Pleasure Consuming Medicine

Race Kane Race

Description

On a summer night in 2007, the Azure Party, part of Sydney's annual gay and lesbian Mardi Gras, is underway. Alongside the party outfits, drugs, lights, and DJs is a volunteer care team trained to deal with the drug-related emergencies that occasionally occur. But when police appear at the gates with drug-detecting dogs, mild panic ensues. Some patrons down all their drugs, heightening their risk of overdose. Others try their luck at the gates. After twenty-six attendees are arrested with small quantities of illicit substances, the party is shut down and the remaining partygoers disperse into the city streets. For Kane Race, the Azure Party drug search is emblematic of a broader technology of power that converges on embodiment, consumption, and pleasure in the name of health. In Pleasure Consuming Medicine, he illuminates the symbolic role that the illicit drug user fulfills for the neoliberal state. As he demonstrates, the state's performance of moral sovereignty around substances designated "illicit" bears little relation to the actual dangers of drug consumption; in fact, it exacerbates those dangers.Race does not suggest that drug use is risk-free, good, or bad, but rather that the regulation of drugs has become a site where ideological lessons about the propriety of consumption are propounded. He argues that official discourses about drug use conjure a space where the neoliberal state can be seen to be policing the "excesses" of the amoral market. He explores this normative investment in drug regimes and some "counterpublic health" measures that have emerged in response. These measures, which Race finds in certain pragmatic gay men's health and HIV prevention practices, are not cloaked in moralistic language, and they do not cast health as antithetical to pleasure.

Sujets

• Sociologie, société et politique
• Medical sociology

Informations

• Publié par: Duke University Press
• Date de parution: 17 juillet 2009
• Nombre de lectures: 0
• EAN13: 9780822390886
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

P L E AS URE CONS UMI NG ME DI CI NE

P L E A S U R E

C O N S U M I N G

M E D I C I N E

š š š

The Queer Politics of Drugs

K A N E R AC E

Duke University Press Durham & London 2009

∫2009 Duke University Press All rights reserved Printed in the United States of America on acid-free paper$ Designed by Amy Ruth Buchanan Typeset in Whitman by Keystone Typesetting, Inc. Library of Congress Cataloging-in- Publication Data appear on the last printed page of this book.

C O N T E N T S • • •

Prefacevii Acknowledgmentsxv

1. PLEASURE CONSUMING MEDICINE AnIntroduction1

2. PRESCRIBING THE SELF 32

3. RECREATIONAL STATES 59

4. DRUGS AND DOMESTICITY FencingtheNation80

5. CONSUMING COMPLIANCE RememberingBodiesInhabit PharmaceuticalNarratives106

6. EMBODIMENTS OF SAFETY 137

7. EXCEPTIONAL SEX HowDrugsHaveCometoMediateSex inGayDiscourse164

Notes191 SelectedBibliography Index245

229

P R E FAC E • • •

A group called Freedom from Fear can serve as a brief illustration and entry point into the mutually transforming relations between medical subjectivity and consumer society that underlie and inform this book. It’s one example of the patient advocacy and support groups that character- ize the scene of health and medicine today. The group is a not-for-profit organization whose mission is to raise awareness about anxiety and depression and their treatment. Since its inception in 1984 it has become a national advocacy organization with many chapters and a significant media presence in the United States. A large amount of its funding comes from pharmaceutical organizations, which may help to explain its growth. The group promotes a range of drug and behavioral therapies and conducts awareness-raising activities, such as running the National Anxiety Disorders Freedom Day—a major media event. Here, medi- cal education becomes indistinguishable from marketing, and health is thought to require consumer identification, as even the group’s founder, Mary Guardino, advises: ‘‘One of the things I’ve found when you’re reaching consumers is you have to have a good tag line. You have to give them a quick message that raises their curiosity and interest and says, ∞ ‘Wow! That could be me!’ ’’ I first came across Freedom from Fear when Guardino was inter- viewed foressSellingSickn, a documentary that investigates the relations between medical science, the pharmaceutical industry, and contempo- ≤ rary society. Couched in a genre that is increasingly well adapted to the intrigues of the contemporary pharmaceutical industry—detective jour- nalism and exposé—the documentary forms part of a mounting critique ≥ of ‘‘disease-mongering.’’ This term was coined by a loose coalition of activists and medical professionals to describe the rapid expansion of disease categories driven by the profit motives of pharmaceutical corpo-

viii PRE FACE .............................................................................................................

