Faculty of Health Sciences

Making Methamphetamine: Enacting a Drug and its Consumers in Scientific Accounts,

Personal Narratives and Service Provision

Nicola Thomson

This thesis is presented for the Degree of

Doctor of Philosophy
of
Curtin University

October 2014

 
 
  

Abstract
Methamphetamine is an illicit stimulant variously referred to as ‘speed’, ‘crystal’, ‘ice’ or
‘meth’. Used globally, consumption of this drug was detected in Australia in the late 1990s.
Since this time, methamphetamine has become the object of significant scientific, policy,
treatment and media attention. In this thesis I critically analyse this attention by tracing the
constitution of methamphetamine and methamphetamine-using subjects in the fields of
science, policy, treatment and media. I also examine methamphetamine-related practices: the
ways in which people consume this drug and service provision related to methamphetamine
use. I do so in order to explore how authoritative discourses shape these practices and how
consumers and service providers draw upon, reject and subvert hegemonic understandings of
methamphetamine in their day-to-day lives.

Two main research questions informed my investigation. First, how are methamphetamine
and methamphetamine consumers constituted in scientific, policy, treatment and media
discourse? Then, in order to explore the material and political effects of these discourses, I
asked: how do consumers and service providers draw upon, reject and subvert authoritative
discourse through consumption and harm reduction/treatment practices? To address these
research questions, I employed concepts from the theoretical fields of post-structuralism and
science and technology studies (STS). These areas of scholarship reject the assumption that
the world is a singular, stable, anterior phenomenon. Instead, reality is considered multiple;
as continually ‘made’ through various practices and, being shaped by epistemic forces, as
inherently political. Using these theories allows the investigation of methamphetamine as an
ontological concern.

Drawing on the work of post-structuralism and STS entailed a methodological approach that
could address multiple and inherently political realities. Thus, in order to carry out my
research, I employed a ‘method assemblage’ approach (Law, 2004). This methodological
arrangement addresses the multiplicity, interactiveness and contingency of realities. It is an
approach that assumes that research practice is performative, creating particular realities
while making absent and even supressing others. In this sense, method assemblage is
unavoidably political. It obliges the researcher to be cognisant and reflective of practice,
being aware of the objects, subjects, practices and spaces that are constituted through method.
It is also a commitment to enacting realities that are less oppressive — ‘to make some
realities realer, others less so’ (Law, 2004, p. 67).
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My research practice involved two methodological stages. I reviewed authoritative literature

concerning methamphetamine to track the ways in which methamphetamine and
methamphetamine-using subjects are constituted in scientific, policy, treatment and media
discourses. I also conducted in-depth interviews between July 2009 and February 2011 with
13 service providers and 28 people who used methamphetamine in order to explore
consumption and service provision practices productive of this drug and drug-using
subjectivities. I recruited service providers through seven alcohol and other drug (AOD)
and/or health services in an inner city suburb in Melbourne. People who used
methamphetamine were also recruited through these services or by snowballing.

Through an analysis of scientific texts, I described how the materiality of methamphetamine

is constituted as a singular and stable phenomenon. I argue that methamphetamine has been
constituted in scientific texts as a ‘hyper’ stimulant — dependence-producing and harmful —
with crystalline methamphetamine inscribed as a specifically potent and destructive form of
the drug. My aim in this exercise is not to reveal the ‘truth’ about the nature and effects of
this drug. Rather, I seek to make visible some of the work involved in establishing scientific
facts and to underline the contingency of facts, as contradictory statements come to light and
rhetoric is employed to support various claims and beliefs about methamphetamine.

To trace the constitution of methamphetamine-using subjects in authoritative discourse, I

analysed key policy, treatment and media texts. This revealed the binaries that shape
methamphetamine-using subjects, including voluntarity/compulsivity, controlled/chaotic and
addict/clean. I argue that, in the case of methamphetamine, these binaries are ‘extreme’ —
enacting bodies in ‘hyper’ absolutes. Methamphetamine-using subjects are materialised as
specifically anxious, violent and chaotic and yet, paradoxically, these bodies are
simultaneously enacted as specifically active drug users, able to be self-reflective and
controlled. Foregrounding practice revealed that these bodies have different capacities but are
shaped by the same assumptions — the centring and valorisation of the agentive, knowing
and self-controlled subject, the fear of methamphetamine itself and disgust at the addicted
subject.

My analysis of in-depth interviews with methamphetamine users explored the relationship

between the ways consumers embody themselves and the absolutes enacted by scientific,
policy, treatment and media discourse, and how hegemonic ideals are (re)produced and
subverted in accounts of methamphetamine consumption. Participants’ accounts indicated

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drug consumption practices were not clearly delineated in absolutes — suggesting that these
practices are complex and multiple. Methamphetamine use may involve controlled,
knowledgeable and ‘expert’ practices, yet this does not exclude individuals from
understanding themselves as ‘addicts’. Likewise, constituting oneself as compulsive and out
of control — compelled to take methamphetamine because of an addictive personality or
traumatic life events — did not exclude highly agentive practices. Methamphetamine was
used in order to capacitate bodies with power — to cope with trauma or to steal drugs. My
research also attended to the material—semiotic networks that constitute methamphetamine-
using bodies, showing how these capacitate bodies in particular ways. ‘Active’ practices and
attributes such as ‘self-control’ and the ability to make the ‘right’ choices are shaped by the
social and material connections an individual is able to make. Likewise, feeling ‘out-of-
control’, ‘taken over’ by methamphetamine and other uncontrolled practices emerge from the
relations an individual forms, and the assemblages they are enmeshed within, rather than a
deficiency of will.

I also analysed accounts of service provision, showing how these practices oblige bodies to
constitute themselves in specific ways and exploring some of the political effects of these
embodiments. This analysis reveals the specificity of methamphetamine specialist treatment
in service accounts, in which people using methamphetamine were conceived as highly
knowledgeable and active. I foreground the concept of ‘change’ in service accounts, using the
different ways in which treatment providers understood change in order to further examine
the binaries that underpin drug use. The participating treatment providers employ
conventional understandings of change, locating the capacity for change solely in the client.
Yet, change also emerges as a more complex phenomenon. Sometimes change is conceived
as a result of individuals making the right choices, but ‘chance’, environment, partners,
homelessness and other aspects are also seen to play a role. Some workers need to see change
in clients in order to find satisfaction in their work, and feel frustrated with clients who are
not ‘ready’ to change. Others expressly stated they did not need to see change; some
considered clients unchangeable and understood their practice as providing ‘respite’.

Accounts of methamphetamine use and service provision show the limitations and political
effects of the absolutes of drug use. Moreover, illuminating how these absolutes shape
practice reveals the ontological politics of methamphetamine and the contested nature of
realities. People using methamphetamine are (like all individuals) constituted through the
connections and relationships they form and to which they have access. These shape drug

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practices — whether ‘controlled’, ‘chaotic’ or ‘functional’ — and the choices they can make.
Individuals who use methamphetamine embody themselves through their local assemblages
of use, but draw upon broader understandings of drug use as well. The bodies they ‘do’ both
embrace and subvert the binaries of drug use. They are, at the same time — or at different
times in their drug ‘careers’ — controlled, chaotic, extreme and knowledgeable drug users.

In this research I sought to disrupt the ‘facts’ of methamphetamine, arguing that all forms of
knowledge are contestable. Using empirical methods, I scrutinised authoritative discourses
that constitute methamphetamine and methamphetamine users in highly pejorative ways and
illuminated their political effects. By treating the assemblages and networks of
methamphetamine consumption and service provision as units of study, I have moved beyond
research accounts that address drug use solely as the act of the pathological and deviant
methamphetamine-using subject. This is both a political commitment to (de)centre the drug-
using subject and a means to describe methamphetamine consumption and service provision
in more complex and nuanced ways.

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Acknowledgements
Completing my PhD has required support, advice and inspiration from many people. This is
my attempt to acknowledge the many individuals and organisations that have contributed to
my research.

To undertake my thesis I received a scholarship as part of the National Health and Medical
Research Council Grant 479208 ‘Understanding the barriers to improved access, engagement
and retention of methamphetamine users in health services’, with the grant administered
through the National Drug Research Institute (NDRI). Professor David Moore, Professor
Gabrielle Bammer, Professor Paul Dietze and Professor Pascal Perez were the Chief
Investigators on this grant and I thank them for allowing me the opportunity to come on as a
PhD student. During my research I have received excellent administrative support through
NDRI and I would particularly like to thank Dr Susan Carruthers, Fran Davis, Jo Hawkins
and Paul Jones for their assistance.

To my principle supervisor David Moore, I offer my profound thanks. David’s breadth of

theoretical knowledge and understanding, formidable writing skills and attention to detail has
helped me develop my thesis into a coherent piece of work, which is much stronger than it
otherwise would be. I would also like to thank my supporting supervisor Associate Professor
Suzanne Fraser, whose theoretical insights and guidance at key points in my studies were
important to the formation of my thesis as a whole. Having two supervisors whose own work
is of such a high standard has encouraged me to produce my best work. Thank you both for
your support and encouragement over the years.

This research was only possible because of the people that gave their time to be interviewed
and I would like to gratefully acknowledge the contribution made by all participants in this
research. Service providers took time out of their busy days to talk to about all aspects of
service delivery. Consumers met with me and spoke candidly about what is an incredibly
stigmatised practice. I am very thankful to all participants and have done my best to ensure
that this thesis reflects the wealth of data I was given access to.

Dr Campbell Aitken of Express Editing Writing and Research provided professional editing
services in accordance with the Institute of Professional Editors’ Guidelines for editing
research theses.

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Brendan Quinn, my fellow PhD candidate, provided me with invaluable assistance in my

research by helping me to recruit a number of participants. Thank you Brendan!

Completing a PhD by distance has created various challenges, not least the lack of a student
community and reduced access to the support resources available to those on campus.
Helping me to overcome some of these challenges have been my NDRI colleagues (some
now ex-colleagues) over the years. Thank you to Amy Pennay, Monica Barratt, Racheal
Green, and Robyn Dwyer for general support – listening, lending me examples of your work
and reading over some of mine. I also would like to thank the ‘second wave’ of students —
Aaron Hart, Adrian Farrugia, James Wilson, and Renae Fomiatti. It was great to work in the
same space as you all even if only for a short while. It certainly made being a distance student
more enjoyable. Dr Kate Seear facilitated a number of student support events and, while I
didn’t attend as many as I should have, I thank her for providing these.

On a more personal note, my friendship with Kate Hughes, has been essential to me
completing my PhD. Kate inspired me to enrol in university in the first instance, she
encouraged me to apply for a PhD scholarship, and has continually provided me with advice
and support. Kate has now skilfully helped me negotiate academia and research for over a
decade. Thank you for your ongoing encouragement and wisdom over the years.

Another good friend Karalyn McDonald has also been a valuable source of support and
advice over the years. Karalyn also encouraged me to apply for a PhD and helped me shape
my application. She has continued to be a source of advice and help and a valuable friend.

My family has played a major role in supporting me to complete my PhD. I owe a big thank
you to my mother Erica and her partner Ross for the support they have shown over the years
with my educational endeavours, and especially for assistance with kid wrangling. Some
excellent family get togethers have also provided some much needed time out — thanks
Mum!

My mother in law, Judith, has also been wealth of support during my candidature. Thank you
Judy for all your encouragement and interest in my work and for your generous help with
child care — it has made a big difference over the years.

My sister Sigrid, and my brothers Joshua and Aaron, as well as their partners, have been
wonderfully supportive during my candidacy. Thank you to all of you for your

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encouragement, the many times you have stepped in to look after children, creating the space
for me to work. Thank you also for your friendship.

There have been many friends over the past few years that have shared some of the highs and
lows of completing this thesis. Thanks in particular to the ‘TP’ crew — Anna, Beck, Kate,
Melissa and Sanja and the Prestonians — Ira, Kathy, Katrina and Michelle. I have really
appreciated your help with child care, debriefing and providing me with a social life!

Finally, I owe a huge thank you to my partner, Kyle. Thank you for your unflagging
encouragement and unconditional support during my candidature. I could not have done this
without you helping me navigate the complexities of study, work, family and building a
house! And to Ella and Finn I also owe a special thank you. I have spent many weekends ‘in
the shed’ working away at ‘my book’. Thank you for being (somewhat!) understanding and
now I look forward to spending more time in one of my favourite assemblages. 

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Contents
Declaration ............................................................................................................................................... i
Abstract ................................................................................................................................................... ii
Acknowledgements ................................................................................................................................ vi
Abbreviations ........................................................................................................................................ xii
Chapter 1: Introduction ........................................................................................................................... 1
Methamphetamine use in Australia..................................................................................................... 2
The specificity of methamphetamine and methamphetamine-using subjects ..................................... 4
Methodological approach.................................................................................................................... 5
Key theoretical concepts ..................................................................................................................... 6
The contingency and political nature of truth/facts......................................................................... 7
Multiplicity and the conditions of possibility ................................................................................. 7
The subject and location of agency ................................................................................................. 8
Assemblages and becomings: An alternative conceptualisation of agency .................................... 9
Ontological politics: What research makes visible ....................................................................... 10
How this research proceeds........................................................................................................... 12
Chapter 2: Sociological accounts of methamphetamine; Sociology for and of public health ............... 16
A sociology for public health ............................................................................................................ 17
Interpreting data using public health concepts .............................................................................. 18
Increasing surveillance of methamphetamine-using cohorts ........................................................ 20
Investigating the subject: Qualitative forms of investigation ....................................................... 23
A sociology of public health ............................................................................................................. 27
Critical accounts of methamphetamine use................................................................................... 28
Textual analyses of methamphetamine-related media and policy ................................................ 37
Party drugs and the theory of normalisation ................................................................................. 43
Critical accounts of drug use ......................................................................................................... 44
Conclusion ........................................................................................................................................ 50
Chapter 3: Addressing ontological contingency; Assembling theory and method ............................... 53
Theoretical toolboxes: The work of Foucault and Deleuze .............................................................. 53
Post-structuralism and moving beyond the knowing subject ........................................................ 54
Foucault’s understanding of power and knowledge...................................................................... 55
The subject: How we understand ourselves in neo-liberal societies ............................................. 56
The neo-liberal subject and emerging technologies of the self ..................................................... 57
Citizens and choice: Understanding agency and control .............................................................. 60

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Deleuze’s conception of humans, non-humans and their relations and effects ............................ 62
Disrupting ‘truth’: Scrutinising scientific practice ............................................................................ 65
Inscription devices and the practice of science ............................................................................. 66
Enacting multiple realities ............................................................................................................ 67
‘Doing’ embodiment: Multiple selves .......................................................................................... 70
Researching multiplicity: Methodological considerations ................................................................ 72
Actor network theory (ANT) and matters of concern ................................................................... 72
Method enacts ............................................................................................................................... 74
Reality is ‘messy’: How to attend to it .......................................................................................... 76
Methodological tools ........................................................................................................................ 77
Methodological steps .................................................................................................................... 78
Textual analysis ............................................................................................................................ 79
In-depth interviews ....................................................................................................................... 81
Recruiting participants .................................................................................................................. 81
Interviewing service providers ...................................................................................................... 82
Interviewing people who use methamphetamine .......................................................................... 83
Field notes and interview spaces ................................................................................................... 84
The production of accounts ........................................................................................................... 85
Interpreting accounts ..................................................................................................................... 88
Practicalities: Ethical considerations ................................................................................................ 89
Privacy and confidentiality ........................................................................................................... 89
Informed consent .......................................................................................................................... 90
Interviewee distress ....................................................................................................................... 90
Conclusion ........................................................................................................................................ 90
Chapter 4: Methamphetamine ‘facts’: The production of a ‘destructive’ drug in scientific texts ........ 92
Introduction ....................................................................................................................................... 92
Enacting methamphetamine in Australian scientific literature ......................................................... 94
Methamphetamine is potent .......................................................................................................... 95
Methamphetamine and dependence .............................................................................................. 99
Methamphetamine is harmful ..................................................................................................... 102
Ice is more harmful than other forms of methamphetamine ....................................................... 104
Conclusion ...................................................................................................................................... 108
Chapter 5: Extreme ‘absolutes’: Methamphetamine-using subjectivities in policy, treatment and media
texts ..................................................................................................................................................... 111
Introduction ..................................................................................................................................... 111
Authoritative texts as practice ..................................................................................................... 112

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What can a body do? ................................................................................................................... 114

ATS policy: Knowledgeable, self-controlled bodies .................................................................. 116
‘Active therapy’: Treated methamphetamine-using bodies ........................................................ 118
‘Active’ methamphetamine-using bodies: Points of tension ...................................................... 130
Resistant, anxious and paranoid bodies ...................................................................................... 132
Violent and toxic bodies ............................................................................................................. 135
Subsumed, disgusting and depraved bodies ................................................................................ 136
Conclusion ...................................................................................................................................... 140
Chapter 6: Consuming methamphetamine: Accounts of methamphetamine use ................................ 142
Introduction ..................................................................................................................................... 142
Embodying multiple selves through practice .................................................................................. 143
The neo-liberal subject? Expert, knowledgeable and self-controlled drug-using practices ............ 145
Uncontrolled methamphetamine consumption practices ................................................................ 161
Conclusion ...................................................................................................................................... 173
Chapter 7: Addressing methamphetamine-related harm: Accounts of treatment and harm reduction
practice ................................................................................................................................................ 176
Introduction ..................................................................................................................................... 176
Change ............................................................................................................................................ 179
Change and individual capacity .................................................................................................. 181
Change and choice ...................................................................................................................... 192
Risks and benefits of responsiblising methamphetamine treated subjects .................................. 194
Resisting and rejecting change ........................................................................................................ 196
Conclusion ...................................................................................................................................... 204
Chapter 8: Conclusion......................................................................................................................... 207
Methamphetamine as a matter of fact ............................................................................................. 209
Methamphetamine-using subjects: ‘Hyper’ absolutes .................................................................... 211
Drug consumption assemblages ...................................................................................................... 213
Harm reduction/treatment assemblages and change ....................................................................... 215
Summary ......................................................................................................................................... 216
References ........................................................................................................................................... 218
Appendix A: Scientific claims about methamphetamine .................................................................... 234
Appendix B: Interview guides ............................................................................................................ 236

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Abbreviations

AA Alcoholics Anonymous

ABC Australian Broadcasting Corporation

ADD Attention Deficit Disorder

A&E Accident and Emergency

AFL Australian Football League

ANT Actor network theory

AOD Alcohol and other drugs

AMPH Amphetamine sulphate

ASSIST Alcohol, Smoking and Substance Involvement Screening Test

ATS Amphetamine-type stimulants

CAT/T Crisis Assessment and Treatment/Team

CBT Cognitive behavioural therapy

CNS Central nervous system

DHS Department of Human Services

DSM Diagnostic and Statistical Manual of Mental Disorders

GHB gamma-Hydroxybutyric acid

HREC Human Research Ethics Committee

IDRS Illicit Drug Reporting System

KIs Key informants

NSP Needle and syringe program

OST Opiate substitution therapy

MA Methamphetamine
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NA Narcotics Anonymous

MDMA ecstasy: 3,4-methylenedioxymethamphetamine

METH Methamphetamine

STS Science and technology studies

SDS Severity of Dependence Scale

UK United Kingdom

US United States

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Chapter 1: Introduction
Methamphetamine is an illicit stimulant that is variously referred to as ‘speed’, ‘crystal’, ‘ice’
or ‘meth’. Used globally, this drug was first detected in Australia in the late 1990s
(Australian Crime Commission, 2001; Topp, Degenhardt, Kaye, & Darke, 2002a). Since this
time, methamphetamine has become the object of significant scientific, policy, treatment and
media attention. My research critically examines this attention, illuminating its political
nature and specificity. I trace the constitution of methamphetamine and methamphetamine-
using subjects in the fields of science, policy, treatment and media. I also research
methamphetamine-related practices: the ways in which people consume this drug and service
provision related to methamphetamine use. I do so in order to explore how authoritative
discourses shape these practices — to show how people draw upon, reject and subvert
hegemonic understandings of methamphetamine in their day-to-day lives. Two research
questions have informed my investigation of methamphetamine and its related practices.
First, I ask how are methamphetamine and methamphetamine consumers constituted in
scientific, policy, treatment and media discourse? Then, in order to explore the material and
political effects of these discourses, I ask how do consumers and service providers draw
upon, reject and subvert authoritative discourse through consumption and harm
reduction/treatment practices?

To address my research questions, I make use of the theoretical fields of post-structuralism

and science and technology studies (STS). These areas of theory provide concepts that
challenge Euro-American or modern Western views of ‘reality’ — that the world is a
singular, stable, anterior phenomenon (Law, 2004). Instead, reality is considered multiple: it
is continually ‘made’ through various practices and, shaped by epistemic forces, inherently
political (Mol, 1999). Employing these theories enables the investigation of
methamphetamine as an ontological concern, moving beyond the assumption that it is a
singular entity with reified material properties. Instead, I address this drug as a fractured
object, inscribed through a range of practices, where some practices have greater authority to
determine what methamphetamine actually ‘is’. In the same way, methamphetamine
consumers are addressed as multiple subjects — with the understanding that people embody
themselves in different ways, depending on the practices involved, their environment and the
connections and relationships they form to other subjects and objects. Foregrounding the
practices of methamphetamine consumption and service provision, I argue that these
constitute an array of drugs and drug-using subjects. By analysing the ways in which

 
  

authoritative discourses and practices come to shape how people constitute themselves and
methamphetamine through day-to-day practices of consumption and service provision, I
make visible the politics of ontology — that is, the open and contested nature of reality (Mol,
1999).

Theories that assume the ontological contingency of realities have rarely been applied to the
area of methamphetamine use or its related harm reduction/treatment practices, yet this is an
area that deserves critical attention. Current ways of constituting methamphetamine and
methamphetamine users are highly pejorative, leading to the stigmatisation and
marginalisation of people who use drugs. My work is important because it illuminates the
political nature of the dominant understandings of methamphetamine and methamphetamine
consumers, and because it suggests that are alternative ways of understanding this drug and
those who use it. In doing so, it contributes to and extends upon a body of critical drug
literature that seeks to provide a nuanced and complex understanding of drug use (see, for
example, Duff, 2014; Dwyer & Moore, 2013; Fraser & Moore, 2011; Keane, 2004; Moore &
Fraser, 2006; valentine, 2007). In this chapter I introduce the way methamphetamine use is
understood in Australia, the methods and key theoretical concepts I have used in my research,
and the central themes of my thesis. I also outline how the thesis will proceed.

Methamphetamine use in Australia

Methamphetamine is classed as a central nervous stimulant (CNS) and as belonging to the
series of drugs known as the amphetamines (Anglin, Burke, Perrochet, Stamper, & Dawud-
Noursi, 2000). It is produced in various forms — including crystal methamphetamine (also
known as ‘ice’), powder, ‘base’1 and tablets — and can be consumed in several ways, such as
injecting, snorting, drinking or eating and smoking. Methamphetamine was first synthetised
in the 1890s and has been legally available in pharmaceutical preparations in the past (Anglin
et al., 2000). It was reportedly provided to Japanese, German and US military personnel
during World War 2 in order to improve performance, and was sold as an over-the-counter
stimulant in Japan in the 1940s (Anglin et al., 2000). Currently, however, this drug is mostly
used illegally, with very few countries allowing its legal manufacture or prescription.
Globally, methamphetamine is considered a drug of concern, and trends relating to its
production, traffic and use feature in the World Drug Report (United Nations Office on Drugs
and Crime, 2013). The 2013 report finds that while ‘traditional markets’ such as North

                                                            
1
 ‘Base’ is a term used to refer to methamphetamine in the form of a sticky, damp powder. 

2
 
  

America and Oceania (including Australia) have remained stable with regards to this drug’s
use, increased use and production has been reported in South East Asia, the Middle East and
parts of Africa (United Nations Office on Drugs and Crime, 2013, p. xi). The report also
states that Australia has a ‘high’ rate of methamphetamine use at 2.1% of the population (in
2010) (United Nations Office on Drugs and Crime, 2013, p. 2).

Significant use of methamphetamine was first reported in Australia in the 1990s (Australian
Crime Commission, 2001). Up until this time, amphetamine sulphate was reported to be the
most commonly used illicit stimulant in Australia (Australian Crime Commission, 2001). The
shift from one formulation of amphetamine to another has been attributed to several
developments. These include legislative changes in the 1990s that curtailed the availability of
precursor drugs needed to manufacture amphetamine sulphate, and increased importation of
methamphetamine from areas such as South East Asia (Australian Crime Commission, 2001).
The 2013 National Drug Strategy Household Survey provides the most recent population-
level data concerning the use of methamphetamine. This study reports that 7.0% of the
Australian population aged 14 years and over, have ever used this drug (Australian Institute
of Health and Welfare, 2014). 2 The study also reports that in the 12 months prior to 2013,
2.1% of people in Australia used meth/amphetamine, which is the same as in 2010
(Australian Institute of Health and Welfare, 2014). However, while there was no significant
change in meth/amphetamine use between 2010 and 2013, different forms of this drug were
used. Among people who had used meth/amphetamine in the previous 12 months, the
proportion reporting use of powder decreased significantly from 51% in 2010 to 29% in
2013, while the prevalence of use of ice (or crystal methamphetamine) increased from 22% in
2010 to 50% in 2013 (Australian Institute of Health and Welfare, 2014). There are also
national data concerning engagement in treatment due to meth/amphetamine use. These data
report ‘treatment episodes’, where one treatment episode represents a completed course of
treatment. Treatment episodes in which methamphetamine or other illicit stimulants was the
primary drug of concern increased from 7% of all episodes during 2009-2010 to 14% during
2012-2013 (Australian Institute of Health and Welfare, 2011). These data are limited in what
they can tell us about illicit drug use (Dwyer & Moore, 2010b), however, they suggest that a

                                                            
2
Both the National Drug Strategy Household Survey and the National Minimum Data Set for alcohol and other
drug treatment services report on ‘meth/amphetamine’. As methamphetamine is reportedly the most common
form of illicit stimulant in Australia, presumably the figures mostly relate to methamphetamine – rather than
other amphetamines. Nonetheless, in order to report these data I use the term ‘meth/amphetamine’.

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substantial number of Australians have consumed this drug, with some accessing treatment
services as a result.

While methamphetamine use was identified in Australia in the 1990s, it emerged as a serious
problem in the early 2000s (Australian Crime Commission, 2001). This occurred after the
interruption to Australian heroin supply that began in early 2001 and had a dramatic effect on
Australia’s illicit drug markets. Prior to 2001, high rates of heroin use and related harms such
as overdose were key public health concerns; however, as heroin became less accessible, the
number of overdoses related to the drug fell (Deitze & Fitzgerald, 2002). At the same time
methamphetamine use was estimated to have increased and, since 2001, the availability, use
and harms of methamphetamine have become major public issues, as demonstrated by
extensive media attention (see, for example, Baker & McKenzie, 2013a; Bartlett, 2006;
Carney, 2006; Hayes, 2006), parliamentary inquiries (see, for example, Drugs and Crime
Prevention Committee, 2004; Law Reform, Drugs and Crime Prevention Committee, 2013), a
national leadership summit (held in Sydney in December, 2006) and policy development (see,
for example, Australian National Council on Drugs, 2007, Ministerial Council on Drug
Strategy, 2008).

With increasing attention to methamphetamine in the arenas of government, science and

media has come a proliferation of knowledge around this drug. Scientific research produces
‘evidence’ about methamphetamine. Policy determines which ‘evidence-based’ strategies are
best used to address methamphetamine (Ministerial Council on Drug Strategy, 2008).
Treatment manuals outline ‘best practice’ for workers dealing with people who use
methamphetamine (Jenner & Lee, 2008; Smout, 2008). The media produces reports on the
harms of this drug, often focusing on its crystalline form, ice (Baker & McKenzie, 2013a).
These fields of knowledge, or discourses, do not emerge in isolation from each other; rather,
they are always mutually constitutive of each other. Highly authoritative, they constitute the
‘truth’ of methamphetamine — generating a broad understanding of methamphetamine as a
highly destructive and dangerous drug, and methamphetamine users as psychotic and violent.

The specificity of methamphetamine and methamphetamine‐using

subjects
In this thesis I address the attention given to methamphetamine use by critically analysing
scientific, policy, treatment and media discourse. I argue that there is specificity to the ways
in which methamphetamine and methamphetamine users are constituted, where

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methamphetamine use and its purported effects is considered uniquely problematic.

Analysing scientific texts, I contend that the materiality of methamphetamine is inscribed by
the limited ways we can understand drug use. I also argue these texts constitute
methamphetamine as a specifically destructive drug. Attending to policy, treatment and
media texts, I investigate the constitution of methamphetamine-using subjects. I argue that
these drug-using subjects are constituted in very specific ways, informed by broad
understandings of the neo-liberal subject where free choice is valorised and compulsive
activity such as drug use is abhorred.

In illumining the specificity of how methamphetamine and methamphetamine users are

constituted in dominant discourse, I argue that these are insufficiently sophisticated ways of
understanding individuals and methamphetamine use. They also have political effects such as
stigmatisation and marginalisation. To demonstrate their inadequacies and their effects, I
present accounts of methamphetamine use and methamphetamine-related treatment practices,
showing how individuals draw on hegemonic understandings of drug use while, at the same
time, their drug-related practices subvert and reject these. This exercise reveals the contested
nature of realities and the politics of ontology with respect to the drug methamphetamine.

Methodological approach
My research involved two methodological stages. First, I analysed scientific, policy,
treatment and media texts. Second, I conducted in-depth interviews with people who used
methamphetamine and with service providers of harm reduction/treatment for
methamphetamine use. To analyse texts related to methamphetamine I searched academic
and ‘grey’ literature. For the purposes of my argument, I separated texts. I examined the
object ‘methamphetamine’ through scientific texts (see Appendix A), and methamphetamine-
using subjects through policy, treatment and media texts. This separation was artificial, as
these texts emerge from discourses that are interlinked — produced by, and productive of,
each other. However, sorting texts into these categories was a useful heuristic device and
enabled to me to make a clear argument concerning the construction of both
methamphetamine and methamphetamine-using subjects.

