85 qualitative interviews with service providers and clients, conducted for a project entitled ‘Comparing therole of takeaways in methadone maintenance treatment in New South Wales and Victoria’. Critical readings of psychoanalysis are used as aconceptual frame. Results: Although pleasurable and problematic drug use are often thought to be mutually exclusive, pleasure is reported from both the effectsof drugs such as heroin and methadone, and from the social worlds of methadone maintenance treatment. Attention to drug users’ narrativesof pleasure has the potential for new understandings of drug use and social disadvantage.Conclusion: Common distinctions between kinds of drug use, such as problematic and recreational, are less useful than is normally thought.© 2007 Elsevier B.V. All rights reserved.

Keywords: Methadone maintenance treatment; Psychoanalysis; Pleasure

Introduction

In September 2005 the London tabloid The Daily Mir-ror published front page photographs of fashion model KateMoss lining up and snorting cocaine. Media coverage of celebrity drug-taking is nothing new, but there was some-thing a little peculiar about this incident. Kate Moss enteredrehabilitation only briey, and lost a few job contracts beforewinning them (and more) back. The trajectory of detection,confession, remorse and rehabilitation that has become typi-

cal was absent and so too were accounts of addiction and itsterrible cost. Perhaps for this reason, coverage in the conser-vativeLondon broadsheet Daily Mail waseven lessrestrainedthan usual in its condemnation. Consider, for example, thefollowing editorial:

∗ Corresponding author. Tel.: +61 2 9385 7825; fax: +61 2 9385 7838. E-mail address: [email protected] (K. Valentine).

URL: http://www.sprc.unsw.edu.au (K. Valentine).

[M]ake no mistake. There is a connection between themiddle-class professionals who believe they can controltheir “recreational” cocaine use and the hopeless and help-lessjunkies incountlesshousingestateswhoaredestroyingtheir lives through such drugs. ( Editorial, 2005 )

Although this kind of name-calling is both familiar andintellectually bereft, it does gesture towards a serious andwell-established phenomenon: drug useand its harms amongthosewhoareimpoverished andsocially marginalised. In this

paper, we aim to explore the strengths and limitations of thisapproach to drugs and propose ways that it can be developed.We are especially concerned to unpack the constructions of drugs and users that (sometimes) allow pleasurable use to‘middle-class professionals’ but inevitably connect drug useby the poor to crime, social misery and addiction. These con-structions do not exhaust the ways in which drug-taking isunderstood, of course, nor the ways in which the pleasure of drugs can be examined. Our purpose here is to scrutinise aparticular analysis of drugs as ameliorating pain rather than

0955-3959/$ – see front matter © 2007 Elsevier B.V. All rights reserved.doi:10.1016/j.drugpo.2007.08.001

mailto:[email protected]://localhost/var/www/apps/conversion/tmp/scratch_4/dx.doi.org/10.1016/j.drugpo.2007.08.001http://localhost/var/www/apps/conversion/tmp/scratch_4/dx.doi.org/10.1016/j.drugpo.2007.08.001mailto:[email protected]


2/7


3/7

412 K. Valentine, S. Fraser / International Journal of Drug Policy 19 (2008) 410–416

choanalytic thinking add? There are two answers. The rstanswer is that research into the causal effects of disadvantageon drugs rarely addresses directly the question of pleasure.Psychoanalytic accounts of development and trauma offer analternative. Pleasure, according to psychoanalysis, is centralto all development, whether normative or abnormal. Pleasure

is never absent, even where it has been repressed or re-routedtowards inappropriate objects. Whereas non-analytic thoughtaround trauma tends to focus on self-medication and the mit-igation of pain, reserving pleasure for those who are nottraumatised, a psychoanalytic schema conrms the impor-tance of pleasure for everyone. For all its heteronormativeand otherwise problematic vocabulary, classical psychoana-lyticthought embeds pleasurewherethose systemsof thoughtthat are indebted to psychoanalysis, and have supplanted it,treat pleasure as marginal. The second answer is that psycho-analysis emphasises the importance of narrative and people’saccounts of themselves. In its focus on the sense of symptomsand its operations as a talking cure, psychoanalytic modes of thinking rely on what people say. These modes are thereforea counter to increasingly important approaches to explain-ing drug use that disregard or even discount the legitimacyof users’ accounts of their use, pleasures, constraints andchoices.

