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Qual Health Res. 2013 Jul;23(7):916-23. doi: 10.1177/1049732313487027. Epub 2013 May 3.

Producing the "problem" of addiction in drug treatment.

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National Drug Research Institute, Curtin University, Perth, Western Australia, Australia.


In this article, we argue that the "problem" of addiction emerges as an effect of treatment policy and practice as well as a precursor to it. We draw on the work of Marrati to analyze interviews with policy makers and practitioners in Australia. The interviews suggest that the episode-of-care system governing service activity, outcomes, and funding relies on certain notions of addiction and treatment that compel service providers to designate service users as addicts to receive funding. This has a range of effects, not least that in acquiring the label of "addict," service users enter into bureaucratic and epidemiological systems aimed at quantifying addiction. Rather than treating pre-existing addicts, the system produces "addicts" as an effect of policy imperatives. Because addiction comes to be produced by the very system designed to treat it, the scale of the problem appears to be growing rather than shrinking.


addiction / substance use; health care; health policy / policy analysis; interviews; sociology

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