In addition to exploring and critiquing methamphetamine-related discourse, I also describe

practices related to methamphetamine use. I do this through analysis of interviews with
people who use methamphetamine and people who provide treatment services to
methamphetamine users. I interviewed people who used methamphetamine; some were in

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contact with alcohol and other drug (AOD) harm reduction or treatment services (‘service
users’) and others were not (‘non-service users’). Service users had accessed a service in the
30 days prior to the interview, and non-service users had not accessed a service in the six
months prior to the interview. Interviews focused on participants’ experiences of using
methamphetamine and accessing services to address their methamphetamine use. These
accounts of methamphetamine consumption and service encounters provide insight into how
people incorporate methamphetamine into their lives, as well as the lived effects of this drug
— pleasurable, harmful, or utilitarian.

I also interviewed practitioners from organisations that provide services to address

methamphetamine use. Participants were recruited to ensure variation in service roles, with
differing levels of responsibility. I interviewed service providers to investigate treatment
practices particularly related to methamphetamine. Accounts of practice show the various
ways in which services address methamphetamine use and drug use more generally. They
also show the wide range of needs of people accessing AOD services. These accounts
illuminate some of the ways in which people draw upon dominant discourses and, in
presenting them, I aim to show the way hegemonic ideals of the ideal citizen and ‘choice’
shape the ways in which we can address drug use and understand drug users.

During interviews, and immediately after, I took field notes. These described the contexts of
the interviews, including treatment and other services. I used these to give insight into the
interview ‘space’ and how this might shape the accounts provided. Thus, my data collection
involved texts, interviews and field notes.

Key theoretical concepts

To attend to the body of knowledge developed around methamphetamine and the accounts of
use and treatment of this drug, I draw on the related theories of post-structuralism and STS.
Post-structuralism is an area of theory that has its origins in the 1960s in France and in which
two scholars, Gilles Deleuze and Michel Foucault, are prominent. More recently, STS has
emerged within post-structuralism, building upon the work of Deleuze and Foucault. Scholars
in these areas provide working concepts that enable the interrogation of what is considered to
be the ‘truth’ about methamphetamine, and argue that knowledge is always political. That is,
‘truth’ is not a transparent reflection of the natural world; it is constituted through power
relations, institutions and rhetoric. Moreover, there are conditions necessary for producing
‘truth’, and new knowledge must be congruent with broader understandings of the world.

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The contingency and political nature of truth/facts

I employ theoretical concepts from the fields of post-structuralism and STS to scrutinise the
‘facts’ of methamphetamine use and describe the political and ontological effects of
knowledge — how these facts shape the lived experience of people using methamphetamine.
Using theoretical ‘tools’ from STS scholars Bruno Latour, John Law and Annemarie Mol, I
challenge the ‘truth’ of methamphetamine by interrogating methamphetamine ‘facts’. Latour
(2004) argues that ‘facts’ are political and limited representations of reality. He urges
researchers to approach the world as a ‘matter of concern’ (Latour, 2004). This is not
necessarily to dispute facts but to expand upon them, making visible their political nature, as
well as other possibilities. Writing with Steve Woolgar, Latour argues that scientific practice
is craft work, and that this work inscribes materiality in particular ways (Latour & Woolgar,
1986). In the case of methamphetamine-related science, the materiality of methamphetamine
is inscribed as specifically potent and dangerous. It is a ‘hyper’ stimulant (Topp et al., 2002a)
and its users are, among other things, violent and psychotic (McKetin et al., 2014; McKetin et
al., 2006b). This body of work thus features descriptions of methamphetamine’s toxicity (see,
for example, Shoblock, Sullivan, Maisonneuve, & Glick, 2003). It concerns itself with
describing the characteristics of methamphetamine-using subjects; the harm they experience,
the predictors of this harm, treatment outcomes and predictors of treatment outcomes (see, for
example, Darke et al., 2008; Rawson, Gonzales, & Brethen, 2002). I scrutinise the scientific
literature, making visible political acts of ‘choice’ and showing how methamphetamine has
been enacted in the literature. I argue that the resulting ‘facts’ of methamphetamine are
shaped by dominant ideas about drug use (such as ‘all drug users are pathologised and in
need of treatment’). Moreover, I suggest that the facts of methamphetamine are contingent
and, with my research, I intend to make visible other possibilities and ways of thinking about
this drug.

Multiplicity and the conditions of possibility

Expanding on my argument that scientific knowledge is contingent, I use the work of post-
structuralist and STS scholars to demonstrate the multiplicity and ontological politics of
reality. A key insight of Mol and Law is that all practice is ongoing, continually enacting
reality; thus reality is multiple, constituted through an array of practices. This reinforces the
contingency of knowledge and, most importantly, it opens up other ways of understanding
drug use — making possible other, less oppressive, realities. At the same time these scholars
acknowledge that not all realities are possible. This brings to light the contested nature of

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realities, or ‘ontological politics’ (Mol, 1999). Practices are always shaped by broader forces
and while multiple realities are possible they will have a common thread. This is the broader
cultural forces at work and the current ‘conditions of possibility’ or ‘episteme’ that make
various statements about methamphetamine present and repress others.

Mol and Law draw upon the work of Foucault in asserting that realities are shaped by broader
forces. Foucault (1978) shows how power and control operate in modern societies, describing
the current conditions of possibility and theorising the episteme. To address the nature of
power, Foucault conceptualises ‘discourse’ as an array of practices, language and concepts
that was productive of what could be said, thought and done about a given issue. Dominant
discourses, such as public health, make possible the ways in which we can understand
ourselves and others (Petersen & Lupton, 1996). In this way, power is exercised over
individuals as they shape themselves according to these dominant understandings. Moreover,
discourses themselves are shaped, and exist within, broader overarching societal norms. This
is what Foucault terms the ‘episteme’ or the current conditions of possibility (Foucault, 1972,
p. 191). These ideas allow me to demonstrate the local and specific ways in which
methamphetamine and methamphetamine users are constituted, as well as provide insight into
broader forces that shape these practices.

The subject and location of agency

Central to the modern neo-liberal episteme is the autonomous, unitary subject. I use the work
of Foucault and Nikolas Rose (who builds upon Foucault’s work) to better understand the
self-governance and obligations of this subject. These scholars show how human agency is
produced and valorised within the current conditions of possibility — understood as an
attribute of the ideal citizen. Rose (1999) argues that modern citizens are defined through the
choices they make and that uncompromised agency is essential to making these choices. Drug
use (and addiction) compromises the ability to make choices, as it implies a compulsive act; it
is not a free or ‘pure’ choice (Sedgwick, 1992, p. 586). Due to their compromised agency,
drug users and ‘addicts’ are non-citizens, failing in their obligation to make the ‘right’
choices. I apply this understanding of agency to my data. I argue that the methamphetamine-
using subjectivities made available by dominant discourses are in binary opposition. On the
one hand, a highly active and self-controlled subject is produced in specific discourses. On
the other, a subjectivity with compromised agency — an anxious, depressed, violent and
chaotic methamphetamine user — is produced. Thus, these subjectivities are enacted in
binaries such as controlled/chaotic or voluntary/compulsive. While this insight has been

8
 
  

applied to drug use and addiction previously (see, for example, Fraser & Moore, 2008;
Sedgwick, 1992; Seear & Fraser, 2010a), there is specificity in the way we understand
methamphetamine-using subjects. These subjects are understood in ‘extreme’ absolutes: they
are hyper-controlled and, at the same time, hyper-chaotic. I explain these forms of
subjectivity in terms of the current conditions of possibility. I also describe their ontological
implications. I do this by examining the ways in which people who use methamphetamine,
and people who treat methamphetamine use, draw upon these dominant understandings —
but also how individuals resist or subvert dominant discourses.

Assemblages and becomings: An alternative conceptualisation of agency

To understand methamphetamine-using subjectivities in a way that moves beyond the current
binaries that underpin drug use, I seek alternative ways of conceptualising agency. To do so, I
use the work of Deleuze and STS scholars. These scholars focus on the relationality of
humans and non-humans. They conceive of the social and material as always constitutive of
each other, rather than as separate entities. This way of thinking takes into account the
expressivity (although not intent) of both human and non-human formations, considering how
they shape and constitute each other. Approaching the world in this way involves a
material—semiotic method. This treats:
everything in the social and natural worlds as a continuously generated effect of webs
of relation within which they are located (Law, 2009).
The concept ‘webs of relation’ draws upon the Deleuzian term ‘assemblage’ (Deleuze &
Guattari, 1987). ‘Assemblage’ captures the idea of the co-constitution of humans and non-
humans, where matter and life forms — what we experience as reality — emerge from the
same source. This source was conceptualised by Deleuze and Guattari as the ‘plane of
immanence’ (1987, p. 266). Assemblages are networks that incorporate myriad
heterogeneous elements and phenomena — the temporal, spatial, social and environmental —
of objects and subjects. From these, subjectivities, objects and other entities emerge in
moments of ‘becoming’. This is where we recognise matter and life forms as inscribed in a
particular way — a drug user, a drug — but it is not a reified state. Emerging from the plane
of immanence, humans and non-humans are continually in states of becoming.

The concept of assemblages, or a material—semiotic approach, acknowledges the dynamic

and shifting nature of the world. In terms of methamphetamine consumption, this approach
enables the consideration of the way spatial and temporal elements shape drug use, along

9
 
  

with the many objects (such as the drug, the utensils required to consume the drug) and
subjects (such as drug users, drug dealers, police, family and friends) involved in this
practice. In terms of harm reduction and/or treatment, the places and spaces of service
provision, as well as the objects of service provision including diagnostic tools,
pharmaceuticals and treatment plans, and harm reduction/treatment practitioners and clients,
are seen as mutually constitutive of these encounters. Further, these encounters are productive
of ‘becomings’. This implies a dynamic reality, where multiple identities and ‘things’ are
possible. For instance, a treatment assemblage may produce a body as a ‘becoming’ addict,
whereas a family assemblage may constitute the same individual as a ‘becoming’ mother.
Making use of these ideas in my research enables me to reject stigmatising and explanatory
terms such as ‘addict’ and embrace a fragmented or multiple form of subjectivity, where
people embody themselves in multiple ways.

Importantly, using ‘assemblage thinking’ (Duff, 2014, p. 633) allows me to move beyond
orthodox accounts of agency and drug use. As I have noted above, agency is constructed in
the modern episteme as located in the neo-liberal subject. Exercising agency in the correct
way and making the right choices is the obligation of this subject. Failure to meet this
obligation requires drug users to be categorised as ‘failed’ citizens and as responsible for their
circumstances. Addressing drug use employing assemblage thinking makes possible a
complex and nuanced reading of methamphetamine use. Rather than viewing
methamphetamine use as the act of an individual with compromised agency (through sickness
or deviance) it can be seen as constituted through assemblages of humans and ‘things’. In this
way agency is dispersed, and myriad phenomena contribute to the act of drug use. Moreover,
assemblage thinking enables analyses of drug use that focus on the immediate connections
and relationships that produce, and are productive of, drug-related practice (Duff, 2014). This
way of thinking does not rely on structuralist concepts such as class or poverty to explain and
describe methamphetamine-using practice. Through local description, however, the lived
effects of social and economic marginalisation are made visible.

Ontological politics: What research makes visible

The theoretical underpinning of my research rejects a singular and anterior reality. I use post-
structuralist and STS thought to argue that reality is multiple, enacted through an array of
practices. A Foucauldian understanding of the ‘conditions of possibility’ is illuminative of
how these practices are limited and so too are the realities that can be ‘made’. Using these
theoretical tools has profound implications for research. Research is no longer the

10
 
  

investigation and revelation of a singular truth; rather, it is performative — a practice that

enacts particular realities. Therefore, to address methamphetamine, I use Law’s (2004) theory
of method assemblage. This theory enables me to articulate the way in which research
practice makes visible certain objects and subjects. Law argues that all research practice is a
process of crafting ‘presence, manifest absence and Otherness’ (p. 42). Presence is what is
made visible by the research. For instance, methamphetamine research may make present
methamphetamine ‘addicts’ and methamphetamine itself as an addictive, dangerous
substance. Research also makes things absent, and Law distinguishes between two types of
absence: ‘manifest absence’ and ‘otherness’. Manifest absence is that which presence
acknowledges — that is, things that are necessary to the objects and subjects made present in
research. For instance, if research constitutes methamphetamine as an addictive drug,
criminal behaviour and treatment centres are manifestly absent. That is, they are absent in this
account, but necessary to the presence of addiction. ‘Otherness’, however, is an absence that
is not acknowledged. This is what is othered, excluded, ignored and even repressed in
research. When methamphetamine addiction is made present, concepts such as pleasure are
othered. Law’s (2004) method assemblage is an approach to research that requires the
researcher to remain cognisant of presence, manifest absence and otherness, and even to
challenge the boundaries between these states.

Employing Law’s (2004) concept of the method assemblage in my research allows me to

challenge the ‘evidence’ that currently constitutes methamphetamine, making visible the
ontological politics of this drug. That is, I acknowledge there are choices and power involved
in ‘making’ reality — it is both contested and open (Mol, 1999). I show how highly
authoritative discourses such as science, policy and treatment constitute methamphetamine in
particular ways. The practices that emerge from these fields constitute methamphetamine as
an anterior and stable substance with inherently toxic properties. Dominant accounts of this
drug constitute users as both specifically violent and psychotic, and knowledgeable and self-
aware. Using accounts of methamphetamine consumption and harm reduction/treatment
practitioner accounts, I bring to light the political effects of these hegemonic enactments of
methamphetamine as well as alternative enactments of methamphetamine use. I show how
particular assemblages of drug use and service provision disrupt, draw upon or reject
hegemonic enactments of methamphetamine and re-make methamphetamine and
methamphetamine users in multiple ways. Further, I acknowledge that my research also
draws boundaries between what is made present and what is ‘othered’. Remaining mindful of

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these distinctions, I use the theories I have outlined above to provide an alternative way of
thinking about methamphetamine use, where pejorative understandings of the drug-using
subject are rejected for a more complex exploration of the many elements involved in
producing drug use and harm.

A corpus of research literature uses the theories I have outlined above to provide insights into
drug use and complex and nuanced accounts of it (see, for example, Duff, 2014; Dwyer &
Moore, 2013; Fraser, 2011). My research is unique, however, as it applies these theories to
the practice of both methamphetamine consumption and related service delivery, including
treatment and harm reduction. It breaks new ground in that it interrogates the science of
methamphetamine using tools from STS, not seeking to debunk the ‘facts’ but to argue that
these are contingent. My research also furthers the work of scholars that have investigated the
subjectivity of drug users (Seear & Fraser, 2010a, 2010b; valentine, 2007) by analysing
authoritative texts to illuminate the specificity of the methamphetamine user. More broadly, I
extend previous qualitative accounts of methamphetamine and other drug use by
foregrounding the ontological contingency of methamphetamine and of drug users. In doing
so I move beyond accounts of drug use that assume there is a ‘true’ representation of drug
issues and that drugs and drug users can be described accurately through scientific practice
(Armstrong, 2007; Ayres & Jewkes, 2012; Jenkins, 1994). This research argues that all things
are ontologically contingent and inherently political and, in seeking to describe the
constitution of drugs and drug users, I aim to provide new ways of thinking about this drug
that could contribute to more sophisticated ways of understanding methamphetamine use.

In order to address my research questions I first document the ways in which the materiality
of methamphetamine has been inscribed in scientific texts. I then explore the materialisation
of methamphetamine-using subjects in policy, treatment and media texts. Following this,
methamphetamine-related consumption and harm reduction/treatment practices are described
and their effects discussed.

How this research proceeds

Chapter Two contains my review of the literature and positions my thesis in terms of
sociological research concerning methamphetamine and, where relevant, other drugs. To
address the sociological literature on methamphetamine, I assign this work to one of two
categories. These are: (1) research that is underpinned by the assumptions of public health,
biomedical and scientific discourses, and (2) research or commentary that critiques these

12
 
  

discourses. I first review qualitative literature that embraces the assumptions of public health,
demonstrating how it increases the scrutiny of the methamphetamine-using subject. I argue
that, while well-meaning, this sociological research has political effects. These include
increasing scrutiny of the methamphetamine-using subject and contributing to its
pathologisation by uncritically accepting terms such as ‘addict’. I then review a more critical
body of work. I show how this literature addresses drug use without relying on concepts
emerging from public health discourse such as ‘addiction’ and ‘abuse’. Instead, drug use is
conceived of as a practice that constitutes and is constituted through networks of subjects,
objects and spaces, rather than as singularly the actions of a pre-existing pathologised and/or
transgressive subject. In this chapter I explain how my research extends upon this corpus, as
it treats ‘reality’ as ontologically contingent, showing the ways in which dominant discourses
such as public health come to bear upon the practices that constitute methamphetamine and
methamphetamine consumers.

Chapter Three presents my theoretical and methodological framework. I set out the
theoretical approach that I use in my research, presenting the key concepts I draw from the
work of post-structuralist scholars Foucault and Deleuze and, more recently, Rose, and STS
scholars Latour, Law and Mol. I explain how these concepts enable me to foreground
practice, decentring the (addicted) subject. I also show how these concepts are useful in
illuminating the ontological politics of methamphetamine use, allowing me to critique the
status of current knowledge around methamphetamine and to challenge the very pejorative
ways in which we currently understand people who consume this drug. I then present the
methodological approach I use to undertake this research, one that is congruent with these
theorists’ work: method assemblage. I explain the implications of using this approach, and its
political commitment to produce realities that are less oppressive.

Chapter Four is my first data chapter, and its object of enquiry is the drug methamphetamine
as it is materialised in scientific literature. In this chapter, I argue that scientific discourse
enacts methamphetamine as uniquely problematic drug. I do this by focusing on texts that
have originated from Australian scientific research, but also discussing some US-based
research. I use theoretical concepts developed by Latour and Woolgar (1986) to argue that
current knowledge around methamphetamine is contingent — the result of considerable
scientific work as well as political choices. Tracing the constitution of methamphetamine in
scientific texts makes visible the ontological politics of this substance, showing how existing
concepts, practices and bodies of knowledge mean that there are limited ways we can ‘make’

13
 
  

methamphetamine. I argue that the reification of methamphetamine has political effects for
people who use this drug, as they are seen as addicts and pathologised by knowing
methamphetamine in this very singular way.

In Chapter Five I shift to analysis of policy, treatment and media texts in order to look at the
ways in which the ‘facts’ of methamphetamine are taken up and reproduced in broader
spheres. I examine methamphetamine-using subjects in these texts, finding that they are
enacted in dualistic spheres — a series of ‘absolutes’ (Sedgwick, 1992). These include active,
self-controlled and reflective subjects versus inactive, violent and chaotic subjects. This
bifurcation is found in previous work that examines the way Western liberal societies
understand drug use and addiction and is underpinned by the valorisation of choice and
disgust of those subjects deemed to be driven by compulsion (see Keane, 2002; Sedgwick,
1992; Seear & Fraser, 2010a). I build upon this work and argue that there is specificity to the
bifurcation of methamphetamine-using subjects; these subjects are enacted in ‘extreme’
absolutes. I examine the specific capacities of the subjects manifested in these dualistic
spheres, noting tensions and slippages and illuminating the epistemic assumptions that are
common to both. In bringing to light the capacities of methamphetamine-using bodies
constituted in authoritative texts, I demonstrate the political nature of these enactments, and
the limited ways in which we are able to understand the human subject and drug use in the
current conditions of possibility.

In Chapter Six I move from discourse analysis to my interview data. I do so in order to

describe how dominant understandings of methamphetamine-using subjects are both
(re)produced and subverted in accounts of methamphetamine consumption — drawing
attention to the ontological politics of drug-using bodies. Moreover, attending to the
material—semiotic networks of drug use, I illuminate some of the ways in which these
produce, and are produced by, controlled and/or chaotic bodies. I argue that active practices
and attributes such as self-control are produced by the social, material and knowledge
connections an individual has access to, rather than being an expression of an individual’s
character. Likewise, feeling out of control, taken over by methamphetamine and other
practices that suggest a lack of self-control emerge from the relations an individual can form,
and the assemblages they are enmeshed within, rather than a deficiency of will. Thus, through
my analysis of accounts, I show how both localised assemblages and broader understandings
of drug use are intrinsic to ways in which individuals who use methamphetamine embody
themselves.

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In Chapter Seven I turn to the accounts of harm reduction and drug treatment practitioners in
order to further scrutinise the dualistic ways in which we understand methamphetamine and
methamphetamine users. As with previous chapters, I am concerned with illuminating the
ontological politics of this particular practice. I show how dominant enactments of
methamphetamine play out in the day-to-day activities of practitioners — how they are
embraced and resisted, and the sets of tensions this may introduce for clients. My argument
uses analyses of change to understand accounts of harm reduction/treatment practice. I trace
this concept, examining how accounts of service provision enact change in conventional
ways — as instigated by the drug-using subject, for instance — but also in less conventional
ways, such as occurring by chance and mitigated by other encounters in the client’s life. As
with Chapter Six, I illuminate the ways in which the localised assemblages individuals are
enmeshed within are productive of capacities and thus of the choices that are possible in
terms of drug use and change.

Chapter Eight concludes my thesis. In this chapter I bring together the themes that I have
explored in my research in order to make some concluding remarks concerning the
ontological politics of methamphetamine and its consumers. I consolidate my argument about
the very specific ways in which methamphetamine and methamphetamine users are
constituted in dominant discourses. I also make some final comments concerning the
contested and contingent nature of reality, re-visiting how individuals may embrace, resist or
subvert these dominant enactments in their day-to-day lives. In my conclusion I suggest that
by making visible alternative ways of constituting methamphetamine, I have illuminated
other possibilities for addressing this drug and contributed to literature that seeks more
nuanced and complex ways of understanding drug use.

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Chapter 2: Sociological accounts of methamphetamine; Sociology for

and of public health
My research is a qualitative exploration of methamphetamine use and related service
provision, drawing on post-structuralism and the field of STS. The following literature review
of qualitative, sociological research concerning methamphetamine consumption maps the
existing empirical literature and positions my research in relation to it. In this review I also
present the particular area of research to which my work will contribute and extend upon,
thus demonstrating its significance.

To address the sociological literature on methamphetamine, I first assign this work to one of
two categories. These are: (1) research that is underpinned by the assumptions of public
health, biomedical and scientific discourses, and (2) research or commentary that critiques
these discourses. I base this distinction on Moore’s (2004) delineation of a ‘sociology in, or
for, health policy, and a sociology of health policy’ (p. 1547). He explains the differences and
tensions between the two in the following way:
In the former, the aim is to employ sociological perspectives and methods in order to
refine or improve health policy whereas, in the latter, health policy itself — its
theories, methods and ideological bases — becomes the object of enquiry. Those
engaged in the analyses of health policy criticise those engaged in applied research for
their collusion in expert-driven social control. The refinements or improvements made
to health policy are portrayed as little more than new forms of governmentality. Those
engaged in more applied health research sometimes characterise the ‘of’ research as
theoretically elegant but of little practical value. (Moore, 2004, pp. 1547-1548)
Using this classification, I examine qualitative methamphetamine research in terms of
whether it contributes to a sociology for public health (and its associated discourses, such as
biomedicine and science) or to a sociology of public health. I argue that, while well-meaning,
qualitative research on methamphetamine that uncritically accepts the assumptions of public
health has certain political effects. These include an increase in the surveillance of drug-using
subjects through the construction of different ‘cohorts’ of drug users and ‘deeper’ experiences
of ‘addiction’ and ‘abuse’ hitherto unexplored in research, and the reinforcement of the
addiction/recovery binary that produces drug users as chronically pathological subjects,
defined only by the practice of drug use.

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My research will build upon a body of work that takes a more critical approach to public
health discourse, acknowledging that this discourse is inseparable from other discourses such
as biomedicine and science. This literature addresses drug use without relying on, or by
criticising, concepts emerging from these discourses such as addiction, abuse and treatment.
Instead, drug use is conceived as a practice that constitutes, and is constituted through,
networks of discourses, subjects, objects and spaces, rather than as solely the action of a pre-
existing pathological and/or transgressive subject. The assumption that drug use is inherently
unhealthy, harmful or addictive is rejected, and the cultural significance and political effects
of this practice are foregrounded. My research extends upon this corpus, as among its objects
of enquiry are the concepts of addiction and treatment as well as the way in which
methamphetamine has been reified through scientific discourse. Through the interrogation of
these objects, and others, my research engages theoretically with the fields of post-
structuralism and STS, demonstrating how these theories can illuminate our understanding of
methamphetamine use and service provision. This is an area which, to date, has received little
theoretical attention. In addition to its theoretical significance, my research has applied
relevance. It describes the lived experiences of people who use methamphetamine in relation
to dominant discourses, such as public health, showing the political effects of these
discourses. It also describes harm reduction and treatment practices and the particular
subjectivities these practices make available, demonstrating the limits of current ways of
thinking about drug users. While I do not offer prescriptive advice to harm reduction and/or
treatment services concerning methamphetamine use, I hope to contribute to alternative ways
of thinking about people who use methamphetamine that may inform the services available to
them.

This review proceeds as follows: first, qualitative research concerning methamphetamine

that, I argue, contributes to a sociology for public health is reviewed. I then review a smaller
body of qualitative research, as well as discourse and policy analyses, that contributes to a
sociology of public health.

A sociology for public health

A large body of qualitative research concerning methamphetamine originates in North
America, but also from countries such as Thailand (German et al., 2006; Sherman et al.,
2008) and New Zealand (Sheridan, Butler, & Wheeler, 2009). This work illuminates the ways
in which culture, gender, economic status, race and other considerations come to bear on
practices of methamphetamine consumption, enriching our understanding of the cultural and

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social practices that produce drug use. Additionally, it personalises the experience of
methamphetamine use, generating empathy and respect for people who use drugs (Keane,
2012). Yet, as a whole, this work contributes to a sociology for public health (Moore, 2004),
uncritically accepting public health assumptions regarding illicit drug use. These include that
drug use is invariably a risky, harmful and addictive activity. This body of qualitative
research is extensive and so, for the purposes of this review, I do not address each article
individually in this corpus. Instead, I make three points about this work generally, using
individual articles to illustrate these observations. My observations are, first, that although
aspiring to an in-depth and rich understanding of methamphetamine use through qualitative
methods, this body of research embraces public health discourse. It analyses and presents
data in very conventional ways, rather than providing insight or alternative ways of
considering drug use. This means that this research then helps to materialise and reproduce
hegemonic understandings of drug use. Second, this work generates cohorts or populations at
risk of, or experiencing, methamphetamine-related harms, thus increasing the surveillance of
methamphetamine-using subjects. Third, this research makes methamphetamine-using
individuals liable to more intensive forms of investigation through in-depth methods. I now
address each point in turn.

Interpreting data using public health concepts

The corpus of methamphetamine research that I classify as a sociology for public health often
mobilises concepts of public health such as addiction, drug-related harm and recovery.
Because these concepts are not critically addressed, they inform data interpretation in very
conventional ways. They therefore lead to assumptions such as drug use inevitably leads to
addiction which must then be resolved through recovery. Two articles that describe
‘trajectories’ of methamphetamine use (Boeri, Harbry, & Gibson, 2009; Sexton, Carlson,
Leukefeld, & Booth, 2008b) exemplify this point. These articles, as with most in this
particular corpus, are well-intentioned and present interesting data. Yet, they both embrace
addiction as the primary way to describe patterns of methamphetamine use. This leads them
to generating understandings of people who use methamphetamine as addicts in need of
recovery.

Rocky Sexton, Robert Carlson, Carl Leukefeld and Brenda Booth (2008) studied the self-
reported trajectories of methamphetamine use among rural populations in the US. When
describing their analysis, the researchers state:

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We identified three trajectories of MA [methamphetamine] use at follow-up:

abstinence, reduced use, and continued use, with decreasing use and abstinence as
dominant themes. (Sexton et al., 2008b, p. 8)
The use of the word ‘identified’ in this statement suggests that the authors consider these
categories as pre-existing their data. It could be argued that rather than having identified these
patterns of use, the researchers imposed them on their data in accordance with their
understanding of methamphetamine as an addictive drug. This understanding is stated up
front in the text as the authors describe methamphetamine as ‘an addictive CNS stimulant that
causes short-term and long-term consequences’ (Sexton et al., 2008b, p. 1). Thus, rather than
looking to their own data to illuminate practices and patterns of methamphetamine use, these
authors inscribe pre-existing pathological categories onto participants’ methamphetamine
consumption.

Miriam Williams Boeri, Liam Harbry and David Gibson (2009b) undertook research with
‘suburban’ users of methamphetamine. This study also considers its participants’
methamphetamine use in terms of addiction. The codes the authors use to describe drug use
trajectories are ‘(a) initiation, (b) access, (c) turning points, (d) treatment, and (e) relapse’ (p.
4). The data presented within their text, however, suggest that methamphetamine
consumption is more complex than these codes imply. For instance, the researchers find that
methamphetamine use among their participants is sometimes driven by people’s ‘need to
“function” rather than a desire to get “high”’ (Boeri et al., 2009b, p. 5). One participant who
said that she often used methamphetamine at home while doing housework stipulated:
Personally, I never associated it with being high. At that point I was not doing enough
to get the high, high feeling. (Boeri et al., 2009b, p. 6)
Other people reported using methamphetamine in order to ‘have the energy to maintain a
normal suburban lifestyle’ (Boeri et al., 2009b, p. 6), and this involved completing mundane
tasks such as housework or overtime at work. Yet, after presenting these data the authors
explain:
Since methamphetamine affects dopamine neurotransmitters, the user feels euphoria
while on the drug. (Boeri et al., 2009b, p. 7)
A state of euphoria seems counterintuitive to the instrumental use of methamphetamine in
order to do housework or work long hours. Further, participants in this research explicitly
stated they were not seeking to experience the possible euphoric effects of methamphetamine.

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The above statement suggests that Boeri and colleagues rely on biomedical discourse to
understand methamphetamine, rather than generating alternative understandings of this
substance on the basis of their own data. This is unfortunate as their participants’ use of
methamphetamine to maintain ‘normality’ provides a counterpoint to the literature that
suggests methamphetamine use is driven by aspects such as emotional abuse (O'Brien,
Brecht, & Casey, 2008), and that it can result in violence (Baskin-Sommers & Sommers,
2006; Sommers & Baskin, 2006) and severe harm (Darke et al., 2008).