It is necessary to very briey rehearse a couple of the cen-tral tenetsof psychoanalytic thought that are relevant here. Inthe early essayson sexuality, Freud described infantile devel-opment in terms of the derivation of satisfaction during oral,genital and anal stages. Pleasure has an evolutionary pur-pose: actions that are necessary to survival are pleasurable,in order that they will be sought and repeated. In earliest

infancy, for example, the taking in of milk is pleasurablebecause the lips ‘behave like an erotogenic zone ’ (Freud,1977, p. 98). This means that the infant will continue toseek out the activity of sucking vital to their existence. Aschildren grow into adults the seeking of immediate plea-sure matures into sublimation, ‘phantasy’and day-dreaming,but pleasure remains vital. Later works such as Beyond thePleasure Principle (Freud, 1961 ) and Civilisation and its Discontents (Freud, 1994 ) describe the tension within indi-viduals between the pleasure principle and the death drive.This is a tension necessary for people to live together insocial worlds but one that also drives societies towards theirend.

Pleasure, then, is critical to the development of individ-uals from infancy to maturity, and for the development of civilisations in drawing people together to live cooperatively.Pleasure also, famously, has the potential to be re-routedin the course of infantile or later development, and this re-routing or perversion can produce neuroses, psychoses orother abnormalities ( Freud, 1985a ; Lapanche & Pontalis,1988). Psychiatric distress has its origin in the misuse ordetouring of pleasure and its development from the infan-tile search for instant gratication to a more mature deferredgratication. Freud argues that symptoms of distress makea kind of sense, indicate the disruption to the mind that

caused them, are not simply indicators of physical decay ordegeneracy ( Freud, 1985b ). Symptoms are substitutes andsatisfactions for what has not happened in real life. Pleasureis not just important to normal development; it can also befound, distorted, in the explanations of abnormal develop-ment.

In addition, there are alternative ways of looking atthe narrative of abuse-trauma-damage than those that tendto dominate both analytic and non-analytic thought. Theparadigmatic example of this narrative is child abuse. JudithButler (1997, pp. 7–8) and Ian Hacking (1995, pp. 65–66)argue that the prevalence and harms of child abuse have beenharnessed too closely to consequences, and that abuse shouldinstead be recognised as an evil regardless of its long-termeffects. Butler in particular uses a psychoanalytic framework to argue that children are not passive cyphers; indeed, theinjustices that are done to them are abuses of the emotionsand pleasures that are essential to their selfhood. Nor shouldthe injustice done to thembe understoodonly in terms of con-sequences, of the bad things that happen to them as a resultof abuse.

In turn, this suggests alternatives to the thinking aroundtrauma, disadvantage and drug use that currently dominate.Rather than thinking of traumaandproblematic drug useonlyin termsofcauseandeffect, it ispossible to acknowledgeboththe injustice of disadvantage and the agency of those whohave been traumatised. That is, poverty and social marginal-isation can be recognised as ills in themselves, regardlessof their association with problematic drug use. People with-out resources will suffer different, and usually more severe,consequences of harmful drug use than people who have

resources. This does not mean that people without resourceshavean inherently exceptionalrelationship to drugs,only thataccess to resources has an impact on the experience of bothharms and treatment. Such a formulation has the potentialto undo some of the more mechanistic links between povertyanddrugusewithout losingsightof theimportanceof povertyto the harms done by drugs. It also involves the recognitionthat drug use is the result of agency as well as trauma, andmay involve pleasure as well as, or as part of, the mitigationof pain. Rather than seeing those who use drugs in terms of passive victimhood, it is possible to acknowledge both thedamage done to them and their capacity to respond and actin their own lives.

