Translating Guān’ài in the People’s War on Drugs: Enacting Relations of Care in China’s State-Run Methadone Maintenance Treatment Program

Abstract

China’s state-run methadone maintenance treatment (MMT) program was launched in 2003 in response to the growing HIV/AIDS epidemic and increasing criticism of compulsory rehabilitation centers. In conjunction with providing methadone replacement therapy, the Chinese state began promoting a politicized discourse of guān’ài 关爱 (care and love) as a more effective and humane method for dealing with drug users. While the medicalization of addiction as a chronic brain disease requiring long-term pharmaceutical treatment marked a watershed moment in the debate over drug control in China, the affective recasting of addiction as a social condition worthy of care is potentially even more revolutionary. But to what extent has this project transformed Chinese drug users into a legitimate target of (state) care? Based on ethnographic fieldwork conducted in Yunnan province from 2013 to 2019, we examine how various stakeholders in China’s MMT program (including methadone recipients, clinicians, public health officials, police officers, and the general public) have attempted to translate the discourse of guān’ài into workable practices and relationships based on divergent understandings of how to care for and about Chinese drug users. Our analysis shows how attending to the everyday dynamics of guān’ài in the People’s War on Drugs provides a novel approach to theorizing the fraught politics of care.

• addiction
• drug control
• care
• moral legitimacy
• anthropology
• China

Acknowledgements

We would like to thank Peter Benson, Joseph Bosco, Catelijne Coopmans, Rebecca Lester, Karen McNamara, Carolyn Sargent, Lihong Shi, Brad Stoner, James Wertsch, Jing Xu, and Yang Zhan for their insightful suggestions on earlier drafts of this article. The fieldwork for this article was supported by grants from Washington University in St. Louis, the Hang Seng Bank Golden Jubilee Education Fund for Research, and the Research Grants Council of the Hong Kong Special Administrative Region, China (project no. HKU C7011-16G, “Making Modernity in East Asia: Technologies of Everyday Life, 19th–21st Centuries”).

Notes

¹ But as Miriam Ticktin (2011) has shown in her analysis of immigration politics in France, this purported claim to be apolitical masks the ways in which humanitarianism has become a form of governance privileging certain suffering bodies as worthy while discounting others. Predicated on “the moral imperative to relieve suffering,” these “regimes of care” produce unintended “casualties of care” that end up further entrenching suffering, such as encouraging undocumented immigrants to sacrifice their bodily health for political recognition (Ticktin 2011: 3).

² When the MMT program was first launched in 2003, injection drug users accounted for 43.9 percent of people living with HIV in China (PRC State Council AIDS Working Committee Office and United Nations Theme Group on HIV/AIDS in China 2004).

³ The outpatient MMT clinics and compulsory rehabilitation centers are two alternative state-run ways of dealing with drug addiction — they are in some ways competing and in other ways complementary in providing addiction treatment and information.

⁴ Based on data gathered during a recent follow-up research trip, we estimate that approximately one-fifth to one-fourth of patients who were enrolled in the central MMT clinic within the first three years of the program were still receiving treatment as of July 2019.

Additional information

Notes on contributors

Priscilla Song

Chaoxiong Zhang is a postdoctoral fellow in the Hong Kong Institute for the Humanities and Social Sciences at the University of Hong Kong. She received her doctorate in anthropology from Washington University in St. Louis. Her research bridges addiction studies, public health governance, and cultural anthropology. She is completing a book manuscript on the moral experiences and addiction treatment trajectories of Chinese drug users.

Priscilla Song, PhD, is an assistant professor in the Centre for the Humanities and Medicine at the University of Hong Kong. Her research focuses on the culture and ethics of transnational biomedical technologies. She is the author of Biomedical Odysseys: Fetal Cell Experiments from Cyberspace to China (2017), which was awarded the 2018 Francis Hsu Book Prize by the Society for East Asian Anthropology.