The two articles I have reviewed above are characteristic of this particular body of literature
and suggest that embracing the concepts of public health leads to understandings of
methamphetamine–using subjectivities as pathological and addicted and methamphetamine as
a singularly harmful and addictive substance. Moreover, as I will show in the following
sections, embracing public health discourse and positioning data in terms of addiction and
recovery have political ramifications. Most notably, they have the effect of making people
who use drugs visible as objects of intervention and treatment. This legitimises their
increased surveillance, both more broadly as ‘populations’ of drug users, and individually as
the ‘inner’ drug user is scrutinised through qualitative methods.

Increasing surveillance of methamphetamine‐using cohorts

The second point I make about the body of qualitative methamphetamine research I classify
as a sociology for public health is that it identifies specific cohorts or populations of
methamphetamine users, highlighting the previously unknown consumption practices of these
subjects, with the specific aim of contributing to interventions such as clinical practice. New
populations suitable for investigation and intervention in this body of work include: gay men
(Diaz, Heckert, &Sánchez 2005), HIV positive gay and bisexual men (Reback & Grella,
1999), mothers (Haight, Carter-Black, & Sheridan, 2009), parents (Haight et al., 2005)
functional users (Lende, Leonard, Sterk, & Elifson, 2007), people in the rural south of the US
(Sexton, Carlson, Leukefeld, & Booth, 2008a; Sexton et al., 2008b; Sexton, Carlson,
Leukefeld, & Booth, 2009), African American people in the rural south (Sexton et al., 2005),
suburban dwellers (Boeri et al., 2009b; Boshears, Boeri, & Harbry, 2011), women suburban
dwellers (Boeri, Tyndall, & Woodall, 2011), ‘baby boomers’ (Boeri, Sterk, & Elifson, 2006),
adolescent girls (Newbury & Hoskins, 2008, 2010a, 2010b, 2010c), ‘street youth’ (Bungay et
al., 2006), Native American and White youth in Appalachia (Brown, 2010) and people living
in Appalachian Tennessee (Macmaster, Tripp, & Argo, 2008). Each cohort in this extensive
list is argued to require investigation although, as I show later, some of these justifications are

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tenuous. I now look at three examples of literature that concern specific cohorts in order to
outline how the particular populations are constructed with the intent to intervene in them.

Wendy Haight, Janet Carter Black and Kathryn Sheridan (2009) research mothers who use
methamphetamine, arguing this is necessary due to the increase in women of child-bearing
age using methamphetamine and the neglect experienced by children whose parents use
methamphetamine. The authors also claim:
Not surprisingly, the abuse of methamphetamine is taking a serious toll on the child
welfare system (Zernicke, 2005), and many child welfare officials report an increase
in the number of children entering foster care because of parent methamphetamine
abuse, especially on the West Coast and in rural areas (Zernicke, 2005). (Haight et al.,
2009, p. 71)
Here, methamphetamine use is explicitly linked to child neglect and strains on the welfare
system. This then justifies research into the use of methamphetamine by mothers. The
citation used in this statement, Zernike (2005), is a New York Times article entitled ‘A drug
scourge creates its own form of orphan’. In it, anonymous ‘officials’ are quoted liberally,
linking children in need to increasing parental methamphetamine use. As a mainstream media
text, it is not a credible source upon which to base an academic argument. Its use
demonstrates the somewhat shaky foundations upon which the justifications for researching
particular cohorts can be built.

That said, the use of drugs by people who care for children is an area worthy of research. This
group is highly stigmatised, and qualitative research could contribute to a better
understanding of these individuals’ circumstances, perhaps challenging stigma. Indeed, this is
one of the objectives of Haight and colleagues’ (2009) article, as they speculate:
Understanding mothers' experience of methamphetamine addiction can increase our
awareness of this illness, reducing stigma and suggesting strategies for engaging them
in intervention. (p. 71)
Yet, while the authors’ stated aim is to reduce stereotyping and stigma, a critical gaze is not
applied to the concept of addiction itself. This concept is part of a broader discourse that
positions people who use methamphetamine as disorderly, unwell and unable to carry out
their societal roles (such as parenthood). Haight and colleagues’ introduction, with its focus
on children’s neglect and overloaded child protection services, flags these assumptions. This
research, therefore, while aiming to address discrimination directed at women with children

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who use methamphetamine, is unable to move beyond conventional (and stigmatising) ideas
of drug use and offer an alternative narrative concerning mothers and methamphetamine use.

In another article concerning a specific cohort — people who live in the suburbs — Boeri and
colleagues (2009b) conduct interviews with 48 former and current methamphetamine users
about their ‘drug careers’ (p. 139). To justify their research with this population, the authors
state:
Methamphetamine users living in the suburbs comprise a hidden population of hard-
to-reach individuals. We know very little about the mechanisms of initiation or
patterns of methamphetamine use among this under researched population. (Boeri et
al., 2009b, p. 139)
It is difficult to see how people who use methamphetamine who live in the suburbs might be
a ‘hidden population’ more so than any other group of drug users. And establishing this group
as a specific ‘population’ with particular ‘mechanisms of initiation’ and patterns of use is a
tenuous proposition, given the sheer number and heterogeneity of suburban dwellers.
Nonetheless, in this research, these attributes qualify these individuals as a specific research
cohort. I have discussed the findings of this research in the previous section, but here draw
attention to the way the authors position their findings solely in terms of intervention:
Through this qualitative inquiry into suburban settings, we have a better
understanding of the diverse trajectories in methamphetamine use that can help us
develop and implement more focused treatment, intervention, and prevention
programs. (Boeri et al., 2009b, p. 14)
The use of the term ‘focused’ in the statement above suggests that, as a result of this research,
greater scrutiny may come to bear on those who use methamphetamine. In this sense, by
constructing suburban dwellers as a specific cohort of methamphetamine users, these people
are remade as legitimate objects of surveillance and intervention.

The final example I give of a particular methamphetamine-using cohort being established

though research is an article published in 2007 by Daniel Lende, Terri Leonard, Claire Sterk
and Kirk Elifson (2007). The article presents research with ‘functional users’; that is, people
who use methamphetamine in order to enhance their ability to function at work or socially. In
this research, 40 participants were interviewed and it was found that methamphetamine
enhanced aspects of their lives, including work and socialising. Participants mentioned
numerous benefits to methamphetamine use such as improved eyesight, improved ability to

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study, and additional stability in their lives. Generally, people who took part in this research
emphasised the positive effects of methamphetamine use — not a particularly surprising
outcome as this group of people deliberately used methamphetamine to improve their
‘functionality’. As a group, such individuals would not seem to be obvious candidates for
treatment or intervention. Despite this, the findings of this research are positioned in terms of
their relevance to interventions. As Lende and colleagues (2007) conclude:
Functional use can help expand theories of self-medication and
motivation/expectancy which have focused on internal feeling states. Not only will
this expand our understanding of why people use drugs, it should help in developing
more appropriate interventions for treatment, prevention, and harm reduction. (p. 475)
This finding does not do justice to the more thoughtful exploration of data in the article itself,
where the idea of functional drug use and what this means to people who use
methamphetamine is elaborated on. The data challenge assumptions concerning
methamphetamine, showing people use the drug to improve work practices, to appear
‘straight’ and feel in control. Ultimately, however, the data are positioned as pointing the way
to new interventions — including treatment. In this way, another population of drug users is
legitimised as the object of surveillance.

In summary, a significant body of qualitative methamphetamine research concerns particular

cohorts of users. This work offers insight into the ways in which specific cultural, economic
and environmental settings shape methamphetamine use. However, the findings of research
are consistently positioned in terms of their relevance to public health objectives (such as
intervention and/or treatment), with concepts such as recovery and addiction accepted
uncritically. Because of this, this work contributes to a sociology for public health. Further,
these cohorts are always considered to be at risk of, or experiencing, drug-related harm.
Considered in this way, documenting the practices of specific populations materialises an
escalating number of drug-using subjects suitable for investigation and intervention,
increasing the surveillance of individuals who use methamphetamine.

Investigating the subject: Qualitative forms of investigation

As well as identifying and researching particular cohorts of methamphetamine users, some
texts within the body of qualitative methamphetamine research that is classified as a
sociology for public health purport to reveal hitherto unexplored dimensions of
methamphetamine users’ subjectivity and/or their experience of abuse and addiction. In these

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texts, qualitative methods such as in-depth interviews are assumed to result in a more
profound understanding of people who use drugs. However, I argue that because this
literature uniformly presents data in relation to interventions such as treatment and does not
critically assess terms such as addiction, these methods also become tools to enable
surveillance of the inner methamphetamine user. While in the previous section I showed how
specific populations are made visible as objects of research, in this section I show how
individual methamphetamine users are made visible as objects of intense scrutiny, such that
their inner selves and experiences are constituted as legitimate objects of research. To do so, I
first review an article that attempts to reveal the inner meanings of methamphetamine use
(O'Brien et al., 2008) and then a series of articles on adolescent girls who use
methamphetamine in Canada (Newbury & Hoskins, 2008, 2010a, 2010b, 2010c).

In a paper published in 2008, Ann O'Brien, Mary-Lynn Brecht, and Conerly Casey present
‘narratives of methamphetamine abuse’. The paper is the result of research with 300 people
using methamphetamine, none of whom had accessed formal treatment programs. The aim of
the article is to discuss ‘the meanings of MA abuse from the users’ perspectives’ (p. 345), and
to describe ‘the development of MA abuse’ (p. 345). The authors argue that this will lead to
‘an understanding of the inner experiences of MA users’ (O'Brien et al., 2008, p. 345) and
that the paper ‘illuminates the emotional experience of MA abuse’ (O'Brien et al., 2008, p.
363). Although purportedly revealing an in-depth understanding of methamphetamine use,
the authors employ the language of addiction and abuse uncritically throughout the article,
presenting methamphetamine use as it is produced through public health discourse. The
fundamental finding of this piece of research is ‘the development of problematic MA use
across the lifespan’ (p. 362). Here, the authors link methamphetamine use to experiences such
as child abuse and treat it as an ‘escape’ (p. 362). This is a typical narrative of ‘damaged’ and
‘traumatised’ drug users, linking drug use to poverty and abuse (valentine & Fraser, 2008).
This familiar trope can be useful in mobilising empathy and advocating for people who use
drugs (valentine & Fraser, 2008). It is, however, a standard interpretation of data and shows
that the deployment of qualitative methods has not led to new insights into methamphetamine
use in the case of this research.

Employing public health assumptions to frame their analysis, O’Brien and colleagues (2008)
position their conclusions explicitly for the purposes of enhancing treatment. The authors
find:

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Because qualitative research can illuminate the meaning of MA abuse to individual

users, which clinicians can then incorporate into their treatment, it allows a direct link
between research and treatment. (p. 364)
Producing research that can contribute to knowledge that informs methamphetamine-related
practices is of great importance. Yet, in this case, the revelations of qualitative research are
linked solely to treatment interventions, with the concept of treatment itself given no critical
attention. If the purpose of revealing the inner experiences of methamphetamine users is to
inform treatment interventions into their lives — rather than to challenge conventional and
pejorative constructions of drug use and users — then greater scrutiny is brought to bear on
methamphetamine-using subjects. Their thoughts and feelings are investigated in order to
ascertain how and why they are ‘deficient’ subjects (abusers of methamphetamine). It also
reinforces narrow conceptions of what drug use is, and limits the research’s capacity to
generate original insights.

Janet Newbury and Marie Hoskins (2008, 2010a, 2010b, 2010c) author a series of articles
that present qualitative research with young women using methamphetamine. This work aims
to contribute to a ‘meaningful’ understanding of drug users (Newbury & Hoskins, 2008, p.
227). However, it uses addiction to understand drug use, contributing to conventional
understandings of the experiences of these young women and the young women themselves.
These researchers studied young Canadian women who used crystal methamphetamine, with
an innovative research method called ‘photovoice’ (Newbury & Hoskins, 2008, p. 232). They
assert that by using qualitative methods they ‘tap into nuanced, contextualized, and socially
constituted aspects of…participants’ experiences’ (Newbury & Hoskins, 2010b, p. 18). This
research project appears to ask a great deal of participants. They are given cameras and asked
to take a series of photographs, respond to two sets of questions, as well as keep a journal.
They are then interviewed about these images, an exercise the researchers refer to as
‘research conversations’ (Newbury & Hoskins, 2010c, p. 171). During the interviews the
young women discuss their drug use and their feelings about themselves. For instance, one
participant (Tara) says of herself:
It’s just how I am. Even though I know I can do anything I want, I always feel pieces
missing. Like, there’s a piece of my life that I’ll never get back. (Newbury & Hoskins,
2010c, p. 168)
This statement demonstrates the personal and revealing nature of the research, as Tara openly
talks about the impact of drug use on her sense of self and her life.

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By collecting this personal and in-depth information, the authors aim to ‘reconceptualise
clinical practice’. This is a worthy aim, but it is not done in a way that challenges the idea
that their participants are struggling with addiction (Newbury & Hoskins, 2010c, p. 167).
While the authors commit to a social constructionist stance, they are unable to consider
addiction itself as socially constructed. This is demonstrated in the following statement:
A social constructionist approach to addiction involves broadening our scope to
include the lived experiences of those who are addicted to substances, including but
not limited to the experience of addiction itself. (Newbury & Hoskins, 2008, p. 230)
Here, a key idea of social constructionism — that knowledge is constructed through forces
such as discourse and power — is not extended to the concept of addiction. And because the
authors never critically attend to addiction, data are consistently explained in terms of this
concept, and its binary opposite — recovery. This leads to conclusions such as the following:
[A]ll of our participants indicated that feeling supported by friends and family, being
permitted to ‘regress’ from time to time, witnessing ‘success stories’ around them of
acquaintances who overcame drug dependency, developing skills and capacities,
finding alternative expressive outlets, and experience [sic] a sense of growth in their
own lives are all factors that led to both the desirability and possibility of recovery.
(Newbury & Hoskins, 2010a, p. 648)
With this statement the researchers suggest that drug use is a multiple and complex
experience, of which the individual is just one part. But the focus is simultaneously on
recovery, requiring that we consider the drug user as ‘sick’ and drug use itself as a ‘disease’.
These are assumptions embedded within public health discourse and ones that consider drug
use as the practice of a pathologised subject, othering the complexity of this practice.

While Newbury and Hoskins (2008, 2010a, 2010b, 2010c) aim to provide new insights into
young women’s methamphetamine use, and change clinical practice in this area by using
qualitative methods, their research falls short. Their methods investigate the experiences and
feelings of participants, rather than interrogating (and hence questioning) some of the
dominant concepts offered up by public health discourse such as craving and addiction.
Because the research findings are couched solely in terms of recovery, the data collected do
not lead to more profound or meaningful understandings of people who use
methamphetamine. Instead, these data reiterate conventional narratives of addiction and
recovery. Moreover, as I argue above, collecting data primarily to find better ways to ‘cure’

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people who use drugs makes participants visible as objects of intervention. That is, people
using methamphetamine are uniformly considered as addicted or at risk of addiction and are
therefore pathological subjects. By using qualitative research methods such as in-depth
interviews, the intimate experiences and feelings of methamphetamine-using subjects are
revealed and scrutinised. In this way, as previously noted, surveillance of the individual
subject can be intensified through qualitative methods.

To sum up, many of the articles in this body of qualitative work demonstrate the cultural
shaping of drug practices, perhaps creating more empathy and respect for people who use
drugs. That said, making drug users visible is a political exercise and none of the researchers
presented here acknowledge this (Keane, 2011). If drug users are made visible only in order
to develop treatment and intervention responses, this has the effect of increasing surveillance
of drug users themselves, and produces and reinforces methamphetamine consumption as a
pathological and/or deviant practice, congruent with bio-medical and public health literature
(see, for example, Darke et al., 2008; Rawson et al., 2002). It makes drug users the central
point of intervention for addressing problematic drug use (Keane, 2011). It also feeds stigma
and discrimination by reproducing assumptions and stereotypes. My work challenges these
insufficiently sophisticated ways of thinking about methamphetamine. It does this by shifting
focus from the drug user as the object of investigation to understanding drug use as a practice
that involves myriad phenomena, including people who use drugs, the drugs themselves and
physical and social spaces of consumption. Further, it interrogates, rather than embraces,
concepts such as addiction and trauma. It does not seek to investigate the truth of
methamphetamine use, seeing it as driven by these concepts, but argues there are multiple
experiences of use. At the same time, I trace dominant understandings of methamphetamine
use and consumers in order to show how these shape methamphetamine-related practices.
While my research makes methamphetamine users visible, I aim to do so in a way that does
not reproduce them as pathologised, violent and psychotic, but that shows the complexities of
drug use, challenging the idea that drug use is inherently harmful and addictive.

A sociology of public health

I now review methamphetamine and other drug literature that contribute to a sociology of
public health. Rather than accepting public health concepts such as addiction and abuse, this
body of work critiques these concepts. It does so through the use of theory that can challenge
the accepted truths of public health. In this section I review methamphetamine-related
literature in order to show how this work extends and challenges common assumptions about

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drugs. I also review some key pieces of other drug research that draw on similar theoretical
concepts to my research. I do so in order to position my work and show how it contributes to
a sociology of public health.

Critical accounts of methamphetamine use

First, I review five qualitative accounts of methamphetamine use (Duff, 2014; Dwyer &
Moore, 2013; Green & Moore, 2013; Slavin, 2004a, 2004b). While there are older qualitative
accounts of stimulant use, these address amphetamine use (see, for example, Boys, Fountain,
Griffiths, Stillwell, & Strang, 1999; Carey & Mandel, 1968). As my work focuses on the
specificity of methamphetamine use, I have not reviewed these earlier pieces. Four of these
articles are reports of Australian ethnographic research that took place in Sydney (Slavin,
2004a, 2004b), Melbourne (Dwyer, 2008) or Perth (Green & Moore, 2013). The fifth article
is a case study of a person who uses methamphetamine in Melbourne (Duff, 2014). This
small body of research rejects key assumptions of public health. These assumptions include
that methamphetamine consumption is an inherently harmful practice and people who use
methamphetamine are always at risk of harm and/or addiction. It offers alternative ways of
understanding methamphetamine use. In doing so, it resists the way in which
methamphetamine has been constructed through public health discourse and so contributes to
a sociology of public health.

Sean Slavin’s (2004a, 2004b) ethnographic research was situated in inner city Sydney, in an
area of 24 hour street social activity. Participants in the research were gay men who often
used methamphetamine, and who considered the recreational use of this drug and other ‘party
drugs’ to be normal. Slavin (2004a) clarifies that his participants’ general view is that
recreational drug use is not ‘morally wrong, but simply against the law’ (p. 436). Heroin use
and injecting drug use, however, are not normalised in this way. Instead they are considered
beyond the boundaries of recreational drug use. In his work, Slavin (2004a, 2004b) draws out
the distinctions between acceptable and non-acceptable drug use, showing how cultural
practices, economic and social status, relationships, and spatial and temporal aspects act to
shape and are themselves shaped by drug consumption. Slavin’s articles foreground the role
of pleasure and desire in drug use, two concepts that are mostly made absent in public health
discourse (Moore, 2008). By making these aspects of drug use visible, Slavin’s (2004a,
2004b) work challenges the narratives of harm, addiction and despair commonplace in
literature underpinned by the values of public health. However, Slavin’s work has other
important theoretical aspects that I will discuss.

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In his exploration of how gay men manage their methamphetamine use (some more
successfully than others) Slavin (2004a) focuses on four men who are regular injectors of
crystal methamphetamine. One of these participants is also an occasional heroin user. While
these men share a geographical and cultural context, they move in different ‘scenes’ where
crystal methamphetamine is used in different ways. By reporting on the different
characteristics of crystal methamphetamine use among participants and their respective
scenes, Slavin (2004a) focuses on particular effects of the drug and how some of his
participants’ management strategies work and others fail in addressing these effects (p. 426).

Slavin employs the concept of ‘boundaries’ (Douglas, 1966, in Slavin, 2004a) to illuminate
the ways participants incorporate methamphetamine use in their lives. For instance,
participants exercise ‘control over themselves and the drugs they used’ (p. 455) by
establishing ‘boundaries’ around their methamphetamine use and only using on the weekend
or in certain places. Slavin uses this concept in a post-structuralist sense, where boundaries
mark social and cultural spaces that are never ‘hermetic’ or ‘homogenous or static’ (Slavin,
2004a, p. 441). Thus, Slavin (2004a) argues that the most significant feature of drug use is its
‘liminality’, and observes that boundaries are never clear-cut (p. 457). To demonstrate the
shifting and complex nature of boundaries, Slavin (2004a) provides an example of the
exercise of control in his participants’ orchestration of ‘drug-use events’ (p. 442). Participants
often made preparations for these events in advance, buying exactly the right amount of
crystal, and stocking up with ample supplies of injecting equipment and other drugs such as
amyl nitrate, cannabis and tranquilisers. Slavin suggests that with this extensive preparation
his participants sought to exercise a high degree of control over their drug use. Yet,
participating in these drug-use events also required being ‘out of it’ and losing inhibitions —
a loss of control (Slavin, 2004a, p. 442). The idea of control, therefore, is not straightforward
or clear-cut. Moreover, these drug-use events sometimes involved participants breaching
boundaries in the pursuit of ‘excessive experience’ and this was ‘intrinsic to the experience
and pleasure of the drug’ (Slavin, 2004a, p. 445). Thus, while boundaries were employed in a
conventional sense by participants, such as in limiting the times and places where drugs were
used, they were also shifting, and intrinsically part of the hedonism and pleasure involved in
drug consumption.

In a second article, Slavin (2004b) gives an account of drugs, space and sociality in a gay
nightclub. This article provides a vivid description of one participant’s (Tom’s) night out at a
gay venue referred to as ‘the Eagle’, which involves methamphetamine consumption and a

29
 
  

sexual encounter. In examining a specific context in which drugs are consumed, various
cultural and physical phenomena that produce drug use, including ‘sexuality, bodily
dispositions and “tribal” affinity’ are explored (Slavin, 2004b, p. 268). To attend to the
context in which Tom negotiates the use of drugs, (Slavin, 2004b) draws upon the work of
Michel De Certeau (1988) and Gilles Deleuze and Felix Guattari (1998) to theorise ‘space’.
De Certeau’s (1988) work provides a dynamic conception of spatial context. In it, ‘place’ is
theorised as incorporating only the materiality of an environment, whereas space is created
through elements such as social interaction, physical movements, mood and the ‘infinite
possibilities of time’ (Slavin, 2004b, p. 289). Deleuze and Guattari’s work (1998) is
employed to move beyond De Certeau’s approach (1988) in that, according to Slavin, it
conceptualises space as a:
fluctuating, multidimensional, social and cultural field that occurs within but not
bound by particular places. (Slavin, 2004b, p. 291)
Slavin (2004b) argues that when space is conceived in this way, rather than being reduced to
context, it allows us to understand the ‘particularity and complexity of Tom and the culture in
which he lives’ (p. 291). In turn, this provides insight into Tom’s methamphetamine use.

Using this theory allows Slavin (2004b) to conceptualise the space of the Eagle as constituted
through multiple elements and phenomena. This includes a particular ‘tribe’ of gay men who
delineate themselves through choices in clothing, drugs and music. Extremely loud and
repetitive music, drug-taking and a mass of dancing bodies also materialise the space of the
Eagle. Additionally, social interactions and exchanges constitute this space, including those
involving the use of drugs and sex. Slavin (2004b) describes one of these exchanges, where
Tom negotiates to take methamphetamine and have sex with someone he has just met:
In roughly a minute, through the blare of the music, and surrounded by a crowd, Tom
and Nick negotiated to have sex at Nick’s house; to pick up two other men; to have
sex without condoms based on the knowledge that they were all HIV positive; to take
drugs to enhance the sex; and to inject those drugs. (p. 285)
Slavin also demonstrates the way in which the space is productive of drug use and drug users
themselves. He finds that in Tom’s case:
spatialised sociality brings risk and pleasure into complex and dynamic relations. The
drug spaces that may appear to exist only in the minds and bodies of those who have
ingested them are not divorced from social or material contexts. All these elements

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are part of a dynamic space — complex cultural fields in which drug users make
themselves and are made by place (understood materially), bodies, and social
practices. (Slavin, 2004b, p. 277)
However, while Slavin (2004b) finds that the spaces that Tom interacts with, and within,
produce the possibility of methamphetamine use, he also argues that these spaces ensure that,
for Tom, consuming this drug is ‘pleasurable, manageable and negotiable’ (p. 290).

Slavin’s (2004a, 2004b) theoretical frameworks enable him to provide a greater

understanding of how gay cultural practices incorporate and produce methamphetamine
consumption. He brings to light strategies that his participants employ to manage their drug
use and identities, including that of boundary negotiation. He also shows that
methamphetamine consumption is produced through space and sociality, rather than being
merely the practice of an individual, illuminating how individuals embody themselves
through social practices and spaces. Slavin’s goal is not necessarily to provide more data for
the purposes of treatment or harm reduction interventions, yet his work is useful for both of
these fields. In illustrating the ways in which individuals manage their drug use, Slavin’s
work provides insights for treatment services seeking to help people to control their use.
Showing how space contributes to the effects of drug use reveals how the employment of
harm reduction strategies is dependent on myriad elements, rather than the agency of a single
drug user. Moreover, by attending to drug use as always a temporal and spatially bounded
phenomenon, Slavin contributes to a growing body of literature that rejects the concept of
drug use as the pathological and/ deviant practice of individual drug users (Keane, 2011). I
draw upon Slavin’s work in my thesis to produce an account of methamphetamine use that
moves beyond drug consumption as an individual act. Like Slavin, I illuminate the many
aspects that come together to produce drug use and drug users, including space and sociality,
considering methamphetamine use as an ontological concern. Slavin’s work is also relevant
in positioning my research, as he reveals the messiness of concepts such as controlled drug
use. I continue this work, showing through participant accounts how drug use is not easily
delineated as controlled and non-controlled.

While using bodies of theory different to Slavin’s, two other ethnographic accounts of
methamphetamine (Dwyer & Moore, 2013; Green & Moore, 2013) also reject the
conventional public health understandings of methamphetamine, seeking a more complex and
nuanced exploration of this drug. Rachael Green and David Moore (2013) use normalisation

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theory to illuminate how young people who use methamphetamine manage their identities in
the face of public health discourse. Robyn Dwyer and Moore (2013) apply theoretical
insights from STS to the issue of methamphetamine-related psychosis, showing how the lived
experience of psychosis may differ from public health explanations. I now review each of
these articles.

In an article concerning the way young people negotiate understandings of public health
discourse and their methamphetamine use, Green and Moore (2013) present ethnographic
research conducted with young people (‘scenesters’) engaged with the ‘dance party’ scene
living in Perth, Australia. A theoretical framework of normalisation is employed in this
article; specifically, the ‘micro-politics of normalisation’ (Pennay & Moore, 2010; Rødner,
2005; Rødner Sznitman, 2008).This approach concerns the way participants manage social
responsibility and self-regulation in relation to drug use. Using this theory, the researchers
explore the complex processes by which this particular network of drug users negotiated
values associated with methamphetamine use, and the interplay between these values and
those generated by dominant discourses such as public health.

Green and Moore (2013) posit that, at the time of the research, public discourses around
methamphetamine use produced extremely negative understandings of the drug and the
people who used it. Using methamphetamine was associated with stigma and harm, and
young people who use this drug were thus required to manage their own perceptions of
themselves in relation to these discourses. As Green and Moore (2013) observe:
The potency of the cultural representation of the problematic drug user — the addict
or the junkie — among scenesters was undeniable. (p. 697)
In order to negotiate their own methamphetamine use and these strong, pejorative cultural
representations of methamphetamine users, participants employed various strategies. These
included using their social and economic status to differentiate themselves from
‘problematic’ methamphetamine users, not engaging with the language of addiction to
describe their methamphetamine use (substituting words such as ‘more-ish’ for ‘addictive’
and defining their methamphetamine use as ‘social’), and using discreetly when in social
situations. Taking these strategies into account, the authors surmise that most participants
responded to dominant representations of methamphetamine by aligning ‘their identities with
values of autonomy, control, and responsibility’ (Green & Moore, 2013, p. 697). By doing so,
their identity management strategies were defensive, actively countering what they did not
want to be (Green & Moore, 2013).

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Based on their findings, Green and Moore (2013) argue that cultural representations of
methamphetamine use reinforce the false dichotomy of ‘recreational and problematic use’ (p.
698). This may cause young people to avoid seeking help for methamphetamine or other drug
use, due to the highly stigmatised subjectivity of the problematic methamphetamine user.
Green and Moore (2013) consider the needs of young people who engage in problematic
methamphetamine use in terms of access to assistance, however, the focus of the article is the
way in which dominant discourses such as public health contribute to very stigmatising
understandings of drug users, even among drug users themselves. As the effects of this
stigmatisation are brought to light in this research, Green and Moore (2013) contribute to a
sociology of public health.

Dwyer and Moore’s (2013) article on methamphetamine use in Melbourne, Australia,

critiques and re-imagines the link between psychosis and methamphetamine forged in
biomedical literature (see, for example, McKetin et al., 2006b). These scholars use STS
theory to assert that reality is multiple: produced and reproduced through practice, rather than
an anterior, singular phenomenon. They then employ this insight to compare and contrast
examples of contemporary public discourse on methamphetamine use with accounts from
people who consume methamphetamine. Through this exercise they aim to:
re-emphasise the heterogeneity and variation in methamphetamine, to argue that it is
not a stable, singular and definite object, and to point to the multiplicity and
situatedness of methamphetamine effects. (Dwyer & Moore, 2013, p. 210)

Upon examination of the public discourse on methamphetamine, Dwyer and Moore (2013)
find that this discourse:
enacts methamphetamine as an anterior, stable, singular and definite object that
produces the inevitably distressing and pathological state of psychosis. (Dwyer &
Moore, 2013, p. 209)
Yet, in accounts of methamphetamine use given by regular users ‘the drug and its effects are
destabilised or rendered “messy”’ (Dwyer & Moore, 2013). For example, in one account of
methamphetamine use, a participant says that upon taking methamphetamine straight for
three days you:
just go insane, you lose your mind. You lose your marbles. You start hearing voices
and freaking out and the whole world starts vibrating and just sort of want to curl up
and sleep it off. (p. 207)

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This certainly sounds like a frightening and unwanted effect of taking methamphetamine.
However, the participant goes on to clarify that there is a somewhat enjoyable aspect to this
experience. He says going insane is:
almost kind of enjoyable on a bad level as well. Like, you get that high, happy feeling
and you enjoy that and then coming down, it’s pretty shit but you kind of enjoy that as
well. Like, when you take it next time, you know you’re going to come down and go
insane. But you almost look forward to that just as much as the high. (p. 207)
This participant’s experience of the drug suggests that the relationship between
methamphetamine use and psychosis is more complicated than allowed in public discourse
(Dwyer & Moore, 2013). ‘Freaking out’ and losing your mind is, for some, a manageable,
and somewhat enjoyable, part of taking the drug.