Methadone clients by denition use, or at least used,drugs problematically. Many are also socially marginalisedor have suffered trauma, or both ( Shand & Mattick, 2002 ).Methadone maintenance treatment is therefore a productivesite from which to explore the connections between pleasure,agency and trauma in the light of this discussion. This paperis guidedby twomethodological principles: rstly, to be alertto the impact of disadvantage and trauma while declining toassume that people are determined by it, or that pleasure isabsent; and, secondly, to recognise both clients’ capacity tospeak and the importance of narrative in making sense of experience.


4/7

K. Valentine, S. Fraser / International Journal of Drug Policy 19 (2008) 410–416 413

Method

Themethod hasbeendescribedin detailelsewhere ( Fraser,2006; Treloar, Fraser, & valentine, 2007 ). This paper is basedon 85 in-depth, semi-structured interviews gathered for anAustralian National Health and Medical Research Council-

funded project entitled ‘Comparing the role of takeawaysin methadone maintenance treatment in New South Walesand Victoria’. Interview participants were methadone clients(n = 50);serviceprovidersincludingprescribing doctors,dos-ing pharmacists, and clinic staff ( n = 27); and policy workers(n = 8) in two Australian states, NSW and Victoria. Twointerview participants classied as service providers werealso classied as policy makers in the analysis due to theirexperience in both service delivery and policy development.Clients were recruited via notices and yers placed in clin-ics and pharmacies, and with the assistance of state userorganisations. Health care professionals and policy workerswere recruited indirectly with the assistance of professionalcontacts and through email list-serves and notices. Eachparticipant was given an information sheet and a verbaldescription of the project, and clients were offered $20 tocover expenses.

Topics covered in the interviews included history of methadone maintenance treatment (as a client or pro-fessional), day-to-day experiences of treatment, attitudestowards takeaways, and views on and experience of diver-sion of methadone. The interviews were tape recorded andtranscribed verbatim, then analysed to identify themes withthe aid of qualitative data management software, NVivo.Analysis involved the ongoing development and revision

of codes to capture the themes as the process of analysingthe interviews proceeded. The material for this paper isfrom the ‘pleasure’ code. Two researchers coded the inter-views, commencing by double coding, then when codingbecameconsistent between researchers, by singlecoding andintermittent checking to ensure that coding remained consis-tent.

The project had approval from the University of NewSouthWalesHuman ResearchEthics Committeeand relevantarea health service committees.

Findings

Traumatic origins

The gure of the drug user who is self-medicating, ratherthan consuming drugs for pleasure, has become relativelyfamiliar. Our interviews, for example, suggest that in Aus-tralian drug treatment the prevalence of childhood traumain client life histories, and the impact of that trauma ontheir lives, is quite widely recognised. Some clients refer topast trauma as an explanation for their drug dependence. Forexample Ed, a client from Sydney, reects on his own historywhen asked for his thoughts on addiction:

In my case it started off as to kill [physical] pain [after anaccident] but looking back now a lot of things were—likemy mother drank very heavily and used to take out on mequite a bit when I was quite younger and she had no, noargument or worry about saying how worthless I was [ . . . ]When I was very young, before I could do anything or

stand up for myself, my brother used to do some thingswhich were pretty wrong. (Ed, 42, Sydney, client)

It is important to note, however, that not all clients nar-rated thesehistories.Somedescribed themselves as mystiedwhen asked to explain their drug usebecause their upbringingwas untraumatised and so a common explanation was deniedthem, for example Sam:

I wish I knew more about it, even just for my own life, yeah[. . . ] because Mum and Dad are both completely addictionfree and never have smoked or anything, but for some rea-son for me it’s just, because I went to a good Catholic allboys school, and had a great upbringing and everything,but for some reason it just turned to addiction. (Sam, 31,regional Victoria, client)

Others acknowledged the damage done by their own andother childhoods but emphasised the importance of their ownand others’ choices. The causal explanation of drug use intrauma is widely acknowledged by our participants: whatdissent we heard came from those determined to assert thepossibility of different narratives. We return briey to thispoint in the conclusion.

