Editor’s note: Points welcomes Todd Meyers, a medical anthropologist at Wayne State University, to discuss his new book, The Clinic and Elsewhere: Addiction, Adolescents, and the Afterlife of Therapy (Seattle: University of Washington Press, 2013).
The book tells the story of a small group of teenagers (some quite young) who abuse opiates (heroin, prescription painkillers) as well as other drugs, and what drug dependency treatment was like for them. I met most of them during their time at a residential drug treatment center in Baltimore – a treatment center that, oddly enough, was once a monastery. I was fool enough to attempt following them around for long periods of time to gain an appreciation of how addiction and treatment took shape in their lives – how these two “modes” (drug dependency and its treatment) blur in unexpected ways. And that’s really one of the key arguments of the book – that clinical activities and thought reach into this thing we call “the social” and vice versa, thus the title of the book, The Clinic and Elsewhere. All of the kids I followed were treated with a relatively new pharmaceutical therapy (buprenorphine) for withdrawal and replacement therapy, and I followed that treatment process through their time in residential care and back into their homes or other institutional environments. The book is simultaneously about the new pharmaceutical therapy itself – tracing its development and approval as a new treatment modality. The book is a bit theoretical (what are the experiential dimensions of therapeutics? of patienthood? of success and failure of medical intervention? of concern? etc.) and a bit straight storytelling (that is to say, it’s ethnographic, through I’m becoming less and less satisfied with the salience of ethnography as both the technology and product of fieldwork). I attempted, at times clumsily, to make sense of treatment and addiction alongside these kids and their families as they themselves struggled with its meaning.
That’s probably what I’d say. But in full disclosure, the last time I had a conversation with a bartender it began with hearing how he makes his own bitters from plants in his hydroponic garden and ended with him describing his thesis project (something about lactose fermentation and legal aspects of local food production), so I don’t think the book would be much of a stretch. In fact, that’s part of my effort – to present work in conceptual terms that is not completely foreign to a broad readership (though not to water things down by any means, keeping with the bartender analogy) – and at the same time I have tried to write against the anticipated trope of marginality. That last part is probably the hardest to convey convincingly. The book is not a series of reworked scenes from The Wire but instead attempts to demonstrate the slow, at times banal, at other times brutal ways in which both addiction and treatment take hold within the domain of individual experience (contrasting a perspective where treatment neutralizes addiction uniformly, or that the experience of treatment is largely unvaried).