Using examples such as these, Dwyer and Moore (2013) find that presenting
methamphetamine use as singularly harmful is not congruent with people’s experiences of the
drug. Moreover, they argue:
The examples we have provided from methamphetamine consumers highlight that in
public discourse, the phenomenology of methamphetamine experiences is silenced in
favour of pharmacology, psychology and neurobiology, and alternative accounts of
these experiences — as potentially enjoyable, as produced by lack of sleep, as the
result of additives — are excluded. (Dwyer & Moore, 2013, p. 208)
This statement makes visible the political nature of discourse, as dominant discourses supress
accounts of reality that are not congruent with their assumptions. Dwyer and Moore (2013)
go on to argue that a consequence of this singular construction of methamphetamine is that it
undermines harm reduction. If methamphetamine is reified as a singularly harmful substance,
harm reduction becomes an inappropriate response. It is not possible to develop strategies to
reduce harm for such a destructive and addictive drug. Dwyer and Moore (2013) recommend
a return to the original principles of harm reduction, in which harm is sought to be reduced,
rather than drug use itself. Although the authors present their findings in relation to harm
reduction, a practice that emerges from public health discourse (Keane, 2003), this is done in
a way that both critiques current harm reduction practice and seeks to incorporate alternative
understandings of drug use (in this case user experiences). By doing so, this research
contributes to a sociology of public health.

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Both Green and Moore (2013) and Dwyer and Moore (2013) are significant in positioning my
research. These articles posit that methamphetamine consumption and the ways which users
understand themselves are shaped by broader, authoritative discourses, such as public health.
This illuminates the ontological politics of methamphetamine-using subjects, showing that
identity is a contested and open domain. This is a main aim of my research: to show that the
limited ways in which we currently understand methamphetamine users are not ‘natural’, but
instead are shaped by hegemonic understandings. Further, Dyer and Moore (2013) show the
messiness of methamphetamine consumption experiences. My work continues this
scholarship as I examine the ways in which methamphetamine users and harm
reduction/treatment practitioners embrace dominant understandings of drugs, but also reject
and subvert these, rendering them messy and multiple.

Cameron Duff (2014) has authored an article concerning the way drug use practice produces
context that is particularly relevant to positioning my work. Duff (2014) presents this
research with the aim of transcending more traditional structural understandings of context.
His goal is to:
clarify the active, local and contingent role of contexts in the mediation of what
bodies do ‘on’ and ‘with’ drugs. (Duff, 2014, p. 634)
Duff (2014) uses a case study of Bill, a methamphetamine user, to make his argument. Duff
explores Bill’s drug consumption using ‘assemblages’ as units of study. That is, the
connections and relationships Bill has with the various objects and subjects, spaces and
environments with which he interacts. Duff (2014) argues that attending to the connections
within assemblages — using assemblage thinking — provides us with a novel view of drug
use (p. 633).

The article describes a difficult period in Bill’s life related to his employment and housing.
Bill works casually3 on night shift in a petrol station, often using methamphetamine during
his shift. He lives in a rented bungalow. His circumstances take a turn for the worse when he
is sacked from his job and evicted from his bungalow. Rather than becoming homeless, Bill
is able to rely on social contacts and the Salvation Army to help out. The Salvation Army
provides him with transitional housing. In telling Bill’s story, Duff eschews structural
explanations of drug use, such as poverty. He argues:

                                                            
3
‘Casual’ work refers to employment on a shift-by-shift basis, with no obligation on the part of the employer to
provide set hours or on-going employment.

35
 
  

Rather than regard Bill’s predicament as a function of his powerlessness in the face of
structural factors (such as the casualisation of unskilled labour in Melbourne; or
disinvestment in public housing), ‘assemblage thinking’ highlights the ways Bill was
able to mobilise novel relations and resources in response to the shock of losing his
home and his work in quick succession. (Duff, 2014, p. 635)
By making visible the connections and relationships in the assemblages within which Bill is
enmeshed, he is embodied as resourceful and responsive to problems in his life. Conventional
accounts would focus on his disadvantage as explained through the structural factors
mentioned by Duff in the above quote. These would then obscure Bill’s resourcefulness and
ability to mobile his resources.

At the same time, assemblage thinking does not necessarily discount the effects of economic
and social marginalisation. While rejecting structural explanations for Bill’s predicament,
Duff goes on to argue that assemblage thinking is able to make visible the effects of broader
structural factors such as poverty at a local level:
Too much social science analysis of AOD use discovers in the midst of consumption
the trace of social and structural forces, without describing how these forces actually
participate in AOD use in particular places, at particular times. (Duff, 2014, p. 637)
In Bill’s account of methamphetamine use, poverty is made visible through its effects. For
instance, Bill is made homeless and is required to go to a charity organisation for housing
assistance. At the same time, in this account, Bill is not rendered powerless by poverty.
Rather, assemblage thinking shows us how his choices are shaped by wider forces through
tracing their effects.

This is an important point, particularly for drug research. Much of the body of scientific
research on methamphetamine use is built upon participants who have experienced years of
heavy drug use, unemployment and limited education. The conclusions drawn by this
research typically make absent the glaring social and economic disadvantage of participants.
Rather, methamphetamine is generalised as a drug that causes violence (McKetin et al.,
2014), depression (McKetin, Lubman, Lee, Ross, & Slade, 2011) and psychosis (McKetin et
al., 2006b) with little or no recognition that the participants in this research have unusually
limited connections to the labour market, education and economic security. This is not to say
that these limited connections are the alternative cause of violence and psychosis; however,
their effects should be revealed and described so that the complexities of violence, psychosis

36
 
  

and addiction are apparent, and these phenomena are not attributed solely to use of the drug
methamphetamine.

Duff (2014) argues that assemblage thinking offers workable strategies to inform the various
practices around drug use:
The best research, the best policy advice, and the best harm reduction praxis never
ceases to concern itself with the real conditions of consumption; with the specific
circumstances in which bodies, spaces and substances interact in the event of AOD
use. (Duff, 2014, p. 638)
Here Duff notes the pragmatism of assemblage thinking. Local descriptions of drug
assemblages can be strategic in terms of bringing about positive change for people who use
drugs. In my research I make visible economic and social deprivation in assemblages by
showing the effects of reduced connections and relationships with significant resources. I do
so to show how assemblages enable drug users in various ways, and that peoples’ ability to
manage and/or control their drug use is produced within these assemblages. In doing so, I
employ assemblage thinking, building upon Duff’s work in this area.

The five articles reviewed above contribute to a sociology of public health. They resist
interpreting methamphetamine use solely in terms of unexamined categories of addiction and
harm; rather, they critique these concepts. Methamphetamine use is not seen as having a
singular trajectory of addiction and recovery; instead there are multiple experiences of use,
with people managing methamphetamine consumption in various ways. Subversive concepts
related to drug use, such as pleasure, are exposed. Participants in this research are
multidimensional subjects who engage in methamphetamine use, sometimes pleasurable,
sometimes harmful, but always the product of a multiplicity of elements, rather than solely
their own agency. These accounts of methamphetamine use counter and resist public health
discourse yet can, and should, be considered by public health practitioners seeking more
nuanced, effective and less stigmatised ways to understand and address methamphetamine
use.

Textual analyses of methamphetamine‐related media and policy

Within the body of literature that I classify as a sociology of public health, there is a corpus
that concerns textual analyses of methamphetamine-related media and policy. This literature
is relevant to my research as it addresses the way in which methamphetamine is constructed
or understood through media and policy texts. This is because my research explores the

37
 
  

representation of methamphetamine in scientific, policy, treatment and media texts. This

corpus, originating from North America and the UK, features drug ‘panics’ (Ayres & Jewkes,
2012; Jenkins, 1994), ‘scares’ (Boyd & Carter, 2010) or ‘moral panics’ (Armstrong, 2007;
Linnemann, 2010). I do not review the entire body of methamphetamine ‘panic’ literature;
rather, I have selected two key articles (Armstrong, 2007; Jenkins, 1994). Jenkins (1994) is a
seminal article outlining the construction of the first methamphetamine panic in the US, while
Armstrong (2007) is a good example of how panics act to marginalise groups along existing
social divides, such as poverty. Both articles also provide examples of the contradiction
inherent in panic accounts, which I will discuss in this section. As I will explain, these
accounts use a social constructionist viewpoint to investigate the methamphetamine problem
as a product of social, political and economic forces.

Social constructionism is a school of theory that argues that the world we experience is a
product of social processes. Panic theory uses elements of social constructionism in that it
sees drug panics as socially constructed rather than objectively real. An ‘ice panic’ — or
‘drug panic’ and moral panic more generally — is a phenomenon involving ‘disparity
between the perceived threat of a substance and the actual harm involved’ (Jenkins, 1994, p.
7). Thus, panic theory is based upon drawing attention to the gap between the socially
constructed elements of the drug panic versus the actual problem. It assumes an anterior
reality and that some accounts are closer to this reality than others. This leads to an
underlying contradiction in the theory, as some realities are ‘real’ and others are socially
constructed. Nonetheless, this body of work is important to my research as it demonstrates
the way in which methamphetamine discourse shapes and reinforces very conventional ideas
around poverty and gender, and further scapegoats and stigmatises those people who use the
drug. These are all ideas that I take up in my research. However, rather than address what is
real and what is not, I argue that all knowledge and realities are constituted through practice.

In this section I also review an article by Fraser and Moore (2011). These authors use post-
structuralist methods of policy analysis to examine policy documents addressing
amphetamine-type stimulants (ATS). Fraser and Moore (2011) move beyond panic accounts
as they employ theory that argues reality is not an anterior and stable phenomenon; rather, all
forms of knowledge (and reality) are constructed. Thus, these authors are not concerned with
arguing about the dimension of the methamphetamine ‘problem’, but rather with illuminating
the ways in which methamphetamine use is constituted as a problem and the effects of this.
While using different schools of theory to critique the methamphetamine problem, both panic

38
 
  

accounts and Fraser and Moore (2011) contribute to a sociology of public health. This is
because the problem of methamphetamine use is not seen as the sum result of individuals
experiencing harm as is the case in public health. Instead it is considered a socially
constructed phenomenon, or, as Fraser and Moore (2001) argue, produced through policy,
with specific political effects.

Phillip Jenkins’ (1994) work describes and deconstructs the ice panic that occurred in the US
in the 1990s. Jenkins argues that the way in which the US media reported methamphetamine
use (specifically ice use), and related government activities in the early 1990s constituted an
‘ice panic’ (p. 7). Jenkins (1994) considers the ice panic itself to have been short-lived,
peaking around 1989 and 1990 in a series of US Congressional hearings. The article is based
on the idea that scrutinising the ice panic can reveal the way in which crime and deviance are
socially constructed, and the role that government activity plays in this. As Jenkins explains:
The panic itself is valuable in itself for what it suggests about the perceptions of a
society as a whole, and specifically of policy makers and legislators. The incident thus
has great significance for understanding the social construction of crime and deviance.
(p. 8)
Building on this assumption, Jenkins then outlines certain political and media events in the
US that, he argues, constructed this particular panic. A key point in Jenkins’ (1994) argument
is that ice use was only ever a problem in Hawaii. He finds that this problem was then
extrapolated to a national epidemic as a result of political rivalries within that state (p. 8). He
argues that, in addition to the events in Hawaii, the ice panic was driven by other factors
including:

the existence of specialised agencies and investigative bodies focusing on drug issues,
and the intensification of public expectations and fears following the crack scare.
(Jenkins, 1994, p. 8)
Jenkins’ (1994) analysis is important as it shows the way social and political aspects shape
expectations of a drug’s effects, rather than seeing drugs as having inevitable effects based on
their apparently stable materiality. Jenkins does, however, refer to the ‘real’ problem of ice,
positing that ice use was a significant problem in Hawaii. This point flags an underlying
contradiction in panic accounts: that some ‘truth’ is constructed and some is not. Nonetheless,
Jenkins’ account is valuable, showing the ways in which political and media activity
produced an ice panic. Jenkins concludes that the elements that led to the 1990s ‘ice panic’

39
 
  

are still in place in the US and predicts that it is highly probable that a drug ‘panic’ will re-
occur.

A series of articles (Armstrong, 2007; Boyd & Carter, 2010; Linnemann, 2010; Linnemann &
Wall, 2013) published in the decade following Jenkins’ (1994) publication confirm his
assertion that ‘[t]he ice incident is likely to be repeated in various forms’ (p. 9). The focus of
this literature is the extensive reportage of methamphetamine use, demonstrating that
methamphetamine use again became a significant public concern in North America. These
articles uniformly concern themselves with the representation of people who use
methamphetamine in the news and popular media. They show how these representations
reflect and reinforce dominant discourses, contributing to existing social, economic and
gender divisions.

An article by Edward Armstrong (2007) finds that methamphetamine is of particular concern

to law enforcement agents in rural America. He applies a moral panic (Goode & Ben-
Yeduda, 1994) conceptual framework in order to understand how the problem of
methamphetamine is socially constructed (p. 429). Armstrong uses Goode and Ben-Yeduda’s
(1994) outline of the characteristics of a moral panic to examine the methamphetamine panic,
describing the five features that signify a moral panic in this way:
First, there is a heightened level of concern over certain behavior. Next, there is
hostility linked to the category of people responsible for the threatening behavior. The
targeted individuals are seen as evil. Third, there is public consensus that the threat is
real. Fourth, there is disproportionality — the perceived threat is far removed from
any objective measure of seriousness. Finally, there is volatility. Moral panics erupt
suddenly and subside just as quickly. The meth scare encompasses all of these
dimensions. (p. 429)
Armstrong then goes through each of these features to argue that the portrayal of
methamphetamine use constitutes a moral panic in the US. He uses examples of political
events, such as the passing of the Combat Meth Act in the US Senate on January 23, 2005
(Armstrong, 2007, p. 429) as well as media reports, to argue his case.

This article is a useful deconstruction of the US methamphetamine moral panic, however, in

asserting what is true about methamphetamine, Armstrong (2007) draws attention to
problematic elements of panic arguments — as noted above in my discussion of Jenkins
(1994). This occurs when Armstrong (2007) attempts to disprove some of the assumptions

40
 
  

about methamphetamine in order to assert what is ‘really’ happening, and show that moral
panic around methamphetamine is undeserved. For instance, he states that ‘[m]edical
researchers appear unified in their opinion that amphetamines do not cause “physical
dependence”’ (Armstrong, 2007, p. 437). He also argues that ‘[r]ecent research appears to
cast additional doubts on meth’s addictive properties’ (Armstrong, 2007, p. 437). Here,
Armstrong attempts to assert methamphetamine is not an addictive drug using scientific
evidence. By arguing for the existence of particular properties of methamphetamine,
Armstrong understands methamphetamine as a pre-existing anterior substance. Moreover,
there are ‘real’ accounts of this substance — scientific ‘fact’. Armstrong’s (2007) argument
here is indicative of the tensions in panic accounts. He is attempting to argue what is really
happening while at the same time positing that the problem of methamphetamine is a
constructed one (Fraser & Moore, 2011).

More successful is Armstrong’s (2007) documentation of the ways in which the

methamphetamine panic has exacerbated existing social divisions in the US. This is done by
documenting examples of the hostility faced by people who are supposed users of
methamphetamine — the white, rural poor. Armstrong (2007) argues that methamphetamine
is portrayed as a ‘white trash’ drug (p. 432) and that constructing methamphetamine in this
way scapegoats the rural poor. As a result he believes that ‘the meth scare is blinding people
to the plight of white, underclass, rural, poor people’ (Armstrong, 2007, p. 438). Thus, a
political effect of the moral panic concerning methamphetamine use in the US is that the rural
poor are viewed as criminal. These people are considered consumers and producers of
methamphetamine, meaning that they are deserving of their poverty, relieving the community
or state of responsibility for any hardship they may face.

The two panic articles I have reviewed offer insights into how news media and government
activity are powerful sources for what we know about methamphetamine and people who use
it. I have argued that panic accounts are contradictory; there is a distinction made between a
constructed problem of methamphetamine use (the panic) and the real problem of
methamphetamine use (what is actually happening). Nonetheless, these articles make
important contributions to sociological methamphetamine literature. They are particularly
successful in demonstrating the political effects of panics, arguing that they further
marginalise and scapegoat certain populations. By doing so, they show how the knowledge
around methamphetamine draws upon hegemonic assumptions about gender, race, poverty
and criminality, effectively producing and re-producing these understandings.

41
 
  

Fraser and Moore (2011) also address the way methamphetamine is produced in textual
accounts, but do so by using a post-structuralist theoretical framework. These authors address
the way that ATS (including methamphetamine) are produced as problematic through
Australian policy documents. They note that social constructionist accounts of panics are
useful in showing both the social and political nature of drug panics as well as how these act
to marginalise particular groups of people. However, Fraser and Moore (2011) depart from
this work by explaining that they:
make no claims regarding the ‘true’ relationship between the extent of a ‘problem’
and the official response to it. (p. 500)
These authors thus avoid the limitation of the earlier work that I have outlined above. Fraser
and Moore (2011) also find that the analytical tools employed in panic accounts of
methamphetamine use are not sufficiently subtle to capture the way in which the drug
problem is materialised in Australian policy texts. These texts are more complex in what they
produce, whereas the notion of panic suggests highly sensationalised and overblown coverage
of methamphetamine use and downplays the role of other ambiguity in the discourse.

According to Fraser and Moore (2011), following Bacchi (2009), drug policy creates rather
than responds to drug ‘problems’. Using post-structuralist analyses, they demonstrate how
ATS are produced as a certain kind of problem which, in turn, allows for certain kinds of
policy development (Fraser & Moore, 2011, p. 500). The authors analyse ATS policy in
Australia by attending to harms and causation as ontological concerns and evidence as an
epistemological concern. This is because they argue that the relationship between ontology
and epistemology — between the nature of reality and knowledge about reality — is
reciprocal. Studying the world does not simply describe it; instead, it shapes it (Fraser &
Moore, 2011, p. 501). They first examine an ontological concern: drug harms and causation
— what do drugs do to bodies and societies? They follow this with examination of an
epistemological concern: evidence —what do we know about ATS? In doing so, the authors
‘identify important slippages between what is treated as known and what is assumed’ (Fraser
& Moore, 2011, p. 501). Without these ‘slippages’ they argue that ‘much of what is said in
the documents about ATS use as a problem would become difficult or impossible to sustain’
(p. 501). Thus, Fraser and Moore (2011) demonstrate that the methamphetamine problem is
not the sum of the harms experienced by those individuals who use the drug, nor is it a
socially constructed panic. Rather, it is carefully produced through policy texts, but with

42
 
  

evidence that is, at best, thin and incomplete and handled in confusing and contradictory
ways.

While the textual analyses reviewed above employ different theoretical frameworks, the
accounts of panics from North America and the UK, and Fraser and Moore’s ATS policy
analysis, all contribute to a sociology of public health. This small body of literature addresses
the methamphetamine problem as a constructed one, recognisable by the way in which it
produces and reifies dominant ideas about drug users, race and gender. My work will
contribute and extend upon these analyses. That is, I assume that all knowledge is contingent,
rejecting the idea that there is a true (and benign) account of reality. I use theoretical tools
similar to those employed by Fraser and Moore (2011) to address knowledge concerning
methamphetamine as constructed, including the scientific literature. In this way I avoid the
inconsistency of panic accounts, and move beyond positivist assessments of what is the real
methamphetamine problem.

Party drugs and the theory of normalisation

A separate body of work that concerns methamphetamine is ‘club drug’ or ‘party drug’
literature. This literature details the use of drugs such as ecstasy, gamma-Hydroxybutyric acid
(GHB), ketamine 4 and sometimes methamphetamine (see, for example, Duff, 2005; Pennay
& Moore, 2010). These texts are noteworthy, but are not of great significance in positioning
my work. Although they concern drugs, ‘clubbing’ or ‘dance party’ culture is also a major
concern and methamphetamine is not the central drug. Further, they employ a different theory
— that of normalisation — than the theory that underlies my work. Nonetheless, this body of
work explores the way in which culture produces particular understandings of drugs and drug
use practices. I briefly review a key Australian paper (Pennay, 2012) from this body of work
that provides insight to the way young people in Melbourne use methamphetamine, as it is
useful in positioning my work.

Normalisation is theory that emerged to explain the shifting attitudes and cultural norms
around drug use in Europe and particularly the UK (see, for example, Measham, Newcombe,
& Parker, 1994; Parker, Aldridge, & Measham, 1999; Parker, Williams, & Aldridge, 2002). It
was argued that young people no longer consider drug use a deviant activity and that this

                                                            
4
These drugs are all taken illegally and often associated with the dance or party scene in Australia (Duff, 2005).
Ecstasy is a colloquial term for 3,4-methylenedioxy-N-methylamphetamine (MDMA). GHB is a colloquial term
for gamma-Hydroxybutyric acid.

43
 
  

changing status has implications for the way in which policymakers and public health deal
with the drug (Duff, 2005).

Amy Pennay (2012) uses normalisation as a way to frame young people’s methamphetamine
use and other party drug use. In her ethnographic account, Pennay describes how a group of
‘mainstream’ youth engages in illicit drug use, albeit with particular boundaries around this
use. Methamphetamine is used by this group to enable them to ‘control’ themselves, or
straighten up, when in public spaces such as mainstream dance or club venues. Thus,
methamphetamine is used as a drug to appear normal — rather than drug-affected. One of
Pennay’s participants explains her use of methamphetamine as follows:
If we're too pissed [on alcohol] we'd usually have it [methamphetamine] to straighten
us out. I never go anywhere without my little vial, just in case. If someone gets too
fucked on ecstasy or too pissed or something I always carry it around, like an
emergency, to straighten them out. (Interview: December, 2006) (Pennay, 2012, pp.
413–414).
This quote shows how the drug is strategically employed in order to appear straight and stay
up to engage in long periods of partying. This offers an alternative narrative to that presented
by public health. Pennay’s participants are not out of control on methamphetamine; they use
it to remain in control. Thus, while Pennay’s work has an alternative theoretical underpinning
to my own, it has similarities in that it presents accounts of methamphetamine use that
challenge dominant discourses.

There are insights to be gained from the literature that concerns club and party drug use,
typically framed by the theory of normalisation. Most notably, this literature shows how drug
use practices shift in relation to changing cultural norms, and that drug use itself has many
outcomes. However, the focus on dance culture, and party drugs, rather than
methamphetamine specifically, as well as the use of theory with which I have not engaged,
means that this work, as a whole, is not key to positioning my research. Nonetheless, it is a
body of work that contributes to alternative and more nuanced understandings of drug use
and contributes to a sociology of public health.

Critical accounts of drug use

There is an extensive body of sociological work on drugs (see, for example, Dwyer & Moore,
2010a; Fox, 2002a; Fraser, 2004; Gomart, 2002; valentine & Fraser, 2008; Vrecko, 2009;
Weinberg, 2000). I have not reviewed this body as a whole, choosing instead to focus on the

44
 
  

considerable volume of work in which methamphetamine use is central. Instead I have

selected three sociological articles on drug use that draw on theoretical concepts that I use in
my thesis and are relevant to positioning my work. I begin with two articles by Kate Seear
and Suzanne Fraser (2010a, 2010b) that interrogate the concept of addiction through
highlighting the voluntarity/compulsivity binary that underpins this term. These authors are
concerned with the concept of agency and how it is subverted in particular accounts of drug
use. My work also addresses this concept and how it is constituted through the myriad
elements that come together in drug use. I then review an article by kylie valentine (2007)
that concerns methadone treatment, looking at the ways in which treatment practice and
broader cultural narratives make up multiple methadone-related identities. Valentine’s work
is significant in positioning mine, as I also describe ways in which drug users constitute
themselves through local networks but draw upon hegemonic ideals to understand their drug
use.

Seear and Fraser (2010a, 2010b) explore agency and addiction in two articles about Ben
Cousins, a former and very successful Australian Football League (AFL) player. At the
height of his career, Cousins was found to be using methamphetamine, resulting in, amongst
other things, his suspension from the game for 12 months. Seear and Fraser (2010a, 2010b)
chart Cousins’ subsequent fall from grace and his vilification in the media, as well as by the
AFL. They interviewed Cousins about his methamphetamine use and the way he understood
his subjectivity as an athlete and a drug user/addict. In their article, they examine how rarely
combined attributes — that of addiction, and sporting virtuosity and leadership — were
represented by the media as well as understood by Cousins himself (Seear & Fraser, 2010a,
2010b). While their work focuses on Cousins’ methamphetamine use, the focus is not on
methamphetamine per se, but rather concepts such as addiction and masculinity and related
binaries such as voluntarity/compulsivity.

To address agency and addiction, Seear and Fraser (2010b) first outline the political effects of
the now generally accepted ‘disease model’ of addiction. They argue that this model provides
a scientific explanation for what has previously been understood as a ‘failure of the will’ (p.
180). Seear and Fraser (2010b) then claim that although some scholars argue this model has
alleviated the stigmatisation of drug users, the disease model:
has merely shifted the forms of stigmatisation in action…the failure of the will
conventionally associated with addiction is actually institutionalised as an illness,

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crystallising, rather than disrupting, essentially arbitrary negative judgements about

drug users. (2010b, p. 180)
These authors argue that while the disease model means that people who are addicts can
identify as sick, they are sick in such a way that ‘impacts on the sufferer’s social and political
standing as a legitimate subject or citizen’ (Seear & Fraser, 2010b, p. 180). In this way,
conceiving of addiction as a disease is still stigmatising for those who use drugs.

Seear and Fraser argue that the issue of illicit drug use in elite sport brings to light the
problem of agency and drug use. Elite athletes are exemplars of masculinity, with a ‘high
capacity for self-discipline, and mental and physical strength’ (Seear & Fraser, 2010b, p.
180). Seear and Fraser note that despite his methamphetamine use off-field, Ben Cousins’
quality of play was unaffected. This leads them to argue that Ben Cousins’ ‘fit/addicted’,
‘disciplined/intoxicated’ body challenges assumptions about both sports players and drug
users, as the intersection of addiction and athleticism disrupts the addicted body (as typically
constituted as passive, unhealthy and compulsive) (Seear & Fraser, 2010b).

By describing key events following the revelation that Cousins was using methamphetamine,
the authors show how the expectations around Cousins’ behaviour reflected subjectivities
seemingly at odds with each other. On the one hand, Cousins was a highly regarded
sportsman, on the other, a drug addict. In this way he was simultaneously:
in control and out of control, manipulative and subject to the demands of his
addiction, criminal and victim, culpable and innocent, ‘sick’ and evil. (Seear &
Fraser, 2010b, p. 185)
Central to these multiple subject positions is the concept of agency, and Seear and Fraser
(2010b) argue that in returning to football Cousins was required to be demonstrably sorry.
This involved enacting:
a particular, highly complex version of subjecthood in which he [Cousins] must both
claim and disavow agency so as to successfully navigate the mixed expectations
imposed on him by popular but insufficiently nuanced concepts of addiction. (Seear &
Fraser, 2010b, p. 186)
Thus, as the ‘sorry addict’, Cousins embodies a ‘paradox of agency’. He is, at the same time,
obviously athletic, and an addict — and thus compulsive. These authors suggest that Cousins’
embodiment of these traits require us to question our understandings of agency and drug use,
moving beyond the dysfunctional and passive subjectivity of the ‘addict’.

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In the second article, the authors explore Cousins’ understanding of addiction and his drug
use (Seear & Fraser, 2010a). Interviewing Cousins, the authors find that he understands drug
use and sporting prowess as ‘mutually interdependent’ and as ‘balancing each other out’ (p.
446). Thus, while understanding himself as an addict, Cousins also considers compulsion as
an important part of his sporting success. At one point he states:
the very things that make me a good footballer are the very same traits that make me
susceptible to being a drug addict. (Seear & Fraser, 2010a, p. 448)
The authors argue that this shows Cousins understands himself as ‘both compulsive and
voluntaristic with each reliant on each other for its existence’ (p. 448). Further, they find that
for Cousins, inauthenticity resides not in his ‘addiction’ but in being unable to be truthful
about his drug use because of the ‘unreflective and normalising conventional approach to it’
(Seear & Fraser, 2010a, p. 449). Thus, they suggest:
The problem for Cousins is that his desire to be liberated from the ‘lie’ of voluntarity
and compulsivity as polar opposites — and his aspiration to tell the truth about
himself — is not possible for so long as the normative fantasy of compulsivity and
voluntarity as mutually exclusive exists. (Seear & Fraser, 2010a, p. 449)
Seear and Fraser draw upon Eve Sedgwick’s (1992) work to offer an alternative to absolutes
such as the voluntarity/compulsivity dichotomy that frame our current understandings of drug
use. Sedgwick (1992) suggests the concept of ‘habit’ is one that captures the ‘regularity and
complexity’ of a practice such as drug use (Seear & Fraser, 2010a, p. 450). Seear and Fraser
argue that this move captures the idea of practice as a constitutive of ourselves, where habit is
about ‘worldly practices that constitute selves, others and the surrounds’ (p. 449). Habit is not
good or bad, it is constitutive of all of us — ‘addicts’ and others.

In their work, Seear and Fraser argue that Cousins’ experience of ‘addiction’ disrupts our
conventional understandings of this concept. In doing so, it raises questions about the policy
and treatment responses underpinned by these understandings. On a broader level, it
challenges disease models of addiction that produce people who use drugs as ‘less-than-full
citizens’ (Seear & Fraser, 2010a, p. 450). They argue that, rather than being shaped by
dualism such as disease models of addiction, policy and treatment responses must be:
shaped by and resonate with the diverse range of individual experiences with and
accounts of drug use, especially those that challenge assumptions about the
‘compulsive’ subject. (Seear & Fraser, 2010a, p. 452)

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This would entail meeting those who take drugs ‘in the domain of their own experience’
(Seear & Fraser, 2010b, p. 189).