Interviews with service providers also illustrate thedegree

to which social disadvantage and drug use are also linked inpractice. This was not always the case: occasionally drugaddiction would be discussed as a ‘disease’ in clinical termsand the social dimensions of problematic drug use deliber-ately eschewed. For example, Howard, a doctor in regionalVictoria, says working with methadone clients is the same asworking with ‘any other disease’, and, when asked if clientshave any differences from other groups of patients, says:

I think it’s basically very similar to other drugs of depen-dence issues[ . . . ] In particular they tend tohaveassociated,ah, social, psychological, psychiatric and personality dis-order characteristics more frequently than most. (Howard,54, regional Victoria, doctor)

Howard reports only on shared characteristics, not on ori-gins or causes. More typically, however, service providerstalked about origins of trauma and disadvantage. Beverley, anurse from Victoria who works in a specialist clinic and hascontact with clients leaving prison, notes that:

Because you see people come out of a very, very dysfunc-tional, horrible and really sad life, usually [ . . . ] especiallyworking with thoseyoungwomen, they were reallybroken.You don’t end up locked up in custody when you’re six-


5/7


teen and seventeen if you’ve got just about any protectivefactor that’s working for you. (Beverley, 50s, Melbourne,nurse)

These accounts support understandings of problematicdrug use as the product of, or response to, disadvantage or

trauma. Methadonemaintenance treatmentcanbeunderstoodas a particularly denuded existence: denied both the legit-imacy of ‘straight’ life and the resistance or rebellion of illicit drugs ( Friedman & Alicea, 2001 ). Our ndings arethen broadly supportive of the research on social traumaand disadvantage in connection with drug use. However,these connections do not exhaust users’ or service providers’accounts. In the next section we discuss the importance of pleasure in these accounts, and what may be missed whenpleasure is neglected.

The illicit pleasures of methadone

Entry to a methadone maintenance treatment programis reserved for those with dependent, problematic use. Themeanings given to drug use in ofcial treatment frame-works are fairly limited. Pleasurable drug use is sanctionedonly as a retrospective or historical experience. Using drugs(normally heroin) may have been pleasurable once, but itmust be problematic now, because recreational use is not areason to enter treatment. Methadone itself, while holdingalmost all the same properties of heroin, is not prescribedfor pleasure, but for stasis: avoiding withdrawal, obviat-ing the need to take heroin. This is not to say that serviceproviders and policy workers are unaware of the pleasures

of heroin, methadone and other drugs. However, pleasure isoften suppressed or submerged in policy and practice. Theutilitarianism of methadone maintenance treatment is sum-marised by one of our interview participants Barry, a doctorwho also works in policy:

it’s the one thing that, to my knowledge very rarely entersinto the patient-doctor discourse, is the issue of prescrib-ing for pleasure [ . . . ] morally, doctors have got a problemprescribing for pleasure [ . . . ] And likewise, patients wouldnever say, “yeah, look, I am on eighty [milligrams], I’mnot using, (whispers) but I’d really like to get a bit morestoned, canI have an extra twentymilligrams?”(Barry, 40,NSW, policy)

Barry identies pleasure as a forbidden category for bothdoctors and clients, but one that inects the clinical relation-ship. He says that some doctors, including him, have ‘noproblem’ with clients deriving some pleasurable effects fromtheir medications, but others will not allow that. In any case,the question of pleasure is very rarely acknowledged andclients especially must avoid it. The clients we interviewedwere very awareof these systems of meaning and the require-ment to stay within them, but pleasure recurs nonetheless.Some clients talk of the pleasures of heroin, and not only

in the retrospective, historical terms that ofcial talk of drugdependence allows:

But on the other hand, don’t get me wrong, I love usingheroin. You know, it’s, don’t get me wrong, I love it justas a smoker loves a smoke, you know. So, I mean, on one

hand I don’t want to give up, because I enjoy it. And, and Ican have heroin and go to work, you know, what’s wrongwith that. (Cameron, 42, Melbourne, client)

Look, I love the drug, simple as that. If it was, if theydecriminalised it tomorrowand youcouldgo in thechemistand buy a gram, I’d be using heroin every day, the rest of my life, bequite happy. (Isaac, 38,regionalVictoria,client)

