title: Addiction stigma and the biopolitics of liberal modernity: A qualitative analysis.
abstract: 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.
authors.affiliation: National Drug Research Institute, Faculty of Health Sciences, Curtin University, NDRI Melbourne Office, 6/19-35 Gertrude St., Fitzroy, Victoria, 3065, Australia. Electronic address: suzanne.fraser@curtin.edu.au.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Fraser
authors.affiliation: National Drug Research Institute, Faculty of Health Sciences, Curtin University, NDRI Melbourne Office, 6/19-35 Gertrude St., Fitzroy, Victoria, 3065, Australia.
authors.forename: Kiran
authors.initials: K
authors.lastname: Pienaar
authors.affiliation: Social Studies in Health and Medicine Research Program, Arts, Monash University, Menzies Building, 20 Chancellors Walk, Clayton Campus, Victoria, 3800, Australia.
authors.forename: Ella
authors.initials: E
authors.lastname: Dilkes-Frayne
authors.affiliation: National Drug Research Institute, Faculty of Health Sciences, Curtin University, NDRI Melbourne Office, 6/19-35 Gertrude St., Fitzroy, Victoria, 3065, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Moore
authors.affiliation: Social Studies in Health and Medicine Research Program, Arts, Monash University, Menzies Building, 20 Chancellors Walk, Clayton Campus, Victoria, 3800, Australia; Centre for Applied Social Research, RMIT University, Melbourne, Australia; School of Social Sciences, Arts, Monash University, Australia.
authors.forename: Renata
authors.initials: R
authors.lastname: Kokanovic
authors.affiliation: Centre for Social Research in Health, Faculty of Arts and Social Sciences, University of New South Wales, Kensington, 2052, Australia.
authors.forename: Carla
authors.initials: C
authors.lastname: Treloar
authors.affiliation: Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, 2305, Australia.
authors.forename: Adrian
authors.initials: A
authors.lastname: Dunlop
mesh_terms: D001315:Australia; D005260:Female; D006801:Humans; D008297:Male; D011057:Politics; D036301:Qualitative Research; D057545:Social Stigma; D019966:Substance-Related Disorders
keywords: Addiction; Neuroscience; Performativity; Qualitative research; Stigma