Seear and Fraser’s (2010a, 2010b) work is relevant in positioning my own as they explore the
concept of agency and drug use. Using the example of Ben Cousins, these authors bring to
light the very limited ways we have of understanding drug use. In my work I also explore the
enactment of the voluntarity/compulsive binary (and other drug using ‘absolutes’) and how
people embrace or resist this understanding of addiction and drug use. Moreover, I further the
work of Seear and Fraser by showing the specificity of the binaries that underpin
methamphetamine consumption and how people who use methamphetamine draw upon these
to understand themselves.

Finally, I review valentine’s (2007) article concerning methadone treatment. Valentine’s

(2007) research involves in-depth interviews with 35 people on methadone maintenance in
Sydney, Australia. This work is important in terms of positioning my own, as it argues that
localised treatment practices are constitutive of certain types of drug users. At the same time,
valentine argues that people also understand themselves in terms of broader social forces. She
thus draws on theorists such as Ian Hacking and Nikolas Rose to understand the ‘making up’
of consumers of methadone maintenance treatment from ‘above’ (through hegemonic
understandings of drug use) and ‘below’ (through localised treatment practice) (valentine,
2007, p. 511). Valentine demonstrates how methadone maintenance is performative by
looking at the way treatment networks — phenomena such as methadone, treatment practices
such as prescribing and picking up a dose from the pharmacy, and subjects such as
prescribers and consumers — constitute particular subjectivities.

In addition to describing the productive nature of localised networks of treatment, valentine

also draws upon Hacking (2002) and Rose (2007) to understand ‘the processes by which
social identities form and change’ (valentine, 2007, p. 511). She suggests that in order to
capture the relationships of power, work and sociality embedded in the ‘real’ world, work
that explicitly investigates the nature of the ‘social’ is required. To do this, valentine employs
Hacking’s concept of historical ontology, in which particular subjectivities are made
available to individuals. She argues that ‘drug addict’ is one such category:
Drug addiction, a historically specific, and historically locatable condition, that is an
established part of medical taxonomies and a recognisable cultural stereotype, could
surely be any part of any project of historical ontology. (valentine, 2007, pp. 499-500)

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Valentine also uses the work of Rose (2007) and his concept of ‘biological citizenship’ to
illuminate how:
changes in the means by which medical, legal and other authorities understand people
and those in which people have come to understand and produce narratives of
themselves. (valentine, 2007, p. 498)
Valentine thus uses Hacking and Rose to show that broad social forces create particular
spaces within which people can ‘make themselves up’.

Guided by these theoretical insights, valentine outlines identities ‘made up’ by methadone
treatment. One identity she brings to light is that of the ‘lay carer’ (valentine, 2007, p. 508).
This identity is one produced through the practice of caring for others that are ‘hanging out’
(withdrawing from heroin or other opioids), and involves the diversion of prescribed
methadone. As one participant explains:
And we’ve had friends that have been…sick and um we’ve given them some
[methadone] to get through…I mean hanging out sick. (valentine, 2007, p. 509)

Valentine (2007) argues that this identity is one that suggests ‘negotiations of medical
regulation and care that are largely unrecognised’ (p. 509). Here consumers divert their
methadone (a practice regarded as non-compliant and indicative of addict behaviour) for the
purpose of caring for friends or acquaintances. It undermines critiques of drug treatment as
‘paternalistic and debilitating’ and also troubles ‘easy’ distinctions between compliant and
disobedient (valentine, 2007, p. 510). The localised practices of methadone treatment — the
informal networks of sharing and exchange — enable the constitution of the lay carer. But it
is also the negotiations of broader fields of medical knowledge and policy around methadone
provision that enacts this social identity. Thus the making up of the lay carer occurs from
both ‘above’ and ‘below’.

Valentine’s consideration of local practices and the work of Rose and Hacking is important in
positioning my work. My research examines how authoritative discourses — those that
produce broad understandings of the world — make available understandings of
methamphetamine and methamphetamine-using subjects. In doing so, like valentine, I draw
upon broader critiques of the social, using Foucault and Rose to understand the ways in
which subjects constitute themselves as highly agentive, as without power, or in other ways.
And, similar to valentine, I seek to understand the ways in which localised assemblages of
human and non-humans produce particular types of drug use and treatment, and how specific

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practices are also productive of subjectivity. In this way my work builds upon valentine’s
insight that there is value in pulling together empirically-driven research, while remaining
cognisant of the broader social forces that shape individuals understandings of themselves.
Further, in applying these insights to the area of methamphetamine consumption and harm
reduction/treatment practices, my work produces new insights about this particular drug.

Seear and Fraser (2010a, 2010b) address the problem of agency and drug use, and this is a
central theme in my work. In my thesis I show the way in which understandings of agency
vary according to the broader networks in which people are enmeshed. Valentine (2007)
shows how people constitute themselves through local practices, drawing on broader
discourses. I continue this work, demonstrating the political nature of ontology. By showing
how people who use methamphetamine embody themselves both through practice and in
relation to broader discourses, I reveal the ways in which these forces shape
methamphetamine consumption, but how people might resist or subvert these. This brings to
light the contested nature of realities and opens up other possibilities for knowing drug use.

Conclusion
In reviewing the qualitative sociological literature on methamphetamine, I have argued that
as a body of work it acts as either a sociology for public health or a sociology of public health
(Moore, 2004). The majority of qualitative research concerning methamphetamine falls into
the former category. This literature works to reveal an increasing range of pathologised
subjects as well as aiming for a deeper understanding of these subjects and/or their
‘addiction’ and ‘abuse’. By situating research findings solely in relation to addressing
methamphetamine ‘abuse’ and ‘addiction’, this literature intensifies the scrutiny of people
who use drugs, as it understands them as always in need of intervention. This then further
scapegoats those who use drugs, seeing these individuals as the sole cause and site of drug-
related harm. Further, as this body of work interprets data through a public health lens, other
aspects of participants’ practice that might challenge current ideas about methamphetamine
are not foregrounded, and findings are presented in terms of an addiction/recovery binary.
This means that this corpus reproduces hegemonic assumptions about people who use drugs,
and contributes to their pathologisation and marginalisation.

There is, however, a small and significant body of work that includes critical qualitative
accounts of methamphetamine use from Australia (Duff, 2014; Dwyer, 2008; Green &
Moore, 2013; Slavin, 2004a, 2004b), social constructionist accounts of the methamphetamine

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panic in North America (Armstrong, 2007; Boyd & Carter, 2010; Jenkins, 1994; Linnemann,
2010) and the UK (Ayres & Jewkes, 2012), and Fraser and Moore’s (2011) post-structuralist
analysis of ATS policy in Australia. It also includes accounts of drug use more broadly such
as Seear and Fraser (2010a, 2010b) and valentine (2007) and party drug research (Pennay,
2012). I have argued that this work contributes to a sociology of public health. These
accounts of methamphetamine challenge the idea that consumption of this drug is solely
addictive and harmful and foreground concepts such as pleasure. They also challenge the link
between public health concepts such as psychosis and methamphetamine use, arguing that
methamphetamine effects are both ‘messy’ and multiple, rather than singularly harmful.
Analyses of media and policy show the way in which methamphetamine use is understood, or
‘made’, through dominant discourses. This work illuminates the conditions of possibility that
are productive of the ways in which we can understand, practise and know drugs.

My research adds to, and extends upon, this body of critical work. It mobilises theoretical
concepts rarely used in the area of methamphetamine use and related service provision,
applying them to authoritative discourses such as science, policy and treatment, as well as
methamphetamine-related practices. In addressing authoritative texts in relation to
methamphetamine, I make a novel contribution by examining the way science ‘makes’
methamphetamine, disrupting accepted truths about the materiality of this drug. I also build
upon the work of Sedgwick (1992) and others (Fraser & Moore, 2008; Keane, 2004; Seear
and Fraser, 2010a, 2010b) who have elucidated the absolutes of drug use. I extend this work,
showing how methamphetamine users are enacted in extreme absolutes, and illuminating how
this specificity is possible. Through extensive interviews with users and service providers I
collate accounts of practice, describing the assemblages of consumption and service
provision. By treating assemblages as ontologically significant, I build upon the work of
scholars such as Duff (2014), illuminating multiple ways in which drug users and drugs are
constituted through material—semiotic networks. Further, by showing the ways in which
authoritative accounts of methamphetamine use shape practice, I contribute to the work of a
range of scholars (Dwyer & Moore, 2013; Green & Moore, 2013; valentine, 2007) in this
area. My research is unique, however, as I identify specific enactments of methamphetamine
and methamphetamine-using bodies and, using ‘lay ethnographer’ accounts, show how these
are mobilised in methamphetamine-related practice. In doing so, I illuminate the ontological
politics of methamphetamine, suggesting the open and contested nature of this drug. My
work is important as it challenges dominant ontological positions — such as that

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methamphetamine is singularly toxic and dangerous, and that methamphetamine consumers

user are inherently violent and psychotic — arguing that it is possible to research and
understand this drug in ways that do not pathologise and further marginalise its users.

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Chapter 3: Addressing ontological contingency; Assembling theory

and method
This chapter presents the theoretical framework and methodology that I apply to the study of
methamphetamine and methamphetamine-related practices. I employ a theoretical approach
that draws upon the work of post-structuralist scholars Michel Foucault and Gilles Deleuze as
well as more recently published work by Nikolas Rose and STS scholars Bruno Latour, John
Law and Ann Marie Mol. I use concepts developed by these theorists in order to critique the
status of current knowledge around methamphetamine, and to challenge the very pejorative
ways in which we understand people who consume this drug. Along with this theory, I use
material—semiotics, a methodological approach congruent with these theoretical precepts. In
this chapter I describe the key theoretical ideas that have informed my work and the
methodology that I used in this research.

The theory and methodology I employ in my research enables me to address the ontological
contingency of methamphetamine and methamphetamine-using subjects. First, I critique the
way in which dominant discourses such as public health and biomedicine understand
methamphetamine as destructive drug, and people who use methamphetamine as addicted or
at risk of addiction, and consider their political effects. Second, a complex and nuanced study
of this issue is undertaken such that an anterior pathologised and/or transgressive subject is
not the site of investigation. Rather, the practices that produce and are produced by drug use
are attended to through the accounts of people who consume methamphetamine and
methamphetamine harm reduction/treatment providers. This opens up an exploration of the
ways in which particular objects, subjects and spaces constitute methamphetamine and
methamphetamine users. By doing so, it allows me to provide an alternative understanding of
the relationships between these phenomena. My aim in assembling this account is to therefore
provide other ways of thinking about the drug methamphetamine and those who use it — so
that these subjects and objects are not manifested as fearful, pathological and inherently
harmful — and to make visible methamphetamine-related phenomena that may be obscured
and/or repressed in conventional accounts from science, policy and treatment.

In this chapter, I first present the theoretical concepts that frame this research. I then outline
and discuss the methodological approach taken in order to fulfil the research objectives. 

Theoretical toolboxes: The work of Foucault and Deleuze

This section presents the theoretical framework of my research. Here, I introduce the
theoretical concepts that I use, providing a sense of their intellectual origins in post-

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structuralism, and how they relate to more recent STS theory. I begin by introducing post-
structuralism and the work of Foucault. I focus on the way in which Foucault, and later Rose,
conceptualise power and knowledge and their constitutive role in the formation of human
subjects. I then turn to Deleuze’s theory of assemblages and the formation or ‘becoming’ of
human and non-human entities and their relationality. Following from Deleuze, I show how
STS later takes up these ideas through a material—semiotic approach to the world, and how
this opens up the study of drug use. These theories move beyond the addicted drug-using
subject and the reification of drugs to a more dynamic conceptualisation of reality, where
reality is constituted through an array of practices, and can be multiple.

Post‐structuralism and moving beyond the knowing subject

Foucault and Deleuze were contemporaries and are regarded as belonging to a group of
French thinkers loosely termed ‘post-structuralists’. Foucault’s respect for Deleuze’s work is
captured in the statement, ‘Perhaps one day this century will be known as Deleuzian’
(Foucault in Deleuze, 2006, p. vi). Likewise, Deleuze authored a highly regarded
interpretation of Foucault’s work (see Deleuze, 2006). Congruent with their understanding of
the world, the relationship between their work is partial and fragmentary, and their bodies of
work, taken either individually, or together, are not intended to provide totalising statements
about existence. There are, however, broad themes common to both philosophers’ work; both
rejected rationalist and scientific accounts of history and nature that consider human
civilisation as progressive and the natural world as immutable. Instead, they sought to find a
more dynamic and fluid way of understanding existence.

Through their work, these scholars aimed to provide useable concepts that might be
employed to instigate change, creating new possibilities (Foucault & Deleuze, 1980). This is
captured in an exchange between Foucault and Deleuze where Deleuze explains, ‘A theory is
exactly like a box of tools….It must be useful. It must function’, and then says ‘A theory does
not totalize’ (Foucault & Deleuze, 1980, p. 208). This suggests that in order to ‘practise’
theory in the spirit of Foucault and Deleuze one should seek functional concepts that work in
a local sense, rather than aspiring to be totalising and explanatory (Foucault & Deleuze,
1980). Remaining mindful of this, I discuss how I have used Foucault and Deleuze’s work to
inform my research.

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Foucault’s understanding of power and knowledge

Foucault wrote extensively on the concepts of power, knowledge and discourse and their
relationship to each other. His work demonstrates how power and control operate in modern,
liberal societies, showing the ways in which individuals are governed and practices are
shaped. Foucault contends that knowledge, or truth, is contingent and inextricably bound up
with power. He argues:
power and knowledge directly imply one another … there is no power relation
without the correlative constitution of a field of knowledge, nor any knowledge that
does not presuppose and constitute at the same time power relations. (Foucault, 1991,
p. 27)
Here, he argues that power is legitimised through knowledge, and that expertise (or
knowledge) is productive of authority. Foucault used the concept of discourse — by which he
means a set of practices, ideas, language and institutions that organise knowledge — to
illuminate how power is exercised in modern liberal societies. Discourse is effectively what
can and cannot be said, thought and done about a given population or issue. Thus it is
productive of ways to understand oneself, other subjects and things, and it legitimises
particular actions while marginalising others.

Foucault’s critique of truth and knowledge makes possible the scrutiny of science and fact.
Science becomes political — considered a series of practices and language that are
constituted through power relations — instead of a body of knowledge that describes the
natural world. In the modern world, scientific discourse has acquired the status of truth
through these power relations; that is, the relationships between this field of knowledge and
various institutions and mechanisms (Foucault, 1978). Moreover, as scientific discourse is
highly authoritative, it legitimises associated discourses (such as public health). At the same
time, this marginalises other discourses — or other practices and ways of thinking. These
discourses then become forms of subversive knowledge. For instance, scientific discourse
overwhelmingly produces drugs as inherently harmful and addictive, but there are other ways
of thinking about drugs, such as within dance culture or party drug culture (see, for example,
Pennay, 2012); these are subversive discourses that produce drug use as pleasurable and as a
legitimate recreational activity.

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Thus, myriad discourses exist at a given time, with a range of relationships and connections
to each other. Foucault argues that while multiple discourses are in play, these are shaped by
broader forces. He names these broader forces the ‘episteme’ and describes this as follows:
This episteme may be suspected of being something like a world view, a slice of
history common to all branches of knowledge, which imposes on each one the same
norms and postulates, a general state of reason, a certain structure of thought that the
men of a particular period cannot escape — a great body of legislation written once
and for all by some anonymous hand. (Foucault, 1972, p. 191)
Discourses therefore emerge through specific conditions of possibility and, as such, have
commonality. They are shaped by the overarching norms of a particular historical moment.
This, at the time Foucault was writing, was the ‘modern episteme’ (Law, 2004, p. 35).

The subject: How we understand ourselves in neo‐liberal societies

As well as helping us to conceptualise the contingency of knowledge and its relationship to
power, Foucault’s work is important in terms of illuminating the ways we understand and
constitute ourselves. Foucault rejected accounts of power as solely a repressive, exterior force
bearing down upon the human populace. He conceived of the relationships between power,
knowledge and discourse as also productive. Discourse makes available particular subject
positions, and power is exercised when these subject positions shape the way that people act
upon themselves and towards others. These subject postions are not static or essential in
nature, as Foucault viewed subjectivity as both fluid and multiple, such that there is no
‘subject of enunciation’ (Deleuze, 2006, p. 47). What is said, Foucault argued, ‘is not said
from anywhere’ (1972, p. 122). Deleuze (2006) describes Foucauldian subjectivity thus:
The subject is a variable, or rather a set of variables, of the statement. It is a function
derived from…the statement itself…the subject is a place or position which varies
greatly according to its type and the threshold of the statement, and the author himself
is merely one of these positions in certain cases. A single statement can even have
several positions. (p. 47)
Here, Deleuze argues a Foucauldian subjectivity is located within discourse and so produced
through power. Further, he explains that this subjectivity is multiple and without foundation.

In terms of control of the populace, Foucault explores ways that power had shifted over the
ages and that, while it may appear that in modern times less control is exercised over
individuals, this is an illusion. Forms of power have changed rather than dissipated. Foucault

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makes this argument by tracing the emergence of different types of control and their relation
to the ‘state’. He argues that in pre-modern times power was enforced through ‘corporeal’
forms of punishment (Foucault, 1991, p. 19), where the state exercised power directly on the
body, in full view of the populace, by methods such as public floggings and hangings. This
later shifted to forms of ‘carceral’ punishment, where power was exercised through
confinement, such as imprisonment and forced labour (Foucault, 1991, p. 293). Through
carceral forms of power, the body itself was no longer directly acted upon but was ‘caught up
in a system of constraints, privations, obligations and prohibitions’ (Foucault, 1991, p. 11).
Carceral punishment was no longer a public spectacle, and prisoners were typically kept from
public view. Foucault argues that power still exists in a carceral sense and this is evidenced in
the existence of modern-day prisons. However, he claims that power has also emerged in
modern societies as a force that controls individuals by compelling them to self-regulate. This
means that while individuals are still controlled through carceral measures (or the threat of
these) they are also obliged to self-govern. Foucault (1978) conceived of power in this sense
as ‘bio-power’. Bio-power requires individuals to monitor and transform themselves as they
‘qualify, measure, appraise and hierarchise’ themselves against ‘the norm’ (p. 144):
One would have to speak of bio-power to designate what brought life and its
mechanisms into the realms of explicit calculations and made knowledge-power an
agent of transformation in human life. (Foucault, 1978, p. 143)
At the same time as bio-power shapes the actions of individuals, the construction of subject
positions and norms enables the categorisation and therefore governance of populations
(Fairclough, 1989; Foucault, 1972). For example, within Australian drugs discourse the
subject position of ‘the addict’ is governed variously through drug treatment, public health
measures such as needle and syringe programs (NSPs) and/or incarceration (Mugford, 1993).

The neo‐liberal subject and emerging technologies of the self

Rose (2000, 2007) has extended Foucault’s ideas of power and the subject, addressing the
obligation of ‘self-government’ in the neo-liberal (or advanced liberal) episteme (Dean, 2009;
Rose, 2000). While Foucault’s work referred to the governance of citizens within what can be
considered a liberal state, Rose examines the implications of governance with the formation
of the neo-liberal state. This is characterised by the:
[w]idespread recasting of the ideal role for the state, and the argument that national
governments should no longer be guarantor and ultimate provider of security: instead
the state should be partner, animator, and facilitator for a variety of independent
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agents and powers, and should only exercise limited powers of its own, steering and
regulating rather than rowing and providing. (Rose, 2000, pp. 323-324)
Thus, as the state continues to withdraw from a provider role, its power no longer centralised,
new ways of controlling, regulating and governing citizens is necessary. Citizens are recast as
‘self-governing’ and, as a result, are ‘autonomised’ and ‘responsibilised’ (Rose, 2000).

Rose argues that with the changing role of the state, and subsequent shifts in the way that
power is exercised, the way in which individuals constitute themselves has shifted. Through
the autonomisation and responsibilisation of citizens, the self becomes the object of
surveillance, and the exercise of free will and control — with the agency these entail — is
valorised. The individual is obliged to ‘assemble one’s identity as a matter of one’s freedom’
and to ‘render one’s existence meaningful as an outcome of choices made’ (Rose, 1999, p.
272). ‘Self-empowerment’ is a responsibility in that individuals are expected to take control
of their lives and accept accountability for all their life choices. Rose (1999) argues:
The self is not merely enabled to choose, but obliged to construe a life in terms of its
choices, its powers, and its values. Individuals are expected to construe the course of
their life as the outcome of such choices, and to account for their lives in terms of the
reasons for those choices. (p. 231)
A consequence of this shift to autonomisation and responsibilisation is that those without
sufficient means or desire to mould themselves in the image of the neo-liberal citizen — to
become self-empowered — are ‘non-citizens, failed citizens, anti-citizens’ (Rose, 2000, p.
331). Further, Rose (2000) claims that:
problems of problematic persons are reformulated as moral or ethical problems, that is
to say, problems in the ways in which such persons understand and conduct
themselves and their existence. (p. 334)
By conceiving of problems as related to conduct, non-citizens are seen as ultimately
responsible for their own status. They have failed to conduct or understand themselves
correctly. Problems they experience — such as poverty, joblessness or drug addiction — are
because they have made the wrong choices. This effectively relieves the wider community,
and the state, of responsibility for these problematic persons.

‘Choice’ then, is the central obligation of the neo-liberal subject. ‘Psy’ disciplines, including
psychology, psychotherapy, psychoanalysis and practices such as cognitive behavioural
therapy (CBT), are integral to providing choice-making citizens with the language and

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practices to understand and constitute themselves in modern Western societies (Rose, 1999).
Rose (1999) argues that the ‘psy’ disciplines are consistent with the concept of the neo-liberal
subject, and governance of the self. These therapies are technologies of the self, and involve
learning techniques of ‘self-reflection, self-knowledge and self-examination, for the
deciphering of the self by oneself’ (p. 245). Therapeutic practices might include confession to
a professional in a non-judgemental environment, narrative therapy where people make sense
of current issue through past events, and even self-help literature. These therapies provide
those individuals ‘unable to bear the obligations of selfhood’ with the techniques to restore
their ‘capacity to function as autonomous beings in the contractual society as the self’ (Rose,
1999, p. 231). Thus, these disciplines are productive of citizens who are ‘free to choose’ as
they assist citizens to learn to make the ‘right’ choices (Rose, 1999, p. 232). However, Rose
argues that this liberation is double-edged. With the freedom to choose our own lives, we are
obliged to undertake constant evaluation of ourselves, never free from working on the
‘project’ of our own identity (Rose, 1999, p. 258).

More recently, Rose (2007) argues that new developments in contemporary biomedicine have
placed even greater obligations on individuals, and provided increasing technology with
which they must constitute themselves. He sees these new fields of biomedicine as productive
of new types of citizens, producing:
certain kinds of being whose existence is simultaneously capacitated and governed by
their organisation within a particular field. (Rose, 2007, p. 20)
Thus Rose sees individuals as not only controlled and governed by emerging health practices,
but enabled and capacitated by these. An overarching requirement of biomedical
developments is that we understand ourselves in increasingly biological terms. Rose calls the
reformulation of the citizen the ‘biological citizen’. This citizen is compelled to use
biological and neurological understandings of the body to make decisions that maximise his
or her current health as well as his or her future well-being (Rose, 2007). Rose explains:
Activism and responsibility have become not only desirable but virtually obligatory
— part of the obligation of the active biological citizen, to live his or her life through
actions of calculation and choice. Such a citizen is obliged to inform him or herself
not only about current illness, but about susceptibilities and predispositions. Once
informed such an active biological citizen is oblige to take appropriate steps, such as
adjusting diet, lifestyle, and habits in the name of minimisation of illness and
maximisation of health. (p. 147)

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Rose is arguing here that, with emerging technology and information, the biological citizen is
required to take in more information and make more choices about their present and future
well-being. An outcome of the obligation to make increasing choices is that it produces ‘new
types of problematic persons’ (Rose, 2007, p. 147). That is, those that cannot, or will not,
undertake the practices of the biological citizen (Rose, 2007).

Rose (2007) uses the field of neurology as an example of an area that is productive of new
ways in which to understand disorders, disease and oneself. He notes that developments in
neurology have resulted in the reformulation of an increasing number of conditions as
diseases of the brain (such as addiction). He argues that, with increasing technologies and
developments in the area of neurology, people are obliged to understand and act upon this
understanding. Explanations of how methamphetamine works in terms of its impact on the
brain — often with an accompanying diagrams or animations (see, for example, meth.org.au;
bluebelly.org.au) — are an obligatory part of methamphetamine resources for users or
potential users. Neurobiological explanations of methamphetamine use focus on the
production of dopamine. They assert that methamphetamine use causes the release of the
‘monoamine neurotransmitters’ (Barr et al., 2006, p. 302) (principally dopamine) from brain
cells. This can result in initial feelings of euphoria, well-being and alertness. According to
neurological discourse, consistent release of these neurotransmitters will eventually result in
the production of ‘free radicals’ that then damage the brain cells containing dopamine (Barr
et al., 2006, p. 303). The emphasis on methamphetamine and its relationship to the brain
obliges those who use the drug to understand themselves as ‘neurobiological citizens’.
Further, those who continue to use methamphetamine despite knowing the impact of this drug
‘neurally’ are constituted as failed citizens. These are individuals who, despite the science,
are making the wrong choices — putting themselves at risk of neural damage.

Citizens and choice: Understanding agency and control

In addition to addressing the obligation of choice, and emerging technologies of the self,
Rose’s work also helps to understand the ways in which addiction and agency are
conceptualised in the modern world. As I have shown above, Rose (1999) argues that
citizenship is primarily realised through acts of ‘free but responsibilised choice’ (p. xxiii):
The neo-liberal individual is considered as the sole agent in his or her life. He or she is
required to exercise control over his or her desires and functions. Yet, drawing on Foucault,
Rose’s work shows us how the capacity for agency — and choice and self-control — is

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produced within various fields, such as the ‘psy’ disciplines and neurobiology. These bodies
of knowledge and their related practices are constitutive of our sense of self, of control (or
not) and freedom.

This way of conceptualising agency is illuminative in the area of drug use and addiction and
other scholars have also explored the complexities of addiction in societies where we are
‘obliged to free’ (Rose, 1999). Eve Sedgwick (1992) argues that the late 20th century is
characterised by an ‘epidemic of addiction-attribution’ (p. 587) and claims that ‘any
substance, any behaviour, even any affect may be problematised as addictive’ (p. 584)
Moreover, addiction is the state of being produced within absolutes; ‘absolute compulsion’
and ‘absolute volition’ (p. 586). Thus addiction is a failure of free will, where:
Addiction…resides only in the structure of a will that is always somehow
insufficiently free, a choice whose volition is insufficiently pure. (p. 584)
This has effectively resulted in a crisis of agency. All our choices and practices must be
scrutinised to determine if they are truly voluntary. Sedgwick (1992) argues that this means
that:
detecting the compulsion behind everyday volition is driven, ever-more blindly, by its
compulsion to isolate some new, receding but absolutised space of pure voluntarity’.
(p. 586)
Pure voluntarity is a space from which we make choices that are driven by our true selves.
These choices must be untarnished by compulsive exterior forces and are central to the
constitution of the neo-liberal subject. Helen Keane (2002) clarifies that while Sedgwick’s
conception of addiction residing in the structure of the individual will is insightful, drug
addiction requires additional clarification. She argues that drugs are unique in that they are
conceived as ‘powerful, artificial and foreign’ to the body (Keane, 2002, p. 24). Thus while
drug addiction can be defined in modern societies as a ‘disease of the will’, addiction is very
much a somatic state, and this is intrinsic to the way we understand the drug-addicted self.

The work of Foucault, and later Rose, brings to light the way in which power is legitimised
through discourse. In my research, I draw upon their theoretical insights in order to
interrogate scientific knowledge on methamphetamine and also to address treatment, policy
and media discourse in terms of the subjectivities they make available for people who use
methamphetamine. I also use the concept of self-governance to attend to the way in which
people who use drugs constitute themeselves and are, in turn, constituted through practices of

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drug use, including harm reduction and treatment practice. In terms of drug use, the
obligation of self-governance and choice reveals the way agency is constructed in a
voluntarity/compulsive binary (and other absolutes) that underpins Western liberal societies
(Sedgwick, 1992). For example, people who use drugs are constituted as choice-making
citizens through practices such as NSPs and opioid substitution therapy (OST). Yet, at the
same time, they are produced as addicts — individuals whose agency and choice-making
capacity has been compromised — and thus they lack the defining attributes of the neo-
liberal citizen. In this way, the theories of Foucault, Rose and Sedgwick illuminate the very
limited ways in which we currently understand humanity and the implications these have for
people who use drugs.

Deleuze’s conception of humans, non‐humans and their relations and

effects
Along with his regular collaborator, Felix Guattari, Deleuze also developed theoretical
concepts that can be used to illuminate practices related to drug consumption. While
Foucault’s work is helpful for considering the status of knowledge and the ways in which
people constitute themselves in relation to knowledge, Deleuze’s work emphasises the
relationality and fluidity of existence and the expressivity of human and non-human entities.
He saw the social and material world as constituted through their connections, interactions
and relationships. Applying these ideas provides new possibilities for conceiving of drug use.
As noted in my literature review, it allows us to view drug use practices as constituted
through the relationships of an array of objects, subjects and spaces, rather than solely in
terms of drug users and their relationship to the fixed substance methamphetamine.

Differences between the work of Foucault and Deleuze are apparent in the way in which they
consider the subject. While Foucault conceives of subjectivities as produced through power,
Deleuze sees desire as a productive force. Deleuze also conceives of the ‘pre-existence’ of
subjectivities (Colebrook, 2002a) — that is, of a world prior to becoming. Deleuze
conceptualised this state of pre-existence as the ‘plane of consistency’ (Deleuze & Guattari,
1987, p. 589). Deleuze posits that desire is ‘a process of production without reference to any
exterior agency’ (Deleuze & Guattari, 1987, p. 154) where desire is a force of connection,
expansion and creation (Colebrook, 2002b). Conceiving of desire in this way, Deleuze sees
subjects and bodies as formed through the result of desiring and the connections that they

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make. For instance, a body desiring a drug may be an intoxicated body, yet the same body
may be a mother due to its desiring relationship to a child.