I think it’s good, it feels good, it’s nice. It wasn’t ‘cause Igot molested as a child or anything like that [ . . . ] I like, Ilove thewholeculture,I love injecting, I love,yeah, thefeelof it, and, it’s a shame it’s not free. (Alina, 39, Melbourne,client)

Heroin remains pleasurable even for those who haveentered drug treatmentand arenowdenedas achieving noth-ingfrom thedrug but theavoidance ofwithdrawal.Evenmoreunorthodox, in terms of the ofcial politics of drug treat-ment, is the pleasure some clients derive from methadone.This is sometimes from the effects of the drug. Melissa, aMelbourne client, injects her methadone, which makes herrelatively unusual in our study. Most reported methadoneinjectionwas in NSW, a regional difference widely attributedto the dilution of methadone in Victoria ( Lintzeris, Lenne, &

Ritter, 1999 ). Dilution is designed to, and does, make injec-tion time-consuming and more difcult than even the fairlytaxing task of injecting undiluted methadone. Despite this,Melissa reports persisting, because she enjoys it:

So it takes, it can takeup to an hour sometimes, and then if,um, buttery clogs up you’ve got a, it can be a real hassledoing it like that. But, um, I got a taste from it, and it, I gota stone feeling ‘cause I had a bit more than my actual dose.So, um, yeah, and I did enjoy the stone feeling. (Melissa,35, Melbourne, client)

Sam, from regional Victoria, reveals deriving an unusualpleasure from methadone. Many clients and professionalsconcur with the view that methadone and heroin are simi-lar but heroin is more intoxicating. Methadone is generallyseen as a substitute for the effects of heroin, preferable forits predictability and cost but not as euphoric. Sam, how-ever, expresses a preference for theeffects of methadoneoverheroin.

Um, and in fact if methadone were illegal I’d probablyscore that instead of heroin and take methadone, becauseit does last longer. It feels, it, um, stops the ups and downsand stuff. So, yeah, [while] I often think “well, I don’t like


6/7

K. Valentine, S. Fraser / International Journal of Drug Policy 19 (2008) 410–416 415

the methadone program”, I often think if it was illegal I’dprobably love it. (Sam, 31, regional Victoria, client)

Renee, a Sydney client, here describes her rst experienceof methadone:

Loved it. [both laughing] I really did. It made me really illthe rst couple of times I got quite sick from it but um IreallyI lovedthe feeling, thecomplete, theum thecompleterelaxation, total relaxation. I had always been [ . . . ] almostum obsessive compulsive person who couldn’t sit still andit was just a wonderful relaxer. (Renee, 37, Sydney, client)

For Renee, the effects of methadone can be described asrelieving stress and unwanted activity. This is not incompat-ible with those effects being pleasurable, though, and whatshedescribes is not just absence of stress, but a desired effect.Aside from the effects of the drug, there is also pleasure in thesocial worlds of methadone. Jenny here describes the earlydays of her time on methadone:

You had to get up because you had to be there by 11 in themorning and you know it was quite nice because you gotup, hooked up with some friends and went and had coffeeand [laughter] went back and watched the Bold and theBeautiful. (Jenny, 46, Sydney, client)

Methadone maintenance treatment, a regimen of pickingup a dose at least twice a week, is difcult for many clients.It is certainly suboptimal for most of them, including Jenny,who elsewhere in the interview describes the difculties she

has had with work rosters and relationships with health careworkers due to restrictions on takeaways. These and otherdifculties are commonly described by methadone clients(Fraser, 2006; Treloar et al., 2007 ). Even here,however, thereis recognition of an unauthorised kind of pleasure in the rou-tinesandsocial worlds of treatment, ratherthan thefunctional‘structure’ and reintegration into routines that daily pick-upof dosing is supposed to achieve. Jenny, like other clients,nds an unorthodox pleasure in methadone. Pleasure fromthe social worlds of methadone, as from the effects of drugs,could haveuses in ourunderstanding of andresponses to druguse, should treatment and other policies routinely allow fortheir articulation.

