Becoming vulnerable: Young women's accounts of initiation to injecting drug use

Abstract

This article engages in a sociological analysis of young women's experiences of initiation; its aim is to complement epidemiological research on women injectors’ relative vulnerability to drug-related risk through an exploration of the social conditions in which this increased vulnerability is produced. This article is based on the findings of qualitative research indicating that young women's initiation to injecting drug use often takes place in the context of intimate relationships. The analysis presented explores the social and personal significance of intimate relationships in young women's lives, and the link between risk-taking and intimacy.

• injecting drug use
• women
• initiation
• intimacy
• risk
• vulnerability

Notes

Notes

1. Studies in Australia and Canada have found, for example, that rates of hepatitis C and HIV infection, respectively, are growing at faster rates for women than men (Spittal et al. 2002; Gifford et al. 2003).

2. These texts are built upon earlier writing on the reflexive project of self in late modernity (Giddens 1991; Beck 1992). Loosely defined, ‘individualisation’ refers to the processes by which inherited roles pertaining to gender, family, class identity and associated codes of conduct are in the process of dissolving along with traditional configurations of marriage and the family.

3. Drug researchers’ emerging interest in the embodied sensations associated with substance use reflects the growing number of studies of the body as a site of subject formation within the social sciences more generally (MacLean 2008). It also reflects an increasing acknowledgement and engagement with the pleasures afforded by substance use in policy debates around harm minimisation (Holt and Treloar 2008).

4. All participants were guaranteed anonymity and confidentiality, and all of them provided informed consent. The research project was granted ethics approval from the University of Melbourne Human Research Ethics Committee.

5. During the period of my involvement with WADS, researchers from three other projects were also recruiting participants through the service. All experienced setbacks in the busy clinic setting with regard to ‘getting the numbers’ of participants they required or expected, a problem they resolved either by more insistently petitioning the WADS staff for client referrals or by carrying out interviews on the hospital site, after clinic appointments or during the postpartum period of hospital confinement. I declined from engaging in these more persistent tactics. It was important to me to conduct the interviews outside of the clinical setting to protect the confidentiality of participants and to informally distinguish the research project from the daily operations of the clinic. Interviews were conducted in a location chosen by the research participants, most often their homes.

6. Organising the interview material this way generated relatively cohesive accounts of shared experiences. It also rendered apparent some of the complexities and inconsistencies across and within women's accounts.

7. A series of analytical questions were used to interpret the ways in which women told their life stories. These questions focused on identifying the continuity or discontinuity in women's narratives, where conflicts or tensions arose, and how key themes–such as initiation, addiction, risk, intimate relationships, mothering, guilt/shame, morality etc.–featured within these narratives.

8. Data analysis also involved identifying the relationship between women's narratives of self and dominant socio-cultural constructs around motherhood or the causes and consequences of addiction, for example.

9. Mahmood frames her study of the women's piety movement in Egypt as an examination of how norms are ‘lived and inhabited, aspired to, reached for, and consummated’ (2005, p. 23). Drawing on her methodology, which is based on Foucault's (1983) analysis of ‘moral subjectification’, women's narratives in this study were coded for the following themes: the substance/object of ethical reform, the techniques of the self, the voice of authority and the ideal mode of being to which women aspired.

10. This was one of many instances where the open, interpretive style of interviews was not conducive to gathering factual data. Women often only indirectly indicated they were in the process of disengaging from injecting drug use, by discussing their decision to access drug treatment and/or drug substitution therapy. Those who implied that they occasionally ‘lapse’, but nonetheless identified themselves as trying to stop or reduce their drug use, fall into this category. All of the women interviewed had accessed some form of drug treatment previously.

11. These accounts should therefore be read as narrative ‘translations’ on the part of the researcher (Sulkunen 2002; MacLean 2008).

12. As sociologist, Frost (2001, p. 119) argues, the expression of desire does not have the same moral implications for young women when it takes place in the context of heterosexual relationships.

13. At the time of our interview, Mira had only recently been released from a Melbourne-based immigration detention centre and granted a ‘bridging visa’ to remain in Australia. This visa prohibits her from working and entitles her to only limited social security benefits. As a result, she is unable to financially support her son, who is currently living with her husband's parents.

14. Joffe (1997) argues, for example, that for male sex workers, non-use of condoms represents a sexual encounter as intimate, while condom use represents the body as usury. She does not explore the ways in which non-use of condoms might also facilitate a particular kind of ‘unmediated’ sexual contact between two people, despite her research participants’ testimonies that this kind of contact brings intimacy into being.

15. Shildrick (2002) begins her analysis by asking what is at stake in the imperative to contain sickness, disease and the risk of contagion in western culture; the answer, she argues, is ontological and is based on a fear of revealing human vulnerability. She proposes that engaging in risk should be re-thought in relation to what she calls the ‘truth of our vulnerability’. In western discourse, vulnerability is figured as a shortcoming, an impending failure of form and function that marks the subject as potentially beyond normative standards, but she suggests that if we accepted ‘always already vulnerability’ as the condition, not only of all bodies, but all embodied selves, we might have a profoundly different conception of risk.