Deleuze depicted essentialist, or closed, subjectivity as oppressive, rejecting this idea as

‘nailed down’ to a ‘dominant reality’ (Deleuze & Guattari, 1987, pp. 159-160).
Understanding the subject in this way entails a static view of the world, as the whole and
complete subjectivity — or singular organism — is passive and unamenable to change.
Instead, Deleuze seeks to understand human existence as dynamic and active. To do so, he
conceives of the body as always understood through its connections with other entities. He
aims for:
opening the body to connections that presuppose an entire assemblage, circuits,
conjunctions, levels and thresholds, passages and distributions of intensity, and
territories and de-territorialisations measured with the craft of a surveyor. (Deleuze &
Guattari, 1987, p. 160)
Here, the human body is a series of assemblages (rather than a singular organism) always in
the state of fluid becoming, rather than static being. Enmeshed within assemblages, the body
is always being produced by desiring, interactions and connections with other bodies, things
and assemblages. At the same time, the body is productive of these assemblages and
connections.

Thus, Deleuze does not focus on what the body is, rather he sees the body in terms of its
relations and connection with other entities. The body’s physicality, while necessary, is only
one aspect of subjectivity and not privileged. According to Nick Fox (2011), Deleuze’s
assemblages and their relations can be understood as follows:
The relations can be drawn from any of the domains, material or non-material, but in
each case, the assemblage is dynamic not static: it is about the embodied process of
eating or working or sexual desiring, not about a state of being. Furthermore, the
assemblage will vary from person to person, contingent on the precise relations that
exist as a consequence of experience, beliefs and attitudes, or from bodily
predispositions. (p. 362)
Thinking of the body in this way is useful for considering drug use. Keane (2002) argues that,
for the becoming body, an encounter with drugs is not necessarily ‘radically other and
inherently damaging’, as rejecting a conception of the body as a biological and singular entity
implies that there is no pure or natural state of biology or being (p. 35). We typically assume

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there is an ideal biological state for each body and that the consumption of drugs (as toxic
substances) interrupts and corrupts this state. Yet, considering the body as ‘becoming’ and as
more than its physical self enables a more nuanced interpretation of drug use. Keane (2002)
argues:
Although each body/drug encounter could be judged positive, negative or neutral
depending on its specific effects, the encounter between the two bodies itself would
not be assumed to be intrinsically bad. (p. 35)
Thus, a Deleuzian approach to embodiment leads away from the study of drug use in terms of
the actions of an anterior, pathologised subject or a stable, toxic drug. In turn, this allows us
to consider this issue in ways that are not reliant on pejorative understandings of people who
use drugs or panics about substances, by actually attending to the lived effects of drugs.

Linked to this understanding of the body as a series of assemblages is Deleuze’s conception

of the non-human world. Deleuze was equally concerned with the formation of matter and
non-humans, viewing the world as self-organisational and expressive:
not only do plants and animals, orchids and wasps sing or express themselves, but so
do rocks and even rivers. (Deleuze & Guattari, 1987, p. 44)
He argued that the expressivity of matter and structures is evident through ‘the organisation
of their own specific form, and substances insofar as they form compounds’ (Deleuze &
Guattari, 1987, p. 43). Thus, for Deleuze, expressivity and experience are not solely human
domains — they are equally applicable to non-humans and objects. The theorisation of the
expressivity of the material world allows a nuanced understanding of the objects of drug use.
Here, the tools used to consume drugs and to treat drug use, and the spaces in which these
practices take place, can be considered not only as conduits to disease, wellness, intoxication
and so on, but in terms of how they constitute, and are constituted by, drugs and people who
use drugs in consumption and service provision encounters.

Conceiving of the world using Deleuzian concepts entails the rejection of essentialist ways of
knowing humans and objects. It involves attending to a different object of study: the
assemblages that constitute a fluid and dynamic world. Moreover, Deleuze’s work provides
alternative ways of being from those available in a progressive, teleological and anterior
account of the world. He shows how becoming or embodiment is a political exercise, in
which certain forms of becoming are possible, dependent on the connections, relationships
and entities available. Thus, a subject’s capacity and attributes — such as its choice-making

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potential, its self-control — are a product of these connections. In this way, Deleuze, like
Foucault, does not begin his critique from the stance that there is an ideal state of humanity
which is currently oppressed, rather, he interrogates the forces that produce subjectivities in
order to understand specific human experiences, as well as the way in which power and
control operates in the modern world.

Disrupting ‘truth’: Scrutinising scientific practice

Foucault and Deleuze turned their attention to the field of science in order to critique
concepts such as power, rationality and progress (see, for example, Deleuze & Guattari,
1994; Foucault, 1978). STS is an area of study that furthers this work, contributing to the
post-structuralist project of critiquing modernity through the scrutiny of scientific practice.
Generally, STS scholars reject the assumption that scientific knowledge is value-free. They
see:
science as a social undertaking like any other, neither more detached from the cares of
the world nor more universal and rational than any other practice. (Stengers, 2000, p.
1)
Many STS scholars, including Bruno Latour, John Law and Annemarie Mol, use both
Foucauldian and Deleuzian concepts in order to further develop their theories.

STS’s preoccupation with the status of scientific knowledge and reality is valuable when
studying methamphetamine. Science plays a key role in how we know the drug
‘methamphetamine’. The materiality of methamphetamine and its effects on the human body,
both physical and social, is the focus of a large body of scientific literature. The resulting
evidence about methamphetamine is integral to the manner in which this drug is dealt with in
law, policy and practice.5 STS offers invaluable theoretical insights for addressing and
critiquing this body of knowledge and examining its relationship to the actual practices of
drug use and service provision. Further, in foregrounding practice, STS makes assertions
about the ontological contingency of the world. These assertions open up the possibility of
change in a field that currently understands drugs and drugs users in very conventional and
pejorative ways. In the following sections I review the work of several STS scholars in
relation to knowledge and reality, and outline some of the theoretical concepts that they have
developed. I do so in order to show how this work can be usefully applied to drug
consumption and harm reduction/treatment practices.
                                                            
5
For example, Australian national policy on drugs makes a ‘strong commitment to…evidence- informed
practice, innovation and evaluation’ (Ministerial Council on Drug Strategy, 2011).  

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Inscription devices and the practice of science

Facts are generally considered to be statements that reflect or describe reality, produced
through the field of science (Latour & Woolgar, 1986). As a ‘proven’ form of knowledge,
facts are defined in opposition to local, ‘unproven’ forms of knowledge. Methamphetamine
(as with many illicit psychoactive substances) is the object of much scientific investigation,
the results of which are reported in scientific texts. These results are ‘facts’— irrefutable
knowledge about methamphetamine. This is, of course, not the only body of knowledge about
methamphetamine. Many people have had experiences with this drug, and therefore ‘local’
forms of knowledge about methamphetamine also exist. This type of knowledge is not
accorded the status of scientific knowledge as it has not been produced through the
purportedly rational exercise of scientific practice. In claiming that scientific knowledge is
contingent and constructed, however, STS rejects this scientific/local binary, and treats both
forms of knowledge in the same way.

STS scholars Latour and Woolgar (1986) undertook careful observation of scientists’
working practices in a seminal ethnographic study at a scientific laboratory in France. Their
research illuminated ‘the daily activities of working scientists [that] lead to the construction
of scientific facts’ (Latour & Woolgar, 1986, p. 40). ‘Facts’ here are not descriptions of a pre-
existing reality; rather, they are crafted through the practices of science where creating facts
involves the inscription of materiality (Latour & Woolgar, 1986, p. 236). Latour and Woolgar
(1986) refer to the processes or mechanisms by which reality is inscribed as ‘inscription
devices’ (p. 51). These are the apparatuses used in scientific practice to translate materiality
into useable data, that is, data that can be used in written documents to make the case for the
establishment of a particular fact. Moreover, the data that inscription devices produce are
assumed to have a direct relationship to the ‘original substance’ (Latour & Woolgar, 1986, p.
51). This means that even though data may take the form of charts or series of numbers, they
are still considered manifestations of materiality.

As part of the process of constructing facts, ‘inscriptions’ are presented in peer-reviewed

journal articles. This allows scientists to ‘make points in the literature on the basis of a
transformation of established argument into items of apparatus’ (Latour & Woolgar, 1986, p.
66). The act of publishing is therefore a form of ‘literary inscription’ (Latour & Woolgar,
1986, p. 76) and an important stage in the construction of fact. Latour and Woolgar (1986)
argue that there is ‘an essential congruence between a “fact” and the successful operation of
various processes of literary inscription’ (p. 76). In order for a fact to materialise, all evidence

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of its inscription process must disappear, and a shift must occur ‘whereby an argument ha(s)
been transformed from an issue of hotly contested discussion into a well-known and
noncontentious fact’ (Latour & Woolgar, 1986, p. 76). Conversely, Latour and Woolgar
(1986) note that a statement is also understood as fact by reference to the process of literary
inscription. Through citation and repetition, ‘scientific fact’ is constructed. They argue that
through publishing facts in journals, and then citing these facts to establish further facts, peer
review and publication operate as an essential stage in the craft of science. Journal articles are
the currency of science, and considered the basis of fact.

Latour and Woolgar’s (1986) work builds upon Foucault’s concepts of discourse and power,
theorising how knowledge is made. By scrutinising the practices undertaken by scientists in
order to produce claims about the natural world, these scholars argue that large heterogeneous
networks and relations are required to produce apparently natural facts. By illuminating the
constructed nature of facts, they demonstrated the way in which the traces of production are
effaced, so that two distinct domains are produced: reality and knowledge of reality (Law,
2009). Thus, the anterior reality on which science relies is remade by Latour and Woolgar as
a political illusion, and the contingency of what we know to be truth and reality is
foregrounded.

Enacting multiple realities

Following the work of Latour and Woolgar (1986), theorists Annemarie Mol and John Law
contributed to a second wave of STS (Latour, 1999). Their work features a commitment to
ontological symmetry where, following Deleuze’s understanding of existence, humans and
non-humans are considered equally capable of expressivity or agency. These scholars seek to
build upon the theory that facts and knowledge are constructed through practice, positing that
reality itself is materialised through practice. Further, the work of Mol and Law is more
explicitly political than that of Latour and Woolgar (1986), addressing very directly the issue
of why some realities are possible and others are not.

Mol (1999) and Law (2004) extend Latour and Woolgar’s (1986) theory of the construction
of facts by contending that reality itself is enacted through practice — scientific and
otherwise. According to Mol (1999) ‘reality is manipulated by means of various tools in the
course of a diversity of practices’ (p. 77). Further, Mol (1999) and Law (2004) reconsider the
concept of ‘construction’ (used by Latour and Woolgar) by arguing that the concept of
‘enactment’ better captures the dynamic and fluid nature of the world, while also opening up

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possibilities for political change (Mol, 1999, p. 77). Construction implies that ‘an object has
been constructed’ (Law, 2004, p. 56) and therefore is closed, completed. This entails that
there are no further possibilities; reality has ‘become’ something. Enactment, however, or
practice better attends to the continuing processes of inscription:
Enactment and practice never stop, and realities depend upon their continued crafting
— perhaps by people, but more often…in a combination of people, techniques, texts,
architectural arrangements, and natural phenomena (which are themselves enacted
and re-enacted). (Law, 2004, p. 56)
In asserting that reality is enacted, and re-enacted, through practice, Mol (1999) argues that
reality is multiple. She claims that an object’s attributes vary according to practice, leading it
to be defined in different ways. For instance, methamphetamine is a multiple object in that it
is available in multiple forms including pills, ‘base’, powder and crystal. Each form is made
through different practices, consumed in different ways, with purportedly different outcomes.
But methamphetamine is also enacted in other ways. It may be smoked at a party for
pleasure, snorted before work for wakefulness or injected into a rat’s brain for the purpose of
scientific observation. These different tools and practices enact multiple and co-existing
versions of methamphetamine, each with different effects. Thus, there is no essential, singular
object ‘methamphetamine’ to be discovered beneath these descriptions. If we consider reality
as performative, powder, base or crystal methamphetamine are not:
attributes of a single object with an essence which hides. Nor is it the role of tools to
lay them bare as if they were so many aspects of a single reality. Instead of attributes
or aspects, they are different versions of the object, versions that the tools help to
enact. They are different, yet related objects. They are multiple forms of reality. Itself.
(Mol, 1999, p. 77, emphasis in original)
In this statement, Mol notes that multiple forms of reality are not disparate; they are related to
each other. (Law, 2004) interprets this idea as a ‘world of fractional objects’ where ‘a
fractional object would be an object that is more than one and less than many’ (p. 62).

If we accept that there are multiple realities, (Mol, 1999) argues that we have a choice as to
which realities we craft. She uses the term ‘ontological politics’ (p. 74) to describe this idea.
Ontology concerns the nature of being and, if this term is then paired with politics, it suggests
a politics of being in which the real is not given (1999, p. 75). Realities are crafted through
practice. Different practices entail different realities and thus, in choosing which practices we

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employ, we choose reality. These choices are always political as different realities have
different effects. For example, the practice of incarcerating a person found to be in possession
of illicit drugs creates prisoners, but also prisons, prison sentencing, guards and parole
officers. If an alternative practice were employed to address this person’s illicit drug
possession, treatment for instance, a different reality would be enacted. This would include
patients, treatment centres, doctors and treatment regimes. Importantly, Mol notes that the
particular conditions of possibility — a concept she borrows from Foucault — shape realities
(Mol, 1999, p. 80). This means that realities are always enacted in relation to political
conditions and available discourses. In the example I have given above, the practices used to
address illicit drug use are different — incarceration or treatment — yet they share
assumptions about people who use illicit drugs. These assumptions include that this group of
people need intervention and rehabilitation, they must cease drug use and they are not able to
address their drug use without expert intervention. Other realities of illicit drugs —
legislation and free access, for example — would require new conditions of possibility to
emerge at this time.

Law (2004) similarly investigates the complexity of enacting knowledge, and why some
realities materialise and others do not. Law argues that for a particular fact to come into
being, it needs to fit in with ‘a network of other statements, materials and practices’ (p. 96).
He refers to these networks as ‘hinterlands’ (Law, 2004, p. 27), and uses this concept to argue
that realities are not crafted arbitrarily, rather they materialise in accordance with previously
accepted truths and knowledge. Critical to any hinterland are inscription devices, a term Law
(2004) extends upon, describing them as ‘a set of arrangements for labelling, naming and
counting’ (p. 29). He sees the practice of science (and of any other body of knowledge) as
involving the ‘orchestration of suitable and sustainable hinterlands’ (Law, 2004, p. 29).
Speaking of scientific knowledge, Law (2004) argues that it is enacted through a ‘single
authorised set of inscription devices’ (p. 32). These inscription devices produce a singular
and anterior reality and, in doing so, obfuscate the multiple possibilities of materiality. In this
sense, Law too, draws upon a Foucauldian sensibility, in which truth and knowledge are
always political. The field of science has the authority to produce what we consider to be
reality, and in doing so it shapes the way in which we think about the world.

I use the work of Law and Mol in my research to acknowledge that realities are enacted.
First, this helps me to overcome a problem I identified in earlier work around
methamphetamine panics. In some cases authors of these works were critiquing the social

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construction of a panic, while asserting there was a ‘real’ problem of methamphetamine. Or,
in the case of Ayres and Jewkes (2012), the authors argued that there was not a
methamphetamine problem and deemed some bodies of knowledge to be an accurate
reflection of reality (statistics for instance), while others were not (such as mass media).
Second (and I will discuss this in greater detail later), Mol and Law’s work also enables me to
acknowledge that my research is merely one account of methamphetamine.

‘Doing’ embodiment: Multiple selves

If reality is enacted, then this has implications for subjectivity. Deleuzian scholars, such as
Ian Buchanan (1997), and STS scholars have attended to ways in which embodiment is
performed. These theorists conceive of subjectivity as enacted and re-enacted through
practice, where there is no anterior, stable identity prior to practice. Buchanan (1997)
addresses the ‘problem of the body’ in the work of Deleuze and Guattari, arguing that they
provide an ‘ethological’ account of the body (p. 73). By this he means an account in which
the body is seen as defined through practice, rather than practice being seen as the actions of,
or a response to, a particular body. Buchanan (1997) argues that the ‘body in Deleuze is an a
posteriori product of newly connected capacities’ (p. 75) and that in order to understand
embodiment in a Deleuzian sense we must ask ‘What can a body do?’ Interrogating bodies in
this way brings to light their various capacities, and, at the same time, the political nature of
practice and embodiment is illuminated, as different practices capacitate bodies in different
ways.

Mol and Law (2004) also conceive of the body as performed through practice, arguing that
we ‘do’ our bodies through practice. That is, in our day-to-day practice we enact our bodies
in different ways. Mol and Law’s (2004) theoretical impetus for conceiving of the body as
something we ‘do’ is to subvert the binary that exists between the ‘body-object’ and the
‘subject-body’. Here, the ‘body-object’ is the body known by science and medical experts, a
body that can be measured and assessed, manipulated and cured. The private ‘subject-body’
is the body that is experienced — ‘the fleshy situatedness of our modes of living’ (Mol &
Law, 2004, p. 43). These scholars enquire into the ‘body-we-do’ in order to escape the self-
evidence of this binary, but also to attend to the lived experience of health or non-health (Mol
& Law, 2004, p. 57). By thinking of the body as something that we ‘do’ and foregrounding
the practice of disease, the body is conceived as entangled with the disease/s it encounters.
The practice of disease enacts certain subjectivities and, at the same time, subjects perform
their disease. Further, the body is not a ‘coherent whole’, rather it is a ‘set of tensions’ where

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tensions and competing interests exist between the various parts and organs of the body (Mol
& Law, 2004, p. 54). This addresses the complexity of medical intervention in that, rather
than enacting ‘pure improvement’, interventions introduce a new set of tensions to the body.
A simple example of this is OST. On the one hand, people may find OST beneficial for
certain parts of their body. They may reduce their injecting and so their vein health improves.
On the other hand, they may find that they sweat more and become constipated. Thus, there is
no pure gain from OST. Some parts of the body benefit, others do not.

Buchanan (1997) and Mol and Law (2004) address the way in which embodiment is
performed through assemblages. These theorists understand bodies as enacted — and
capacitated — through connections and relations they establish with other entities, both
human and non-human. Buchanan uses the concept of assemblage to show us the capacities
of bodies. Mol and Law (2004) use the idea of the ‘body-we-do’ to consider the way in which
practices enact. In my research, I use Buchanan’s insights to describe how drug-using
subjectivities are performed through texts, and ask ‘what can a body do?’ in order to address
the political nature of the way in which policy, treatment and media texts constitute
methamphetamine-using subjectivities. I use Mol and Law’s work to address the way in
which individuals ‘do’ themselves through methamphetamine-related practices — such as
consumption or harm reduction/treatment — and also to describe interventions into
methamphetamine use in terms of the ‘sets of tensions’ they introduce to people’s lives. Both
works allow me to consider the political nature of embodiment. Individuals embody
themselves through practice, but the ‘conditions of possibility’, which operate at a given time,
limit which practices are possible. This means that practice is always shaped by political
forces. Showing how bodies are capacitated through practice enables me to illuminate the
absolutes that underpin our understanding of drug users’ agentive capacity — such as
voluntarity/compulsion, controlled/chaotic — and points to the inherently political nature of
practice. Here, I again draw on Foucault and Rose to make visible the way drug users are
enacted, or embody themselves, in relation to the obligation of choice and control that inform
the broader cultural norms of neo-liberal societies.

The theoretical concepts that I have outlined in this chapter point to a complex and multiple
reality and suggest the ontological contingency of the world. I employ these concepts to
address my research questions; that is, to show the ways in which dominant discourses, such
as science, policy, treatment and media, constitute the drug methamphetamine and the people
who use this drug. Most scientific accounts of methamphetamine materialise this drug as a

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singularly potent and addictive object; at the same time, these accounts enact drug-using
subjects as deviant and/or pathological. STS challenges these accounts, allowing me to
identify them as contingent upon the available hinterland of AOD knowledge and the
inscription devices embedded within this. In doing so it creates other possibilities for
understanding drug use. Building upon Deleuze’s understanding of the world, STS rejects
pre-existing ontological categories of nature and culture, seeing humans and non-humans as
both constitutive of, and constituted by, the connections they make. Thus the practices of
methamphetamine service provision and consumption can be analysed as multiple networks,
always materialising particular subjects and objects of drug use. This enables the tracing of
relationships between the object ‘methamphetamine’ and consumption and harm
reduction/treatment practices, without assuming anterior categories such as ‘addict’,
‘addictive substance’, ‘client’ and so on. Instead, such entities are seen as produced through
methamphetamine-related practices. These practices are always political, shaped by the
contemporary conditions of possibility and have specific effects.

Researching multiplicity: Methodological considerations

Undertaking research using the theoretical insights I have outlined above entails employing a
methodology that can attend to the fluidity of objects and subjects, and focus on the
performative capacity of the connections and relationships they form. In this section, I
present two methodological concepts: a material—semiotic method that Latour (2005)
espouses as a ‘renewed’ form of empiricism, and Law’s (2004) ‘method assemblage’ — a
concept that assumes the performative capacity of method. I define and discuss these two
concepts and how I use them. Then, using insights from both these scholars, I discuss how
my research practice can attend to the messiness of the world, without ‘making’ a singular
and oppressive reality. Finally, I present my method and discuss some of the implications of
my approach in light of the issues raised by Latour and Law.

Actor network theory (ANT) and matters of concern

ANT is a well-known form of material—semiotic methodology. This approach considers the
‘relationality of entities, the notion that they are all produced in relations, and applies this
ruthlessly to all materials’ (Law, 1999, p. 4). Law (2004) gives the following definition of
ANT:
Actor network theory is a disparate family of material—semiotic tools, sensibilities,
and methods of analysis that treat everything in the social and natural worlds as

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continuously generated effects of the webs of relation within which they are located.
(Law, 2009, p. 141)
In terms of the practice of ANT, Law states:
The actor network approach thus describes the enactment of materially and
discursively heterogeneous relations that produce and reshuffle all kinds of actors
including objects, subjects, human beings, machines, animals, ‘nature’, ideas,
organizations, inequalities, scale and sizes, and geographical arrangements. (Law,
2009, p. 141)
ANT enables a symmetrical approach to research, whereby humans and non-humans are
accorded the same significance and their relationships to each other scrutinised. Moreover, as
Latour argues, by using the concept of ‘network’ and tracing a ‘trail of associations between
heterogeneous elements’ (Latour, 2005, p. 5, emphasis in original) we ‘render the movement
of the social visible’ (Latour, 2005, p. 128). Eschewing structural explanations of power or
‘the social’, ANT makes visible localised power arrangements and the lived effects of
inequity by describing networks and the relationships between entities. In my research I
employ an ANT approach, finding it valuable in the way it enables me to attend to the
relationality of human and non-human entities and the practices of drug use and harm
reduction/treatment. I also find it helpful in illuminating the lived effects of various power
arrangements such as an individual’s encounter with a treatment agency.

Through using ANT, Latour urges researchers to ‘get back to empiricism’, ‘follow the actors’
and to ‘go back to the object’ (Latour, 2005, p. 146). Here, Latour commits to specificity and
description, rather than totalising and final statements about reality. This echoes a primary
theoretical concern of Foucault and Deleuze, that of localised and specific responses, a
‘micro-politics’ of existence (Colebrook, 2002b, p. 92), rather than explanatory and absolute
theories of the world that ‘nail down’ reality. Latour (2004) argues that scientific research
produces facts: totalising statements that reify the world in knowable ways. As he puts it,
while facts are certainly related to the material world:
Matters of fact are only very partial…very polemical, very political renderings of
matters of concern. (Latour, 2004, p. 232)
Latour draws on a Foucauldian understanding of knowledge here. He asserts that facts — the
body of knowledge that informs what we can do, say or think about the world — are a
specifically political representation of the world. Yet, in critiquing facts Latour seeks not to

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deny their relationship to the material world but to extend upon it. This requires a renewed
form of empiricism to interrogate facts, and expand upon them, turning matters of fact back
into what he calls collective ‘matters of concern’. Studying ‘matters of concern’ thus requires
expanding our understanding of issues so that they become ‘intrinsically political’ (Fraser,
2011, p. 95). Taking my lead from Latour, my aim in this research is to address
methamphetamine as a ‘matter of concern’, rather than a ‘matter of fact’. This is not to refute
the material effects of methamphetamine, or to ‘disprove’ the ‘facts’. Instead I aim to
understand the materiality of methamphetamine in a more nuanced, complex and expansive
way than the ‘facts’ of methamphetamine currently allow.

Method enacts
While Latour (2005) conceptualises ANT as an approach that addresses the problem of
method, Law (2004) attends to this issue through the concept of method assemblage (p. 161).
This is a more explicitly political approach to method that acknowledges that research
practice makes certain realities present and others absent. Law (2004) argues that methods of
data collection such as observation, online surveys, individual interviews and focus groups
act as inscription devices. As such:
method does not ‘report’ on something that is already there. Instead, in one way or
another, it makes things more or less different. (Law, 2009, p. 143)
Conceived in this way, sociological research is not a neutral practice. As with all other
practices, it involves enacting particular realities. Law (2004) argues that most sociological
research is shaped by ‘Euro-American common sense realism’ (p. 143), that is, it sees
research practice as descriptive, and methods as tools to ‘collect’ data that then represent a
singular, definite, anterior reality. He argues:
Realities are produced along with the statements that report them. The argument is
that they are not necessarily independent, anterior, definite and singular. If they
appear to be so (as they usually do), then this is itself an effect that has been produced
in practice, a consequence of method. (Law, 2004, p. 38)
Thus, as with scientific practice, most sociological research produces a singular version of the
world, obfuscating the multiplicity of reality.

Law (2004) defines a method assemblage approach to research as one that addresses an
‘interactive, remade, indefinite and multiple’ world (p. 122). This involves:

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the process of crafting and enacting the necessary boundaries between presence,
manifest absence and Otherness. Method assemblage is generative or performative,
producing absence and presence. (Law, 2004, p. 161)

Here, a method assemblage approach is one that makes explicit the ways in which method
constitutes realities. All research makes present objects, subjects, practices, spaces and
effects. Yet with presence comes absence and Law argues there are two forms of this —
manifest absence and Otherness. He clarifies that:
manifest absence is that which is the ‘necessary Other’ to presence, what is made
absent, but recognised as relevant to presence. (Law, 2004, p. 157)

Thus, this is what is manifest in its absence — objects and subjects and other phenomena that
correlate to presence (Law, 2004, p. 84). Otherness, on the other hand, is absence that is not
made manifest; it is what disappears or is repressed with absence (Law, 2004, p. 162). Law
explains that sometimes what is othered is routine and insignificant. Sometimes, however:
what is being brought to presence and manifest absence cannot be sustained unless it
is Othered. (Law, 2004, p. 85)
Here Law sees a method assemblage approach as acknowledging the political of research;
that it makes present some realities and, in doing so, will repress and other alternative
accounts.

As already noted, in much scientific research on methamphetamine, the drug is made present
as an addictive and destructive substance. Necessary and relevant to this presence are
contexts such as treatment centres, practices such as rehabilitation and subjects such as
addicts. These entities might be absent from particular statements or accounts that concern
the addictiveness of methamphetamine, but they are made manifest in that they are a
necessary part of addiction. At the same time, other phenomena are othered in order to make
methamphetamine in this way. Addiction in the current conditions of possibility is a practice
devoid of pleasure and functionality; it is a singularly compulsive and pathological activity.
Therefore concepts such as pleasure or functional use of methamphetamine are othered. So
too are subjects such as individuals who take this drug for pleasurable reasons, on an
intermittent basis, experiencing no harm.

Enacting the boundaries between presence, manifest absence and Otherness requires that the
arrangements of method assemblage are unavoidably political. They produce ‘truths and non-
truths, realities and non-realities, presences and absences’ (Law, 2004, p. 143). This means

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that rather than implying a set of specific methods, method assemblage is about being
cognisant and reflective of practice, committing to enacting realities that are not oppressive
— ‘to make some realities realer, others less so’ (Law, 2004, p. 67).

Reality is ‘messy’: How to attend to it

If we understand the world as ‘interactive, remade, indefinite and multiple’ (Law, 2004, p.
122) how, in practice, do we attend to it? Doing justice to the complexity and multiplicity of
reality is no easy task. Law (2004) notes that in addressing ‘messiness’ and the overwhelming
nature of reality, one must find patterns, ‘bundle’ them and make a story. And in order for
these patterns and stories to make sense, they must be situated within a theoretical context.
The process of theoretically locating one’s data involves interaction between theory and data
as these resonate and amplify one another ‘to produce pattern and repetition’ (Law, 2004, p.
111). This process is academic, but it is also creative:
Scientists (and other people too) creatively detect and select appropriate similarities
between instances whilst ignoring others […] Inscription devices make traces which
sometimes map on to one another to produce a sustainable set of similarities. Again,
the metaphor is about the need to find or make a pattern against an endless
background of noise. (Law, 2004, pp. 108-109)
Here, Law argues that the creative exercise of identifying patterns, situating them
appropriately, and telling a story is common to all research. Research underpinned by ‘Euro
American common sense realism’, however, obfuscates these processes as it claims it is
‘objective’ and ‘neutral’. In doing so, this research crafts singular outcomes, making
multiplicity absent. Employing a method assemblage approach entails that these processes are
explicated and messiness and multiplicity are revealed.

Both Latour and Law argue that research is an intuitive, reflexive and descriptive process.
Researchers produce objects of study through their practice, and then make choices about the
ways in which they follow these objects through their data. The research findings will
recognise the multiplicity of the objects of study, yet are only a partial rendering of this.
Researching matters of concern aims to approximate the complexity of reality and rejects the
need to produce incontestable knowledge about the world. Method assemblage is the process
of exposing the political nature of and work involved in research practice. Further, a
satisfactory account must address the political nature of multiplicity, describing the effects of

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particular materialisations, and acknowledging the conditions of possibility that enable the
production of particular realities.