Polemical notes towards a conclusion

We will nish by suggesting that recognition of the plea-sures of methadone indicates that some common distinctionsbetween kinds of drug use are less useful than is normallythought. If drugs, including methadone, can be pleasurablefor even traumatisedclients thenanyeasydistinction betweenthe pleasurable, occasional drug use of the middle-class pro-fessional and the traumatised, non-pleasurable use of thesocially marginalised fails to hold. This is not to say thatthis distinction is always made, of course. There are familiar

arguments that all drug use is in fact problematic, regardlessof how it may appear (the Daily Mail editorial with whichwe opened is an example). But we are proposing a differentresolution, suggesting that pleasure can reside in drug usenormally seen as problematic; suggesting, in turn, that mostdrug usecould beconsidered asboth problematicandpleasur-

able. Such a resolution raisesof courseall kinds of questions,which is one reason why it is useful: who is warranted todene ‘problematic’? What does such a designation revealabout norms of social order and health? What are the neo-liberal uses ofpleasure?Howfarcan wegowith ‘pleasurable’and ‘problematic’ before they cover so many multiplicitiesthat their utility is exhausted? How can we discuss both thesimilarities and differences between people and use, withoutdoing violence to either?

It is the nal question that is perhaps most urgent, becauseit speaks to the circumstances of material and social inequal-ity experienced by many problematic users. And we wouldliketo makea secondsuggestionhere: that there ismuch tobegained in disentangling the experience of poverty and abusefrom their effects. This disentangling would involve turn-ing away from an important legacy of psychoanalysis, thesometimes hidden and always complex effects of trauma. Inmaking this argument we are not in any way discounting theimportance of deprivation and disadvantage on problematicdrug use, only that thecausal relationshipbetween them neednot be emphasised. Povertyand deprivation warrant interven-tion in their own right, and so do the harms associated withdrugs. Access to adequate resources to prevent those harms,and adequate treatment services where needed, should notbe contingent on drug use being an effect of poverty. We

know enough about the experience of poverty that we do notneed to continue making new arguments for its long-termeffects on ‘crime’ and ‘drugs’. Poverty and abuse, whetherthey happen to children or adults, are an assault on what peo-ple need to live now, regardless of their effects. They shouldbe addressed for reasons other than consequences or seque-lae. There are, doubtless, connections between problematicdrug use and living in poverty or the experience of abuse,but there are limits to the advantages gained by making thoseconnections.

Recognition that problematic drug use is often a corre-late or effect of poverty should be a useful tool in advocatingfor systematic policy efforts to dismantle poverty (althoughsuch a conclusion could seem optimistic, considering thepolicy responses to ample evidence of other correlates andeffects). Recognition that problematic drug use is a responseto trauma, abuse, poverty, social disenfranchisement andpsychiatric distress should also be useful in countering thecruel banalities of those who condemn both drugs and themarginalised. Inusing that tool, however,we need to beawareof unintended effects. We have been attempting to argue inthis paper that one of those effects may be closing off thespace in which users’ capacity for pleasure can be acknowl-edged. Explaining drug use in terms of social determinantsrisks robbing drug users of their capacity to narrate their own


7/7


accounts of how and why they use drugs, and to present alter-native narratives to those of science, treatment professionals,and their friends. Opening up that space involves animatinganother important legacy of psychoanalysis, the importanceof allowing users’ voices to be heard, interpreted, analysedanddisputed.Thereare pleasures revealedin methadoneeven

in the most constrained of circumstances. Allowing thosepleasures to be revealed more fully could give rise to newnarratives and counter-narratives of drug use that could, inturn, give rise to new knowledge.

Acknowledgements

This study was fundedby theNationalHealthandMedicalResearch Council of Australia, andconductedat theNationalCentre in HIV Social Research, University of New SouthWales.Thanks to theChiefInvestigatorsand referencegroup:Carla Treloar, Susan Kippax, Alex Wodak, Max Hopwood,Catherine Waldby, Susan McGuckin, Andrew Byrne, AnneLawrance, Denis Leahy and Sarah Lord. Thanks also to theanonymous reviewers and editors who commented on earlierversions of this paper.