rations. While I don’t wish to deny the importance of this e√ort to ex- pose corporate interests and investigate their sociomedical e√ects, I did begin to wonder what would happen if we suspended its terms for just a moment and took initiatives such as Guardino’s at face value for the insight they provide into the terms of medical rationality today. Guardino’s commitment to her version of therapeutic salvation is evi- dent in the film: she describes her personal experience at a promotional event where she suggests that, if all else fails, it is really worth trying an antidepressant. In another scene she is shown, perhaps gratuitously, recounting her story and exhorting her audience: ‘‘After I overcame all these things I said ‘Why wouldn’t anybody really want to take some drugs if it could help them to overcome their terrible life?’ ’’ Well, precisely. The starting point for this book is the irony of a situation in which the medical industry persistently succeeds in widen- ing the parameters of the uses to which drugs are put, while a punitive war on drugs escalates that takes a similar form of widening as its justification. I want to ask how, why, and with what e√ects contemporary strictures around the ‘‘improper’’ use of drugs are so ruthlessly main- tained, while in the medical sphere the liberal application of drugs for varied purposes is increasingly promoted as a simple matter of consumer choice. In the current biomedical context, corporeal existence has be- ∂ come a privileged site for experiments with subjectivity. This being the case, what purpose does the legal distinction between licit and illicit drugs serve, and why does it wield medical authority so selectively to demarcate the bounds of moral citizenship and identity? My aim in asking this question is not exactly to endorse a free market in drugs, for drugs do demand great care, but rather to use this perverse coincidence to open up a series of questions about how best to conceive the relations between drugs, bodies, subjectivities, identities, and practices. For if regulatory regimes determining the illicit use of drugs have acquired excessive power to frame individuals as normal or abnormal, decent or deviant—with criminal and damaging e√ects—as I will argue, then dif- ferent conceptions and practices of responsibility—practices capable of attending more carefully to particular uses of drugs and relations of consumption—might have a better chance of preparing subjects for a society already permeated by drugs. Initiatives such as Freedom from Fear embody many of the paradoxes,

PRE FACE ix .............................................................................................................

possibilities, and tough dilemmas of a situation I refer to in this book as ‘‘pleasure consuming medicine.’’ This phrase aims to evoke the contem- porary enthusiasm for drugs, in a deliberately ominous gesture. But it also tries, however improbably, to inject an element of hope and em- bodied inquiry into this situation—principally by activating the critical agency of pleasure. Pleasure is more or less absent from serious talk within public health, though it is a common enough motive for, and ∑ element of, human activity. When it comes to drugs, it could be said to provide the basis upon which legal and moral distinctions (between licit and illicit instances) are made. Taking drugs for pleasure would appear to transgress the moral logic of ‘‘restoring health’’ that guarantees their pharmaceutical legitimacy. But the undeniable importance and common appeal of pleasure might lead us to wonder whether this routine exclu- sion and disavowal of pleasure doesn’t serve to prop up the self-evidence of medical rationality. Enabling pleasure is one of medicine’s most basic concerns, after all. Though the pursuit of pleasure is frequently pro- jected onto others in e√orts to expose them as intolerably indulgent— positioned as a vice pursued only by the marginal or depraved, or a luxury conceded only to the privileged—pleasure can be framed more generally as a need or aspiration that informs all manner of human activity. It has a generalizable or ‘‘whatever’’ quality that might also prompt a more expansive inquiry into particularity. Anyone can relate to the need for pleasure, though the precise content of what they are relat- ing to may remain an open question. Against the blinking incomprehen- sion that confronts unhealthy behavior, then, pointing to pleasure can function as a claim on understanding, an insistence on agency, and a sort of challenge. Situated in this way, pleasure o√sets the actuarial calcula- tion of risks and harms with a more situated inquiry into the terms of everyday life, while evoking a sense of agency and experimentation that the redemptive category of ‘‘self-medication’’ is unable to capture. No longer framed as restoring some natural order, drug use becomes intelli- gible as a specific intervention with specific consequences that is at any rate only one of a number of possible interventions. Recent inquiries into pleasure provide an alternative vocabulary of experience than that propounded by the pharmaceuticalization of every- day life. Much of the recent work on a√ect seeks to value the sen- sibilities, pleasures, odd feelings, and attachments that are not imme-