Into the cracks: a geology of encounters with addiction as disease and moral failing

Abstract

The author is thinking with Deleuze’s ethical practice of ‘being on the lookout’ for encounters with the cracks. Drawing on research in the USA on access to health care for people who use illicit drugs, the author works with Deleuze and Guattari, Deleuze and Foucault in a geological and genealogical mode of inquiry to investigate the preoccupation over whether addiction is a disease or a moral failing, raising questions about the modes of subjectivation produced by these designations. The author works through a series of encounters, entering into the cracks, where things are already breaking up to unhinge thinking from usual habits to consider what our explanations of addiction produce and to chart different territory, creating different possibilities for insight and action.

Keywords:

• Gilles Deleuze
• Michel Foucault
• addiction
• geology
• genealogy

Acknowledgements

Earlier versions of this article were presented at the International Congress on Qualitative Inquiry, Urbana‐Champaign, IL, May 2008; The Honor’s Center, SUNY New Paltz, September 2008; the Seventh National Harm Reduction Conference in November 2008, Miami, FL; the Feminist Epistemologies, Methodologies, Metaphysics, and Science Studies conference in Columbia, SC in March 2009. I am especially grateful for the comments provided on these earlier versions by Patti Lather, Lisa Mazzei, Alecia Youngblood Jackson, and Chelsea Bailey. Thanks to Elizabeth Gross, a student in my SUNY New Paltz Women and Drugs class Fall 2008, whose final paper inspired me to investigate women healers and witches. Thanks to my anonymous reviewers from QSE, my friend Bill Hoag, and colleagues Charles Stivale and Eve Tuck for their generous readings and suggestions for the improvement of this work. Thanks to Amy Hannes for formatting the photographs.

Notes

1. Primary data were collected in a study of health care accessibility and acceptability for people who use heroin and cocaine with the New York Academy of Medicine (NYAM) between 1999 and 2002 (see Weiss et al. 2004).

2. This reference is in an English translation of Illuminati’s review essay, originally published in Italian. The translator, Arianna Bove, has added these references. I do not have the date of the translation.

3. For example, it is still a common practice to shackle imprisoned pregnant women while they are in labor (see Associated Press 2009; Liptak 2006). This practice affects many women who use drugs because of the large numbers of women incarcerated for drug offences (Correctional Association of New York 2008).

4. Deleuze and Guattari distinguish the map and the rhizome from the tracing and the tree. In A Thousand Plateaus, they associate the tracing with tree logic and mapping with rhizomatic connectivity. Tracing, they argue, is based on ‘an overcoding structure or supporting axis, something that comes ready‐made’ (Deleuze and Guattari 1987, 12).

5. See Heller, McCoy, and Cunningham (2004) and the Harm Reduction Coalition website: http://www.harmreduction.org.

6. Not all physicians responded to the study in this way. Some were on board with the project from the beginning. Several of those physicians and psychiatrists joined together to create the Manual for Primary Care Providers: Effectively Caring for Active Substance Users (Finkelstein and Ramos 2002). In particular, McLellan et al. (2002), quoted in the opening scene, present compelling arguments to encourage physicians to consider drug dependence as a ‘chronic medical illness’, using comparisons to asthma, hypertension, and diabetes, though, as this article suggests, such a formulation may do little to interrupt current dehumanizing practices.

7. In ‘Towards a geology of evidence‐based practice – A discussion paper’, Rolfe and Gardner (2006) think with Deleuze about evidence‐based practice in nursing. Their investigation disrupts the common belief that evidence‐based practice is a coherent construct with a linear developmental history.

8. Even geology concerns itself with ‘epistemic uncertainty’ and ‘aleatory methods’ when in the service of assessing the structural integrity of building sites. For example, geologists have found that it is wrong to assume a consistent composition of a stratum of rock (Crawford, Neretnieks, and Moreno 2005) or to predict seismic activity (Cramer 2001) without consideration of aleatory or unforseeable possibilities at particular sites.

9. Another thing that Deleuze and Guattari do is mix up their concepts and use them interchangeably, even when they seem qualitatively different. For example, the map works with the concept of the rhizome, whereas the tracing works with the concept of the tree. In an article entitled ‘Geology of morals: A neo‐materialist interpretation’, De Landa (1995) enriches the mix by using stratum with the tracing and the tree and what he calls ‘meshworks’ or ‘self‐consistent aggregates’ with the map and the rhizome. De Landa explains the stratum, the tree, and the tracing as made up of homogeneous elements organized into hierarchical formations that develop according to goals imposed from the top down, while meshworks, rhizomes, and maps are ‘decentralized’ and ‘self‐organized’ and they ‘grow and develop mostly by drift’ (1995).

10. Colombat notes that this quote comes from a 1983 interview with Deleuze published in Libération, 3 October 1983.

11. From Burchell, Gordon, and Miller (1991).

12. While the criminalization of drug use does not immediately translate into the execution of those found ‘guilty,’ it is arguable that punitive drug policy also deals in death. See, for example, Heller, McCoy, and Cunningham (2004).