References

Advisory Council on the Misuse of Drugs. (1998). Drug misuse and theenvironment . London: The Stationery Ofce.

Bourgois, P. (1995). In search of respect: Selling crack in El Barrio . Cam-bridge, NY: Cambridge University Press.

Butler, J. (1997). The psychic life of power: Theories in subjection . San

Francisco: Stanford University Press.Editorial. (2005, 17 September). Drugs “War” and liberal hypocrisy. Daily

Mail .Fountain, J., Howles, S., Marsden, J., Taylor, C., & Strang, J. (2003). Drug

and alcohol use and the link with homelessness: Results from a surveyof homeless people in London. Addiction Research & Theory , 11(4),245–256.

Fraser, S. (2006). The chronotope of the queue: Methadone maintenancetreatment and the production of time, space and subjects. International Journal of Drug Policy , 17 (3), 192–202.

Freud, S. (1961). Beyond the pleasure principle (J. Strachey, Trans.). InOn metapsychology: The theory of psychoanalysis (Vol. 11). Middlesex:Penguin.

Freud, S. (1977). Three essays on sexuality (J. Strachey, Trans.). In Onsexuality (Vol. 7). Middlesex: Penguin.

Freud, S. (1985a). Fixation to traumas—the unconscious (J. Strachey,Trans.). In Introductory lectures on psychoanalysis (Vol. 1). Middlesex:Penguin.

Freud, S. (1985b). The sense of symptoms (J. Strachey, Trans.). In Introduc-tory lectures on psychoanalysis (Vol. 1). Middlesex: Penguin.

Freud, S. (1994). Civilisationand itsdiscontents (J.Riviere,Trans.).London:Hogarth.

Friedman,J., & Alicea, M. (2001). Surviving heroin: Interviews with womenin methadone clinics . Gainesville: University Press of Florida.

Hacking,I. (1995). Rewritingthe soul: Multiple personality and the sciencesof memory . New Jersey: Princeton University Press.

Hall, W. (2006). Avoiding potential misuses of addiction brain science. Addiction , 101 , 1529–1532.

Lapanche, J., & Pontalis, J.-B. (1988). The language of psycho-analysis (D.Nicholson-Smith, Trans.). London: Karnac Books and the Institute of Psycho-Analysis.

Lintzeris, N., Lenne, M., & Ritter, A. (1999). Methadone injecting in Aus-tralia: A tale of two cities. Addiction , 94(8), 1175–1178.

Marmot,M. (2003).Understandingsocialinequalitiesin health. Perspectivesin Biology and Medicine , 46 (3), s9–s23.

Marston, G., & Watts, R. (2003). Tampering with the evidence: A criti-cal appraisal of evidence-based policy-making. The Drawing Board An Australian Review of Public Affairs , 3(3), 143–163.

Moore, D. (1992). Deconstructing “dependence”: An ethnographic critiqueof aninuential concept. Contemporary DrugProblems , 19(3), 459–490.

Moore, D., & Fraser, S. (2006). Putting at risk what we know: Reecting onthe drug-using subject in harm reduction and its political implications.Social Science & Medicine , 62(12), 3035–3047.

Najavits, L., Weiss, R., & Shaw, S. (1997). The link between substanceabuse and posttraumatic stress disorder in women: A research review. American Journal of Addictions , 6 (4), 273–283.

Rado, S. (1933). The psychoanalysis of pharmacothymia. Psychoanalytic

Quarterly , 2, 1–23.Shand, F. L., & Mattick, R. (2002). Clients of treatment service agencies: May 2001 census ndings . Canberra Commonwealth Department of Health and Ageing.

Spooner, C., & Hetherington, K. (2004). Social determinants of drug use(No. Technical Report No. 228). Sydney: National Drug and AlcoholResearch Centre.

Treloar, C., Fraser, S., & valentine, k. (2007). Valuing methadone take-away doses: The contribution of service user perspectives to policy andpractice. Drugs: Education, Prevention and Policy , 14(1), 61–74.

Documents

Trauma, Damage and Pleasure