Methamphetamine use and its treatment is situated in an AOD/scientific hinterland,

comprising many research projects, practices, theories, policies, institutions and so on. By
situating my work in post-structuralist and STS theory, employing a material—semiotic
methodology and a method assemblage approach, I describe the ways in which
methamphetamine and methamphetamine-using subjectivities are constituted, revealing some
of the inscription devices involved and the hinterlands these are embedded within. I also
examine methamphetamine-related practices — including consumption and harm
reduction/treatment — and describe how individuals embrace and/or subvert these specific
enactments. In doing so, I produce an account of methamphetamine that acknowledges the
multiplicity and complexity of reality. However, congruent with understandings of the world
as fragmentary and multiple, this account can only be a partial rendering of
methamphetamine-related practices. In this spirit, I present the methodological tools I used in
collecting data for this project, and the activities I undertook, in order to trace the effects of
the object ‘methamphetamine’ and the practices of people who use this drug, as well as
methamphetamine harm reduction/treatment practices. I show how these activities enabled
me to address the ways in which dominant discourses, such as science, policy, treatment and
media, constitute the drug methamphetamine and the people who use it.

Methodological tools
I used three qualitative methods in conducting this research. These were:

1. A mapping exercise involving authoritative literature concerning methamphetamine in

order to trace the textual enactments of methamphetamine and methamphetamine-
using subjects in scientific, policy, treatment and media discourses.

2. In-depth interviews with people who use methamphetamine regularly and

methamphetamine service providers in order to explore consumption and service
provision practices productive of this drug and drug-using subjectivities (see
Appendix B).

3. Field notes and diagrams made after interviews in order to describe the spaces within
which harm reduction/treatment and consumption of methamphetamine takes place.

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Methodological steps
In this section I describe the key methodological steps I took in conducting this research.
Although I attempt to place these steps in chronological order, the research process is
necessarily flexible, reflexive, iterative and messy and, during the research, tasks usually
overlapped.

1. I reviewed the epidemiological, public health and sociological literature concerning

methamphetamine. Epidemiological and public health reports gave a sense of the
scale of use and reported harms associated with methamphetamine. Combinations of
the following key terms: ‘methamphetamine’, ‘amphetamine’, ‘dependence’,
‘addiction’, ‘harms’ and ‘treatment’ were used.

I also reviewed qualitative sociological literature to identify areas that were

theoretically underdeveloped and also to identify problems in the knowledge to date. I
used combinations of the following key terms: ‘methamphetamine’, ‘qualitative
research’, ‘qualitative method’, ‘social construction’, ‘STS’, ‘post-structuralist’ and
‘ANT’.

2. Ethics approval was obtained from the Curtin University Human Research Ethics
Committee (HREC) (approval number HR 54/2009).

3. I identified the geographical area in which I would conduct the research and I began
the process of data collection. Five types of health and AOD services were identified
in the area and chosen to take part in the research. These services were chosen on the
basis that they represented a range of different treatment types and services for people
using drugs (including methamphetamine). The services were approached through an
introductory letter, followed by a telephone call. All services I approached agreed to
take part in the research project.

4. I met with services individually to discuss their preferred method of client recruitment
and how I would go about interviewing staff members. The research proposal was
then submitted to two additional HRECs. These were St Vincent’s Hospital HREC A
(Melbourne) (approval number HREC-A 120/09) and Eastern Health HREC
(approval number E99/0910).

5. Thirteen in-depth, semi-structured interviews were conducted with workers from the
services taking part in the research.

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6. Twenty-eight in-depth, semi-structured interviews were conducted with people using

methamphetamine, including people in contact with services and those who were not.

7. Authoritative texts were identified and analysed in order to map the ways in which
methamphetamine is constituted in public discourse.

8. Interviews were professionally transcribed. I listened to each interview after

transcription and ensured the transcription was accurate.

9. I entered all interview data into database management software (NVivo8™) and
coded it.

In the sections that follow, I discuss these methods in more detail.

Textual analysis
Given, as I have argued, discourse is productive of methamphetamine-related practices and
the ways in which we understand methamphetamine and methamphetamine-using subjects, a
mapping exercise was an important part of this research. In this exercise I described how
methamphetamine and methamphetamine-using subjects were constituted in authoritative
texts. By ‘authoritative’, I mean texts that contribute to dominant discourses such as
biomedicine and public health. I examined the object ‘methamphetamine’ through scientific
texts (see Appendix A), and methamphetamine-using subjects through policy, treatment and
media texts. The selected texts are heterogeneous, differing in origin and intent, particularly
in the case of media texts. However, they are similar in that they have been authored and/or
produced by institutions with considerable power and authority and, as a whole, constitute an
authoritative methamphetamine discourse.

The texts I analysed were separated for the purposes of a clear and easy-to-follow argument.
In doing so, I do not mean to assume a linear reality where the scientific field produces
knowledge which then informs other fields. Scientific knowledge, as much as any other field,
is shaped and driven by the interests of significant individuals in the field, funding
constraints, public concern and so on. However, separating the texts in this manner
acknowledges, as Foucault (1978) has argued, that discourses are ‘hierarchised’ (p. 30). As
the creators of facts that describe our natural world, scientists produce knowledge that usually
trumps other forms of knowledge (Jasanoff, 2011). Consequently, texts that purport to be true
must be based on scientific knowledge.

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To map textual enactments of methamphetamine in scientific discourse, a literature search

was carried out using Google scholar and the databases ScienceDirect, ProQuest and Medline
using combinations of the following key terms: ‘methamphetamine’, ‘amphetamine’,
‘dependence’, ‘addiction’, ‘harms’ and ‘treatment’. I restricted my search to articles
published between 1995 and 2010. This search strategy generated over 1000 articles. As my
primary focus was the discursive production of methamphetamine in the Australian context, I
focused my analysis on the subset of Australian scientific texts, except where these texts led
me to literature that originated overseas. This was because while my focus was Australian
texts, I was also interested in the extent to which these texts echoed, or contributed to, claims
made in the international literature. Through careful reading of these texts, key claims or
‘facts’ regarding methamphetamine were identified. I define ‘key claims’ as those that are
made repeatedly in the literature and/or that are prevalent in public discourse on
methamphetamine.

In order to analyse these claims, I was guided by the work of Latour and Woolgar (1986) and
their scrutiny of scientific practice. Articles were selected on the basis that they contributed
significantly to a particular claim. That is, they presented evidence that was ‘proof’ of a
particular claim. These texts were then carefully re-examined for contradictions in the cited
evidence, inscriptions of methamphetamine’s materiality and instances of ‘literary
inscription’ (Latour & Woolgar, 1986, p. 76). In some cases, additional searches were carried
out. For instance, in some articles, a path of inscription was traced back through earlier
publications cited as evidence for various claims about methamphetamine.

I selected other authoritative texts for their significance in the field. I analysed the national
policy document that addresses methamphetamine, the National Amphetamine-Type
Stimulant Strategy 2008-2011, the federally-funded treatment manual Treatment approaches
for users of methamphetamine: A practical guide for frontline workers as well as A brief
cognitive behavioural intervention for regular amphetamine users (Baker, Kay-Lambkin,
Lee, Claire, & Jenner, 2003) and the website meth.org.au. I also analysed the documentary
The Ice Age, televised by the national broadcaster, the Australian Broadcasting Corporation
(ABC), in 2006. I scrutinised these texts in terms of the subject positions made available for
people using methamphetamine. I considered these subjectivities in terms of the object
‘methamphetamine’ as it is discursively realised through scientific texts. I also considered
these subjectivities in terms of their relationship to the ‘absolutes’ of drug use — such as

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voluntary/compulsivity, controlled/chaotic — an understanding of drug use that is shaped

within the neo-liberal episteme (Sedgwick, 1992).

In‐depth interviews
In addition to textual analysis, I undertook in-depth interviews to gather empirical data
concerning experiences of methamphetamine-related practices such as harm reduction,
treatment and consumption. Accounts of drug use were used to better understand people’s
relationship to the object methamphetamine, and the objects and spaces of drug use.
Accounts of drug harm reduction/treatment were collected to gain insight into the way in
which these practices, and the spaces of drug service provision, shaped drug users and drug
use. Overall, accounts were used to show the ways in which people incorporated, produced,
embraced and resisted dominant enactments of methamphetamine. I discuss some of the
epistemological and ontological implications of using in-depth interviews later in this
chapter, but first I describe the groups of people I interviewed and their recruitment.

I interviewed 41 people in total, grouping these people in three ways:

 people who use methamphetamine and had recent contact with harm reduction and/or
treatment services (n=15)

 people who used methamphetamine and had no recent contact with harm reduction
and/or treatment services (n=13)

 harm reduction and/or treatment service providers (n=13).

Recruiting participants
I recruited most of my participants from services located in an inner-city suburb in
Melbourne, Australia’s second largest city. Although in recent years the suburb has
experienced gentrification, a lot of public housing remains, including a high-rise housing
estate. This suburb has an array of services targeted towards low income earners, people who
are homeless, people who do not have paid employment and people who use illicit drugs or
alcohol. With a few exceptions, these services are concentrated in one area of the suburb,
away from the café and retail precinct. I undertook research in this suburb because of the
concentration of AOD services. Also, I had previously lived and worked in the area (at an
AOD service) and was familiar with it. This meant I could easily identify the services I
wished to recruit through, and often personally knew workers at the services. Further, I
expected that with the mix of socially and economically privileged residents, as well as those

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who were residing in government housing, I would have access to varying accounts of
methamphetamine use.

Five types of services were approached in order to recruit service providers and people using
methamphetamine. These services were NSPs, outreach programs, accident and emergency
(A&E) care, primary health care, and AOD specialist treatment. Seven services were
contacted in total. When services were initially contacted about taking part in the research, I
asked to interview up to five workers and to recruit up to 15 users of the service.

Interviewing service providers

Service providers were interviewed from six of the organisations approached. It proved too
complicated to access A&E workers who might provide services to people who use
methamphetamine. Interviews would have had to take place late in the evening and there was
no private space on site where interviews could be conducted. All other services agreed to
identify workers and pass on their email addresses so that I could contact them and arrange an
interview. This was a simple process, and I interviewed 13 workers between 8 July, 2009 and
22 February, 2011. Interviews usually took place in a local café or the worker’s office.

A range of workers from each type of service was interviewed, allowing for coverage of
service type, organisational role, professional background, seniority and decision-making
responsibility. The interviews focused on the services offered; the practices of treating
methamphetamine; guiding philosophies, beliefs or models; perceptions of people who used
methamphetamine characteristics and needs; and strategies employed to meet these perceived
needs. In some cases, vignettes outlining possible service scenarios were also used in order to
prompt service providers to describe their practice in more detail.

Vignettes were based upon themes that emerged from interviews with people who used
methamphetamine. I had hoped that the use of vignettes would assist to elicit the step-by-step
procedures involved in the practice of treating methamphetamine, in a way that did not
threaten service providers’ professional identity. I had initially planned to use the vignettes in
all interviews, but in some cases there was not enough time (almost every service provider
that I interviewed was pressed for time and only able to meet for a maximum of an hour). In
other cases, I felt that questions of practice had been thoroughly covered to the point where
the use of a vignette would have been tedious for both the interviewee and myself.

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Interviewing people who use methamphetamine

People who use methamphetamine were eligible for participation in this study if they were
over 18 years old, and had been using methamphetamine at least once a week for the previous
six months. These eligibility criteria ensured that the people I interviewed had reasonable
experience of methamphetamine use. As stated above, I sought to interview both people in
regular contact with health services and those with no contact with services. People who use
methamphetamine were considered service users if they had accessed one of the harm
reduction, treatment and other services taking part in the study in the 30 days prior to the
interview. This meant that they could be interviewed about their recent experience of a health
service. This group of participants were not considered to be service users if they had had no
contact with health services in the six months prior to the interview.

Most of the participating services identified potential research subjects through their practice
and provided them with my contact details. In one case, a flyer was placed in the service
waiting area with my contact details so service users could contact me if they wished. In the
case of two inpatient services, a staff member contacted me to let me know that there was a
potential participant on site. We then arranged a time for the service user to meet with me (on
site) so that I could tell them about the research and see if they were interested in taking part.
In all cases, once I had met the person on site, they agreed to participate in the research and
we did the interview immediately.

People who use methamphetamine were interviewed through only four of the seven services I
approached. This may have been because several services were not accessed by people who
were regularly using methamphetamine. Most service users were recruited through two of the
services approached, and then one each from the remaining two services. In total, I
interviewed 15 people who use methamphetamine who were also accessing harm reduction
and/or treatment services between 12 October, 2009 and 2 March, 2011.

Initially I was apprehensive about my capacity to recruit people who use methamphetamine
and did not access services; however, this task proved to be easier than I had expected for two
reasons. First, a personal acquaintance living in the area in which the research was conducted
knew people who used methamphetamine regularly and agreed to distribute my business card
amongst his peer group. As a result, I was contacted by seven people and I interviewed all of
them. Second, I was able to access eight people through a concurrently run epidemiological
research project on methamphetamine use in Melbourne (Quinn, 2012). I purposively

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recruited people by asking the researcher conducting this project to pass on my contact details
to people using methamphetamine that lived in or near the area in which I was conducting my
research. In total, 13 people using methamphetamine who had not used services in the past
six months were interviewed between 11 July, 2009 and 2 November, 2011.

My aim was to interview people using methamphetamine ‘heavily’ in order to ensure

participants were very familiar with the practices of methamphetamine use, including
purchasing and (possibly) selling the drug, as well as the various ways it can be consumed. I
also thought that people using the drug regularly would be more likely to have experienced
effects such as financial stress, relationship and family problems, employment and health
issues. Further, ‘heavy users’ are often the subject of research and I wanted to provide an
alternative account of heavy users that was not based on their individual pathology or the
amount of drug-related harm they experienced. For my purposes, ‘heavy use’ was defined as
using methamphetamine more than once a week. I did, however, interview three people who
used methamphetamine less often than this. This was because these participants thought of
themselves as methamphetamine users and had used methamphetamine heavily in the past.

Interviews with people who used methamphetamine focused on the practice of use and its
effects. Attention was given to age, gender and length of involvement with methamphetamine
use in order to explore a range of experiences. Interviews covered family background;
education/employment histories; drug use history; current methamphetamine (and other drug)
use; rationale for, and elements influencing, use (including attitudes, beliefs, practices, and
social and physical environments); previous health service encounters; and barriers and
incentives to accessing health services. Participants were reimbursed $40 cash
(approximately US$37.50 in 2014) or the equivalent in the form of a voucher for their time
and out-of-pocket expenses in accordance with accepted practice in Australia (Fry & Dwyer,
2001) and internationally (Anderson & DuBois, 2007).

Field notes and interview spaces

I took notes after each in-depth interview. A material—semiotic approach to research
requires attention to spaces and objects. Law (2002) argues that ‘spaces are made with
objects’ (p. 96, emphasis in original), so describing objects was integral to establishing the
space within which each interview took place. These spaces included an inpatient detox
centre, a beer garden, the lounge room of a student group house, various cafés and staff
rooms. After each interview I made notes about the interview context, sometimes drawing a

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diagram of the space where the interview had taken place. In my notes I described how I felt,
how I perceived the interviewee reacted to me and to the content of the interview, our
surroundings and other people I interacted with in the context of the interview. These field
notes were invaluable in helping me to take into account the ‘things’ that acted to produce
accounts, as well as those that shape and produce drug use and drug harm reduction/treatment
practices.

The production of accounts

Approaching research from a material—semiotic standpoint entails assuming that research
practice is constitutive of the objects of research (rather than reflective of them) and is a
political exercise in that it makes some objects present and others absent or othered.
Therefore, in defining the participants that are eligible for interview, the researcher
materialises particular objects of research. My objects of research were people who used
methamphetamine and people who treated methamphetamine use. This was because I
expected that these two groups of people would be able to relate experiences and ideas about
both consumption and harm reduction/treatment. Of course, in interviewing these particular
actors, I would also enact the object ‘methamphetamine’ itself. In materialising these objects
of research, and employing particular methods to inscribe them, specific accounts of
methamphetamine-related practice were produced. In this section I discuss some of the ways
in which these were constituted.

The main tool with which information about methamphetamine-related practice was collected
was the in-depth interview. In-depth interviews are a mainstay of qualitative research. As a
research tool they are employed to elicit ‘thick’ descriptions of the subject’s experience of
their social world (Minichiello, Aroni, Timewell, & Alexander, 1995). However, they may
also make particular assumptions about the subject — for example, that the subject is the
centre of experience, unitary and autonomous (Martin & Stenner, 2004). I wished to avoid
using interviews in this way and instead sought to use interviews as a way of documenting
practices. I was interested in how these practices enacted methamphetamine and
methamphetamine using-subjects. By focusing on practice, interviews were not used in order
to make assumptions about the individuals who participated in this research, but instead as
lay ethnographer accounts. In their research on diabetes, Mol and Law state:
The quotes in this article are not supposed to tell the reader about the specificities of
the people uttering them. Instead they are intended to inform us about the practices of
dealing with diabetes — practices that are so spread out that they are hard to study

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ethnographically for a limited number of researchers who have only limited time, and
would prefer not to intrude for long periods into other people’s lives by spending days
and days with them. So we take professionals as well as people with diabetes as (lay)
ethnographers in their own right, taking it upon ourselves to select, translate, combine
and contrast their stories (Mol & Law, 2004, p. 59, emphases in original).

These accounts were also used as a method of following the actors (Latour, 2005), literally as
well as figuratively. In a literal sense, interviewing people using methamphetamine led me
into their houses, to their treatment providers and to the places they socialised, such as a local
café or pub. Likewise, interviews with service providers led me into their services. This gave
me access to the spaces in which methamphetamine was consumed and treated. In a
figurative sense, this meant allowing the interview to be led in perhaps unexpected directions.
As the researcher I set the parameters of the interview and the research topic and determined
the relevance of what was discussed during the interview. However, taking the lead from
participants meant that although there was a set list of themes, I was open to the interviewee
raising any methamphetamine-related topic. For example, questions on gender and the
practice of methamphetamine were not included in this set list yet, on multiple occasions,
interviewees led the interview to discussions on this issue.

In addition to the practice of the in-depth interview itself, other subjects, objects, spaces,
inscription devices and hinterlands acted to produce particular accounts of methamphetamine
use and service provision. In order to demonstrate some of the ways in which particular
accounts were constituted I describe the interviews that took place at two inpatient services.
The physical surroundings of these services were very different from those of the other
interviews I conducted; they were highly regulated clinical environments. Some of the
behavioural restrictions to which clients were subject included being unable to consume sugar
and (for the interviewee) being unable to leave the building. Before my first interview at one
of the inpatient sites, I was waiting in the ‘quiet room’ while my interviewee was notified that
I had arrived. Looking around the room I became aware of at least five ‘do not’ notices,
including ‘Do not smoke’, ‘Do not leave this door open’ and ‘Do not touch this stereo’. These
small signs acted to emphasise what was a highly regulated environment. Without them, the
room would have been a simply furnished, quiet and warm room. With them, one was
reminded at all times of the need to adhere to the rules. Thus, the ‘quiet room’ was a space
for quiet but not a space in which one could easily relax.

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All but two of the people I interviewed in this particular setting gave evidence that they
experienced significant social and economic disadvantage. They were recipients of
unemployment payments or pensions, described low levels of education and substantial
degrees of state intervention in their lives (such as contact with the legal system, child
protection system and so on). I have not experienced these forms of disadvantage and upon
meeting these inpatient clients I was keenly aware that various ‘things’ (such as my black-
rimmed glasses and haircut, my notebook and pen, and the way I spoke) made it clear that
significant social and economic differences separated us. These objects acted to constitute me
as a privileged individual and perhaps a figure of expertise. It is possible that they shaped the
interaction between myself and the interviewee. Certainly, I was positioned by a number of
the interviewees at the in-patient services as a case worker or a social worker/psychologist.
This was evidenced by the following statement from Ross, a 38-year-old man, at the
completion of his interview:
I know that the more I do it [talk about methamphetamine use], the better, the easier
it’s going to feel for me, like the better I’ll feel about meself because I’m releasing all
this stuff and I, I can just feel it already, it feels like a little bit has been lifted off my
shoulders just from sitting here talking, you know.
This statement appeared to be intended to reassure me that the interview itself was part of
Ross’s therapeutic process. At the completion of another interview that took place in an
inpatient service, the participant seemed to think I was a case worker and requested that I
contact an AOD counsellor in his local town and make an appointment for him.

It was frustrating being perceived as a worker of some sort rather than as a researcher, as this
might have generated particular accounts of methamphetamine use, and of the needs relating
to this activity, that were shaped by treatment discourse. This could have led inpatient
participants to position themselves as someone who was sick from drug use and needed
treatment to stop taking drugs. In addition to the way in which my position was
(mis)understood by clients at the inpatient services, the space in which they were interviewed
was also constitutive of accounts. These participants were being interviewed during a course
of treatment in a highly regulated treatment facility. Their status as drug treatment clients was
reinforced even in areas designated for quiet time. It is not surprising, then, that in order to
understand and explain their drug use, they drew upon the meanings available within the
AOD hinterland. I am not seeking here to negate these accounts, or to downplay the
experiences of drug use and drug treatment related during the interview. Rather, I wish to

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draw attention to the multiple possibilities of interview practice. Had I appeared as other than
a ‘worker’, or had the interview taken place in different spaces, it is possible an alternative
account of methamphetamine use and treatment would have been produced, perhaps one that
subverted treatment discourse.

In describing my experience of interviewing inpatient residents here, I aim to demonstrate

that interviews are a constitutive practice. They are spatially and temporally located, and
enacted though the connections and relationships formed between myriad subjects and
objects. They can also be conceived as an inscription device. This is because they are a tool
with which one makes data, transforming a phenomenon (for instance, the act of consuming
drugs) into data. The accounts within this text are, in this way, contingent, enacted through
the connections and interaction of a range of entities, not least myself and the participant.
However, despite the assertion that these accounts could have been different, they are always
constituted within, and in relation to, particular hinterlands and conditions of possibility.
Because of this, while there are multiple possibilities, these are shaped by the current
episteme. In the case of this research, the commonality is the restrictive ways in which we
can think about drug use and drug users.

Interpreting accounts
In conducting interviews and taking field notes I collected a large amount of data. As a first
step in managing these data, interview transcripts and field notes were entered into the data
management software program NVivo8™. This allowed large amounts of data to be stored
and accessed easily. I then undertook coding: the identification of patterns through repetition
and amplification (Law, 2004, p. 111). Once patterns were distinguished, appropriate
theoretical tools with which these patterns might be analysed were employed. For example,
when reading through scientific texts concerning methamphetamine I was struck by what
appeared to be glaring contradictions within and between texts. This led me to the body of
knowledge that addressed the contingent nature of science – STS – and specifically Latour
and Woolgar’s early work. I therefore used STS theoretical concepts to illuminate these data.
The theoretical concepts I used underwent a process of exchange and adaption as data were
collected and coded. Subsequently the patterns that were established in the early stages of the
research developed into the themes of my research. These included the way in which
methamphetamine is enacted in authoritative discourse and the co-existing subjectivities of
agentive and non-agentive methamphetamine users materialised in treatment practices.

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When presenting accounts, researchers necessarily make decisions about which statements to
amplify and which to leave out. I collected a large body of data on methamphetamine,
consumption practices, harm reduction/treatment practices, purchasing and selling, gender,
parenthood and so on. Ordering these data to produce a research text was a necessary but
limiting process. In selecting some themes to amplify I have necessarily left many out. My
‘controversial agency’ as author of this research account (Latour, 2005, p. 138) determines
what is made present, what is made ‘manifestly absent’ and what is ‘Othered’ (Law, 2004, p.
161). To acknowledge one is effectively employing a method assemblage is a commitment to
make the political nature of realities overt and to the enactment of realities that might be
‘systematically Othered’ (Law, 2004, p. 132). Thus, in undertaking this research, I seek to
create a text that is an ethical account of methamphetamine-related practices, without further
pathologising and marginalising people who use methamphetamine.

Practicalities: Ethical considerations

I was mindful of several practical ethical considerations during the course of this research.

Privacy and confidentiality

People who use methamphetamine risk prosecution as well as social exclusion. For these
reasons, interviews with methamphetamine users were confidential, and the majority took
place in private spaces within harm reduction/treatment or other health services or within the
interviewee’s house. Twenty-seven interviews took place in public spaces such as cafés or
parks. In these cases, every attempt was made to ensure privacy. If the interviewee felt his or
her privacy was compromised at any time, we stopped the interview and moved to a more
private space before resuming. Interviews conducted with service providers were also
confidential as they were asked to discuss issues of service philosophy and practice that could
have been considered contentious within the workplace. However, for the most part, the
majority of service providers were at ease being interviewed in a public environment such as
a café. All of the services involved in this research remain anonymous and I have not named
the suburb in Melbourne in which the majority of interviews took place. This ensures that any
critique of service practice is not seen as specific to a particular service. It also ensures that
service providers who were interviewed cannot be identified. All those who took part in the
research were asked to choose a pseudonym and this was used to identify their data. All
printed data were kept in a locked cabinet accessible only to me.

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Informed consent
A participant information sheet outlining the purposes of the research and the implications of
participation was prepared in plain language (see Appendix B). Participants were given this
sheet prior to the interview and oral or written consent was obtained after reading the plain
language statement and before commencing the interview. At all stages of the research,
participants were able to withdraw their consent to participate, however, none did so. As 13
participants were recruited through services at which they were undertaking drug treatment,
the participant information sheet stated that taking part in the research was not a requirement
for access to these services and that declining to take part in the research would have no
impact on service access.

Interviewee distress
In case people became distressed during the interviews, I established a set of procedures
including the provision of harm reduction information and the contact details of counselling
or other drug services if required. These procedures have been implemented in previous
research involving people who use drugs (Neale, Allen, & Coombes, 2005). None of my
interviewees became noticeably distressed as a result of the interview despite, at times,
relating distressing events in their lives. On a few occasions during or after an interview I was
asked for my ‘professional’ opinion on a particular drug treatment or drug. In these cases I
usually gave participants the contact details of a 24-hour AOD counselling and advice
service.

Conclusion
Methamphetamine and people who use this drug are currently understood in particular ways.
Most biomedical, public health and a body of sociological literature addresses
methamphetamine as a ‘matter of fact’, reifying it as a potent and dangerous object. People
who use methamphetamine are enacted as highly transgressive, addicted or at risk of
addiction and always in need of intervention. These fixed and pejorative identities contribute
to the marginalisation of these individuals. Further, this literature explains the social,
economic and health problems they may experience in terms of their purported relationship to
the consumption of methamphetamine. This effectively locates responsibility for these
problems within the individual drug user and negates the requirement of a collective response
to any disadvantage they may experience.

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My aim with this research was to investigate the ontological politics of methamphetamine.
That is, to show how dominant discourses and practices constitute methamphetamine and
methamphetamine users and how, at the same time, these are resisted and subverted. I
achieve this by examining authoritative texts and tracing the ways in which these constitute
methamphetamine and methamphetamine-using subjects. Contradictions, slippages and the
inscription of materiality in these texts are foregrounded. I also address methamphetamine-
related practices in a way that acknowledges the multiplicity and complexity of the world. I
undertook individual interviews, treating these as lay ethnographer accounts, constituted
through interactions between the interviewees and myself, as well as myriad spatial and
temporal aspects. Analysing these accounts, I consider methamphetamine and
methamphetamine-using subjects as located within assemblages of objects, subjects, spaces,
networks and institutions. I show what these assemblages enact, spotlighting the multiple
subjects and objects constituted through localised networks of methamphetamine-related
practice. In describing the effects of hegemonic understandings of methamphetamine on these
materialisations, the political and contested nature of realities is illuminated.

A post-structuralist and STS sensibility assumes that research itself enacts realities, and the
realities it produces are the result of, among other things, the patterns and themes that the
researcher has chosen to amplify. As such, this research is only a fragmented and partial
rendering of methamphetamine-related practice. It makes some things present, and in doing
so, makes others absent. In noting what is present and potentially made absent or othered,
however, I aim to remain cognisant of the political implications of realities and produce a text
that does not marginalise or pathologise people who use methamphetamine.

The following chapters are ordered to give consideration first to the object
‘methamphetamine’ and then to the practices that enact it. In the first of my empirical
chapters, Chapter Four, I describe the way methamphetamine is enacted in scientific practice
and authoritative texts. Chapter Five describes the enactment of methamphetamine-using
subjects in policy and treatment practice. Chapter Six describes methamphetamine-using
practices and how they materialise particular subjects and methamphetamine. Chapter Seven
describes harm reduction and treatment practices and their materialisations.

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Chapter 4: Methamphetamine ‘facts’: The production of a ‘destructive’

drug in scientific texts

Introduction
This chapter addresses the first of my research questions: how are methamphetamine and
methamphetamine consumers constituted in scientific, policy, treatment and media
discourse? I analyse the ways in which methamphetamine, its use and those who consume it
are discursively produced in scientific research.6 I do this because scientific discourse plays a
key role in the enactment of ‘methamphetamine’, and shapes how the drug is understood in
policy and practice.7 In this chapter, I argue that scientific texts enact methamphetamine as a
specifically destructive drug and constitute users of this drug as uniquely problematic.
Although I focus on Australian research in my discussion, some of the methods, assumptions
and analytical trends that I identify can also be found in international research on
methamphetamine. In particular, neurological research on AOD addiction is almost
exclusively driven by researchers from the US and so, when addressing this issue, I refer to
US research.

In making my argument I draw on several insights from STS. These were discussed at length
in the previous chapter but here I briefly revisit them in order to make explicit the theoretical
underpinnings of the analysis presented this chapter. First, STS conceptualises science as a
form of cultural practice no different from other cultural endeavours such as art and religion
(Latour, 2004; Latour & Woolgar, 1986). Thus the outcomes of scientific practice — ‘facts’
— are worthy of interrogation and should not be considered a ‘sphere of incontestable
knowledge’ (Jasanoff, 2011, p. 11). The facts produced by scientific practices do not merely
describe an anterior reality but are constructed and contingent. They involve ‘slow, practical
craftwork’ (Latour & Woolgar, 1986, p. 236) and supportive technical apparatus. These act as
‘inscription devices’, which Latour and Woolgar (1986) defined as:
any item of apparatus or particular configuration of such items which can transform a
material substance into a figure or a diagram which is directly useable. (p. 51)
In order for a fact to materialise, all evidence of its inscription process must disappear, and a
shift must occur ‘whereby an argument ha[s] been transformed from an issue of hotly
contested discussion into a well-known and noncontentious fact’ (Latour & Woolgar, 1986,
                                                            
6
See (Dwyer & Moore, 2013) for a related analysis of the production of methamphetamine psychosis in
Australian public discourse and consumer accounts.
7
For example, the Australian national policy on drugs makes a ‘strong commitment to … evidence- informed
practice, innovation and evaluation’ (Ministerial Council on Drug Strategy, 2011).

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p. 76). Such work emphasises (1) the made-ness of facts as the material world is transformed
into a stable object of scientific study; and (2) the contingency of facts — alternative ways of
knowing the material world are always possible using different inscription devices.

The second insight from STS focuses on the performative dimension of scientific practice
(Latour, 1999; Law, 2004; Mol, 1999), in which reality is conceived as fluid and multiple.
This insight extends the idea that science is the construction of facts, objects and a singular
and stable reality, by positing that scientific practices continually enact and re-enact multiple
realities. Whereas the concept of construction implies that ‘an object has been constructed’
(Law, 2004, p. 56) and is therefore closed or completed — it has ‘become’ — ‘enactment’ or
‘practice’ (Mol, 1999, p. 77) emphasises the ongoing, never completed, practice of
inscription. Realities, thus, depend upon ‘continued crafting’ (Law, 2004, p. 56). Further,
there is no essential, singular object or reality to be discovered beneath these inscriptions;
reality is a multiple phenomenon. Law (2004) states:
If we attend to practice and to objects we may find that no objects are ever routinised
into a reified solidity. We may find that there are no irrevocable objects bedded down
in sedimented practices...And if things seem solid, prior, independent, definite and
single then perhaps this is because they are being enacted, and re-enacted, and re-
enacted, in practices. Practices that continue. And practices that are multiple. (p. 56)

A third insight from STS relates to the politics of realities. Law (2004, p. 27, 96) argues that
specific facts emerge from hinterlands, which he defines as ‘network[s] of other statements,
materials and practices’. Therefore, realities are not enacted arbitrarily but materialise in
accordance with previously accepted truths and knowledge. Inscription devices — which
Law (2004, p. 29) defines as ‘a set of arrangements for labelling, naming and counting’ —
are a crucial component of hinterlands. Scientific knowledge is generated by a ‘single
authorised set of inscription devices’ (Law, 2004, p. 32), obscuring the multiplicity of reality
and enacting a singular and highly authoritative version of the world.

The final insight from STS concerns the distinction between ‘matters of concern’ and
‘matters of fact’ (Latour, 2004, p. 231). Responding to critiques of his earlier work on the
social construction of scientific knowledge, Latour (2004) argues that scholars have
misunderstood him to be suggesting that all facts are fabricated and lacking any material
basis:

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The question was never to get away from facts but closer to them, not fighting
empiricism but, on the contrary, renewing empiricism. (p. 231, emphasis in original)
Here Latour calls for a renewed empiricism, one that would attend to the complexity of
reality, scrutinising facts and expanding upon their materiality. As it stands, Latour argues
that facts are related to the material world but ‘are only very partial…very polemical, very
political renderings of matters of concern’ (Latour, 2004, p. 232). By critiquing facts and
expanding upon their relationship to the material world, Latour seeks to turn matters of fact
back into collective matters of concern. This means finding ways, such as a renewed form of
empiricism, to describe matters of concern in the world without reducing them to
incontestable matters of fact.

I draw on these insights to analyse the enactment of methamphetamine in scientific texts,

focusing mainly on Australian research. This does not mean that I see the body of evidence
on methamphetamine as fabricated or as having no material basis. Rather, my interest is in
how specific realities of methamphetamine and its use come to be enacted as scientific facts
by particular inscription devices and hinterlands, and the political effects of these enactments
for people who consume methamphetamine.

Enacting methamphetamine in Australian scientific literature

Methamphetamine emerged as a new problem in Australia during the late 1990s and early
2000s with police seizure data suggesting that this form of amphetamine had supplanted
amphetamine sulphate as the dominant Australian type (Australian Crime Commission,
2001). The identification of methamphetamine as an emerging problem in Australia spawned
numerous studies that sought to establish its prevalence, quantify the types and levels of harm
relating to its use, and identify and evaluate the available treatment options (see Appendix A).
Although identified as new in the Australian context, by 2002 methamphetamine was already
well established as a drug of scientific interest internationally. The scientific texts existing at
that time identify methamphetamine use as widespread in the US, especially in Hawaii
(Freese, Obert, Dickow, Cohen, & Lord, 2000; Wolkoff, 1997) and the mid-Western states
(Rawson et al., 2002) , as well as in Japan (Suwaki, 1997; Tsuchihashi et al., 1997), China,
Indonesia, Thailand and the Philippines (Farrell, Marsden, Ali & Ling, 2002). In these texts,
methamphetamine use is repeatedly described as an ‘epidemic’ (Farrell et al., 2002, p. 771;
Freese et al., 2000, p. 177; Rawson et al., 2002, p. 145), or as ‘extensively abused’
(Tsuchihashi et al., 1997, p. 1796). Other international texts state that methamphetamine is a
more potent form of amphetamine that is associated with ‘structural abnormalities’ in the
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brain (Thompson et al., 2004, p. 6028), neurocognitive ‘impairment’ (Kalechstein, Newton,

& Green, 2003, p. 215) and poor physical health (Greenwell & Brecht, 2003). This body of
existing scientific knowledge produced methamphetamine in very specific ways, and
provided an established set of facts about methamphetamine — a hinterland (Law, 2004) —
that Australian researchers referenced and extended in their work.

In analysing scientific texts on methamphetamine, I focus on four claims that help to produce
methamphetamine as a new and destructive drug: that (1) methamphetamine is more potent
than other amphetamines, (2) methamphetamine is associated with dependence, (3)
methamphetamine is harmful, and (4) crystalline methamphetamine (ice) is more harmful
than other forms of methamphetamine. I have selected these claims for analysis because they
are made repeatedly in the scientific literature. Furthermore, because these claims are
ubiquitous in scientific discourse, they actively shape understandings of methamphetamine in
policy, practice and public discourses. In order to attend to these claims, I was guided by the
work of Latour & Woolgar (1986) and their scrutiny of scientific practice. Scientific articles
were selected on the basis that they contributed significantly to a particular claim. These texts
were then carefully examined for contradictions in the cited evidence, inscriptions of
methamphetamine’s materiality and instances of ‘literary inscription’ (Latour & Woolgar,
1986, p. 76). In some cases I carried out additional searches. For instance, in some articles, I
traced a path of inscription back through earlier publications cited as evidence for various
claims about methamphetamine.

Methamphetamine is potent
The first claim I investigate is that methamphetamine is a specifically potent drug. This claim
is often made to justify the assessment of methamphetamine as uniquely ‘destructive’ (Topp
et al. 2002a). Moreover, methamphetamine is delineated from amphetamine by asserting it is
more potent. For example, Kaye and colleagues (2008) state:
Following a shift in the mid-1990s from the production and supply of amphetamine to
the more potent methamphetamine, as well as increases in the availability and use of
high purity crystalline methamphetamine, there has been a marked increase in
methamphetamine-related problems (McKetin, 2007). (Kaye, Darke, Duflou, &
McKetin, 2008, p. 1353)
The following statement is repeated in two separate articles concerning methamphetamine:
Compared with amphetamine, methamphetamine has proportionally greater central
stimulatory effects than peripheral circulatory actions (Chesher, 1993), and is a more

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potent form with stronger subjective effects. (Degenhardt & Topp, 2003, p. 17; Topp
et al., 2002a, p. 342)
These statements assert the specificity of methamphetamine on the basis of its greater
potency — it is a ‘hyper’ stimulant — stronger and more problematic. And yet the assertion
that methamphetamine is ‘potent’ in these statements is tenuous at best. In the first statement
from Kaye et al. (2008) the assertion that methamphetamine is more potent is verified by
citing McKetin (2007); however, the cited text states that methamphetamine is a ‘more potent
analogue’ of amphetamine without citation (McKetin, 2007, p. 24). In the second example
both Degenhardt & Topp (2003) and Topp et al. (2002a) cite a chapter (Chesher, 1993) in a
report funded and published by the Federal Government and the NSW Health Department
(Burrows, Flaherty, & MacAvoy, 1993) to assert that methamphetamine has greater central
stimulatory effects than amphetamines. Reading the chapter by Chesher (1993), one finds this
claim is made without evidence or citation:
It [methamphetamine] has proportionally greater central stimulatory effects than
peripheral circulatory actions. (pp. 11-12)
Chesher (1993) bypasses the step of literary inscription and asserts the potency of
methamphetamine without the required act of citation. It is testament to the authority of
scientific literature, as well as the reputation of methamphetamine itself, that these statements
are left unchallenged, and yet repeatedly made in scientific journal articles.

As I shall show below, measuring a drug’s potency is a difficult task, typically involving
neurological research with animals. While this area of research has not been a major research
focus in Australia, in the US it is ‘a well-funded, state-sponsored specialty’ (Vrecko, 2010, p.
54). There is, for example, a significant body of work originating from the US comparing the
potency of a range of stimulants (see, for example, Hall, Stanis, Marquez Avila, & Gulley,
2008; Sevak, Stoops, Hays, & Rush, 2009; Shoblock et al., 2003). In these experiments
potency per se is not measured; rather, researchers study effects that might indicate potency.
They then measure these effects and present the resulting data as evidence of potency. This
requires that the scientists undertaking these experiments make decisions about how to
conceptualise, and thus measure, the concept of potency. Typically, these experiments aim to
assert that methamphetamine is more potent than other amphetamines, but the results are
rarely unequivocal. For instance, Hall and colleagues (2008) conclude:
These results, in addition to studies with higher doses of these drugs (Shoblock et al.
2003; Segal and Kuczenski 1997), suggest that there are certain conditions where

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METH [methamphetamine] is more potent than AMPH [amphetamine sulphate] at

stimulating behaviour, but the common characterisation of METH as a more potent
psychostimulant is not consistent with the available experimental evidence. (Hall et
al., 2008, p. 478)
This statement recognises that methamphetamine is typically considered a more potent drug
than other amphetamines. However, in noting that this characterisation is not borne out by the
available research evidence, a definitive assessment of methamphetamine’s potency over
other forms of amphetamine is left open.

I now examine the article ‘Neurochemical and behavioral differences between d-

methamphetamine and d-amphetamine in rats’ (Shoblock et al., 2003) because it provides an
example of the work involved in establishing the difference between dextroamphetamine and
methamphetamine. This research sought to delineate these two substances in two ways,
through ‘potency’ and ‘addictive potential’ (p. 367). For the purposes of my argument, I
address only the claim of potency. The researchers measured potency by comparing
locomotor activity after injecting methamphetamine and dextroamphetamine into the brains
of rats (Shoblock et al., 2003, p. 360) and assuming that greater locomotor activity is
associated with higher potency. They measured locomotor activity by observing and
recording the rats’ movements within ‘black, opaque cylindrical photocell activity cages
(diameter 60 cm, three crossing beams)’ (Shoblock et al., 2003, p. 361). If two light beams
were interrupted in succession, this was recorded as one ‘activity count’ (Shoblock et al.,
2003, p. 361). Thus the box, light beams and observation enabled rat activity to be translated
into data. Using these data the researchers were able to make particular claims, and so the
concept of potency becomes a stable object of study.

At the commencement of the article, the authors note the similar chemical structure and
properties of methamphetamine and amphetamine:
METH and AMPH are both phenylethamines, METH being the N-methylated
analogue of AMPH. Besides sharing a similar structure, METH and AMPH share
several pharmacokinetic and pharmacodynamic properties. (Shoblock et al., 2003, p.
359)
Following this, the authors report that, in relation to amphetamine, ‘it is commonly accepted
that METH is more addictive and favoured by drug addicts’ (Shoblock et al., 2003, p. 359).
The authors provide no basis for this statement, demonstrating the pervasiveness of this

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particular understanding of methamphetamine. Nonetheless, the purpose of the article is to

differentiate between the two drugs and in order to demonstrate a need for their study,
Shoblock and colleagues’ explain that:
despite the repeated claims of METH being more addictive or preferred than AMPH,
proven differences between METH and AMPH in addiction liability and in reward
efficacy have evaded researchers. (Shoblock et al., 2003, pp. 359-360)
This statement acknowledges that while it is claimed that methamphetamine is more
addictive and potent than amphetamine, researchers have not yet been able to prove this.

When the results of the research are presented by the authors in this text, it is apparent that
they do not reflect the ‘commonly accepted’ properties of methamphetamine. According to
the results, amphetamine produced greater locomotor activity in the rats than
methamphetamine, leading the authors to conclude:
In contrast with the well accepted view, we conclude that METH is not a greater
central psychomotor stimulant compared to AMPH, at least not in female rats.
(Shoblock et al., 2003, p. 366)
At this point, the researchers discuss the origins of the assumption that methamphetamine is
more potent than amphetamine. By referring to older texts, they conclude that previous
research was flawed and cast doubt on the claim that methamphetamine is a more potent
drug:
Examination of the literature finds no evidence in any behavioural paradigm that METH
has greater central stimulatory effects compared to AMPH. (Shoblock et al., 2003, p.
367)
However, given the strong statements made at the commencement of the text about the
potency of methamphetamine, it is difficult to understand why the researchers do not make
more of this finding. It is notable that in the conclusion of the article and the abstract, this
finding is not mentioned. Instead, in the conclusion the authors focus on the implications of
their findings for methamphetamine addiction (p. 367).

This article is an example of the work involved in crafting ‘facts’ and of how materiality is
inscribed to make claims about the world. In this case, the movement of rats was translated
into data that inscribed methamphetamine in a specific way. However, the article also
demonstrates the interplay between the scientific hinterland and more lay understandings.
Shoblock and colleagues downplayed their finding that methamphetamine was less potent

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than amphetamine. Perhaps this was because it did not fit with the way in which the
hinterlands of the mass media and addiction research generally understand
methamphetamine.

Methamphetamine and dependence

The second major claim I examine concerns dependence. At approximately the same time as
methamphetamine was increasingly being identified as an illicit stimulant of concern in
Australia, several journal articles and technical reports defining amphetamine as a drug of
dependence were published (see Topp & Darke, 1997; Topp & Mattick, 1997a; Topp &
Mattick, 1997b; Topp, Mattick, & Lovibond, 1995). While much of the evidence regarding a
dependence syndrome was established in relation to amphetamine, this evidence was readily
applied to methamphetamine even as intensive efforts were underway to establish
methamphetamine as different from amphetamine (Hall et al., 2008; Sevak et al., 2009;
Shoblock et al., 2003). Consider, for example, the following statement (Topp et al., 2002b, p.
153):
Although historically the subject of much debate, the existence and destructive nature
of a methamphetamine dependence syndrome, comparable to that long acknowledged
to exist for alcohol and heroin, was recently documented (Topp & Darke, 1997; Topp
et al., 1998; Topp & Mattick, 1997a, 1997b).
I draw attention to two aspects of this quotation. First, all of the articles and reports cited as
documenting the existence of a ‘methamphetamine dependence syndrome’ deal specifically
with ‘amphetamine’. This re-labelling of amphetamine as methamphetamine is widespread
(McKetin, Kelly, & McLaren, 2006a, p. 199) and points to a tendency to distinguish
methamphetamine and amphetamine in accounts emphasising the rise of a new, more potent
and more harmful drug — methamphetamine — but to collapse them in other contexts and
for specific strategic purposes (for example, when the evidence relating specifically to
methamphetamine is limited or unavailable).

Second, it provides a glimpse into the production of the ‘fact’ of methamphetamine

dependence, while at the same time reinforcing this ‘fact’. In the first part of the statement,
the authors refer to the previous ‘debate’ regarding the existence of the ‘methamphetamine
dependence syndrome’ (even though the cited evidence relates to amphetamine rather than
methamphetamine). Having acknowledged this debate, the second part of the statement
ignores it by treating the methamphetamine dependence syndrome as a ‘documented’ fact.
This discursive move achieves its aim by ‘drawing attention to the (mere) processes of

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literary inscription [in order to] make the fact possible’ (Latour & Woolgar, 1986, p. 76). In
other words, by the act of citation — referring to articles that ‘recently’ inscribed a
methamphetamine dependence syndrome — this fact is (re)produced.

One reason for the controversy regarding the original amphetamine dependence syndrome
was the apparent absence of physical withdrawal following prolonged amphetamine use.
While earlier understandings of addiction included both physical and psychological
dimensions (Room, 1985), particular significance had been attributed to the physical
manifestations of addiction (Keane, 2002). In order for amphetamine to be enacted as a drug
of addiction, the psychological components were emphasised while the physiological aspects
were downplayed. Topp and Mattick (1997a) argued that defining amphetamine dependence
in this way was the result of changing ideas concerning the nature of dependence. These
changes, while retaining physical tolerance and withdrawal in the definition of dependence,
attached:
greater importance to symptoms such as a compulsion to use, a narrowing of drug-
using repertoire, rapid reinstatement of dependence after abstinence, and the high
salience of drug use in the user’s life. (Topp & Mattick, 1997a, p. 839)
Thus, the authors draw attention to the shift in the understanding of addiction, driven by
changing opinions that enabled the inscription of amphetamine as a drug of dependence.

The shift towards emphasising the psychological aspects of dependence expanded the
‘conditions of possibility’ (Mol, 1999, p. 75) within which the fact of amphetamine
dependence could be established. At the same time, previous facts, such as the dependence
syndrome associated with cocaine use, were part of a hinterland that could support the
concept of amphetamine dependence. In the following statement, Topp and Darke (1997)
note the similarity between the cocaine and amphetamine dependence syndromes:
Compulsion to use is an integral component of the amphetamine dependence syndrome,
which fits well with results that have identified preoccupation as the central feature of
cocaine dependence. (p. 117)
With this statement, we see how the establishment of the amphetamine dependence syndrome
is, in part, assisted by previous claims regarding cocaine dependence. The concepts of
compulsion and preoccupation, already well established as integral to cocaine dependence,
provide a ready-made framework for characterising amphetamine dependence.

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In addition to redefining the central features of dependence, the identification of an

amphetamine dependence syndrome required the adaptation of existing, or development of
new, inscription devices for researching and classifying the practices of methamphetamine
use. As Cho and Melega (2001) state:
The modelling of human METH abuse patterns is complicated by the lack of accurate
data, especially when it is derived anecdotally from reports by drug abusers. (p. 29)
Inscription devices that translate methamphetamine ‘abuse patterns’ into stable objects of
study include the Severity of Dependence Scale (SDS) (Gossop et al., 1995; Topp & Mattick,
1997a), the Severity of Amphetamine Dependence Questionnaire (Topp & Mattick, 1997b)
and the Diagnostic and Statistical Manual of Mental Disorders (DSM) (American Psychiatric
Association, 2013). These devices allow the inscription of methamphetamine consumption as
‘non-dependent’, ‘dependent’ and ‘severely dependent’.

Translated into these categories, methamphetamine consumption becomes a stable object of

investigation. This investigation involves diagnosing methamphetamine dependence and,
therefore, the dependent/non-dependent binary is a central variable for analysis in research
reports and journal articles that concern methamphetamine use (Glasner-Edwards et al.,
2008a; Glasner-Edwards et al., 2008b; Gonzalez et al., 2009; Kalechstein et al., 2003;
Kalechstein et al., 2000; Kinner & Degenhardt, 2008; McKetin et al., 2006a; McKetin et al.,
2006b; Newton, De La Garza, Kalechstein, Tziortzis, & Jacobsen, 2009; Payer et al., 2008;
Zweben et al., 2004). These reports and other methamphetamine-related research describe
methamphetamine dependence by linking dependence to a range of other pathologies, such as
trauma, depression, anxiety and psychosis, through measures of statistical significance. For
instance, Messina and colleagues (2008) describe dependent methamphetamine users in terms
of a comprehensive list of pathologies. The authors administer the Mini-International
Neuropsychiatric Interview (MINI; Sheehan et al., 1998) to their sample of dependent
methamphetamine users, which determines:
psychiatric conditions and symptoms in 16 domains (major depressive episode;
dysthymia, suicidality, manic/hypomanic episode; panic disorder, agoraphobia, social
phobia, obsessive-compulsive disorder, posttraumatic stress disorder, alcohol abuse and
dependence, substance abuse/dependence, psychotic disorders, anorexia nervosa,
bulimia nervosa, generalised anxiety disorder and antisocial personality disorder).
(Messina et al., 2008, p. p 403)

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This exhaustive list of pathologies is applied to already marginalised subjects and, invariably,
serves to further compound the stigmatised identity of the ‘dependent methamphetamine
user’.

This body of work reinforces both the pathologised identity of people who use
methamphetamine and, through repetition, the concept of dependence itself. Yet, as the texts
considered previously indicate, it is apparent that the definition of ‘addiction’ has subtly
shifted. This demonstrates that methamphetamine addiction is not a pre-existing condition
that has been revealed through science. Rather, scientific craftwork has enacted this condition
by placing greater emphasis on the psychological aspects of addiction, and by referencing a
hinterland involving the materiality of cocaine. It is this shift that has enabled the materiality
of methamphetamine to be relocated within the addictive/non-addictive binary, and the
subsequent pathologisation of methamphetamine ‘addicts’.8

Methamphetamine is harmful
The third major claim in scientific texts that I examine concerns methamphetamine-related
harm. In addition to establishing methamphetamine (and amphetamine before it) as a drug of
dependence, the scientific literature has also attempted to establish the facts of
methamphetamine-related harm. In Australia, multiple journal articles published since 2002
identify and measure a range of harms deemed to be associated with methamphetamine use
(Darke et al., 2008; Degenhardt et al., 2008; Degenhardt & Topp, 2003; Kinner &
Degenhardt, 2008; Rawstorne, Digiusto, Worth, & Zablotska, 2007). The concept of ‘harm’
is far from straightforward, however, as the following example demonstrates. Two articles
that examine the harm associated with methamphetamine are ‘Major physical and
psychological harms of methamphetamine use’ (Darke et al., 2008) and ‘The epidemiology of
methamphetamine use and harm in Australia’ (Degenhardt et al., 2008). Although these
articles originated from the same research centre and were published in the same volume and
issue of the journal Drug and Alcohol Review, they make very different claims regarding the
‘harm’ related to methamphetamine use.

The first article, by Darke and colleagues (2008), outlines an extensive list of physical and
psychopathological harms associated with methamphetamine use. Physical harms include
toxicity, cardiovascular and cerebrovascular pathology, dependence and the transmission of
                                                            
8
 This is by no means specific to methamphetamine use. Eve Sedgwick (1992) and Helen Keane (2002) have
comprehensively documented the widespread desire to understand substance use and a range of other
behaviours as addictive. 

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blood-borne viruses.9 Psychopathological harms include psychosis, depression, suicide and

anxiety, violent behaviours and neurotoxicity. Darke and colleagues (2008) conclude by
stating that:
this is a drug class that causes serious heart disease, has serious dependence liability
and high rates of suicidal behaviours. The current public image of methamphetamine
does not adequately portray the extensive, and in many cases insidious, harm it
causes. (p. 259)
In this quotation, methamphetamine is constituted as a destructive and dangerous drug. This
is a drug that causes ‘serious’ and ‘specific’ harms (Darke et al., 2008, p. 254). The use of the
term ‘insidious’ implies that there is malicious intent involved in methamphetamine harms,
attributing a treacherous agency to the substance itself. The concluding sentence warns that
the effects of methamphetamine are not taken seriously by the public and that as a
consequence methamphetamine has a more benign reputation than it deserves.

The second article, by Degenhardt and colleagues (2008), also reporting on the harms of
methamphetamine use, presents a very different set of facts. In the article’s introduction, the
authors refer to the public perception of methamphetamine and suggest that ‘unbalanced
reporting’ (Degenhardt et al., 2008, p. 244) has contributed to increased concern about the
nature and scale of methamphetamine use and harm. In other words, rather than having an
undeservedly benign reputation, the authors of this article suggest quite the opposite; that the
effects of methamphetamine are not as destructive as they are portrayed in the media.

Degenhardt and colleagues’ article focuses on the available types of methamphetamine and
their use among the general population before presenting data on harm. One of their
conclusions (Degenhardt et al., 2008) is that:
other indicators of meth/amphetamine-related harm did not show the dramatic
increases that might have been expected given recent media attention, with indicators
stabilising over recent years. (p. 250)
While the authors of this article readily acknowledge that there are issues of concern
regarding methamphetamine, such as the availability of ‘stronger forms’, they offer the
following conclusion about the effects of methamphetamine use among the Australian
population (Degenhardt et al., 2008):

                                                            
9
 Note that despite the extensive earlier work on the importance of the psychological component in
methamphetamine dependence (by colleagues in the same research centre), ‘dependence’ is listed as a ‘physical’
harm. 

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Concerns about harms related to methamphetamine, while deserved, must be placed

within the context of harm related to other illicit drugs, as well as population level
use. (p. 250)
This conclusion regarding methamphetamine-related harm is markedly different from that of
Darke and colleagues (2008). Rather than understanding methamphetamine as responsible for
extensive and insidious harms, Degenhardt and colleagues suggest that such harms should be
kept in perspective.

How should we understand these multiple enactments of methamphetamine and harm? They
illustrate my argument that scientific facts are inherently political forms of craftwork. For
example, they involve decisions about data, methodological and analytical techniques, and
interpretation. Although Darke and colleagues (2008) produce methamphetamine as an
underestimated drug that causes extensive and insidious harms, Degenhardt and colleagues
(2008) produce methamphetamine as a drug whose harmful effects are overestimated. Given
the widespread view that methamphetamine is a potent, highly addictive and harmful drug, it
seems no coincidence that Darke et al. (2008) has a much higher citation count in Google
Scholar (223 citations) than Degenhardt et al. (2008) (69 citations) (Google Scholar search
conducted on 8 August 2014). Darke et al’s (2008) higher citation rate perpetrates the
perception that the article itself is a more authoritative text on methamphetamine. It also
indicates the findings of this article are more strongly broadcast.

Ice is more harmful than other forms of methamphetamine

The final major claim I discuss is that ice is more harmful than other forms of
methamphetamine. As I have argued above, methamphetamine is enacted within scientific
texts as different from amphetamine in that it is more potent and addictive. Yet
methamphetamine itself takes multiple forms, and scientific literature elaborates on the
specificity of each of these forms. Four forms of illicitly manufactured methamphetamine are
typically described: pills, base, powder and crystalline methamphetamine. Of these four
forms, crystalline methamphetamine (ice) is considered purer, and thus more potent, than
other forms of methamphetamine (Degenhardt & Topp, 2003; Fairbairn et al., 2008; Leonard,
Dowsett, Slavin, Mitchell, & Pitts, 2008; McKetin et al., 2006a; Topp et al., 2002a). Further,
in ascribing a greater potency to ice, it is claimed to have a greater capacity to cause harm
(Cho, 1990; Fairbairn et al., 2007; Fairbairn et al., 2008; Kinner & Degenhardt, 2008;
McKetin et al., 2006a; Topp et al., 2002a).

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A key Australian article investigating the relationship between crystalline methamphetamine

and one form of harm – dependence – is that authored by McKetin et al. (2006a). The authors
justify their research by citing an earlier US study (Cho, 1990):
Cho (1990) attributed the addictive nature of crystalline methamphetamine to its high
purity, and also to the fact that it can be smoked or ‘chased’, which causes an intense
drug effect similar to intravenous administration. Despite this view, there has been no
empirical investigation of whether crystalline methamphetamine users are more likely
to report symptoms of dependence than people who use other forms of
methamphetamine. (McKetin et al., 2006a, p. 199)
However, a close examination of Cho’s text reveals that, although he describes crystal
methamphetamine’s dangers and refers to ‘compulsive abusers’ (p. 634), at no point does he
state that it is an addictive drug or refer to its addictive nature. Cho’s (1990) main point is
that the ice problem is not new. He claims that it is ‘a slightly different form of drug abuse
problem that has been around for decades, if not centuries’ (p. 634). He points out that the
form this stimulant takes, and the way in which it is consumed, may lead to a range of
problems but addiction is not mentioned. McKetin and colleagues (2006), however, in a
subtle reframing of Cho’s comments, present the addictive nature of crystalline
methamphetamine as an established fact. Confusingly, they then state there has been no
empirical investigation of this ‘view’ and this serves as a justification for the research that
they report. This particular interpretation of Cho’s commentary on ice further inscribes this
drug as addictive and possessing destructive properties.

Further examination of the text produced by McKetin and colleagues reveals some of the
ways in which ‘facts’ are produced through the inscription of drug use practices. On the basis
of their research, McKetin et al. (2006) argue that:
crystalline methamphetamine users are more likely to be dependent on
methamphetamine than their counterparts who use other forms of the drug. (p. 203)
In order for the researchers to reach this conclusion, it is first necessary for crystalline
methamphetamine use to become a stable object of study. This was accomplished by creating
two groups of research participants: those who used crystalline methamphetamine and those
who did not. These two groups could then be compared and differences described in order for
conclusions to drawn about the nature of crystalline methamphetamine. Participants were
categorised as ‘crystalline methamphetamine users’ if they had used this form of
methamphetamine in the previous 12 months. In this group, 63% of people seemed to be

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regular and even ‘heavy’ users of the drug, using crystalline methamphetamine in the month
prior to the research interview, for a median of 5 days (McKetin et al., 2006a, p. 200).
Conversely, this also means that it is possible that the remaining 37% of people in this group
may have used crystalline methamphetamine only once in the previous 12 months. These
participants, despite using crystalline methamphetamine very infrequently, are still
categorised as crystalline methamphetamine users. Further, as the use of other forms of
methamphetamine such as powder and/or base is disregarded in the analysis, it is also
possible that members of the crystalline methamphetamine-using group may have used
greater amounts of powder methamphetamine and/or base than crystalline methamphetamine.
The authors note this issue and state that:
A further consideration is that most crystalline methamphetamine users also took
other forms of the drug (i.e. so-called ‘base’ methamphetamine and powder
methamphetamine, or ‘speed’), and were not exclusively crystalline
methamphetamine users. (McKetin et al., 2006a, p. 203)
This acknowledgement does not, however, lead the authors to be more careful or nuanced in
their conclusions concerning crystalline methamphetamine users.

Close examination of the processes through which people are classified as crystalline
methamphetamine users shows the choices and work involved in translating crystalline-
methamphetamine-using practices into an object of scientific study. I argue that in the process
of translation from consumption to research object, McKetin and colleagues (2006a) simplify
crystalline methamphetamine use to the point where it becomes almost meaningless.
Nonetheless, the authors make several claims about people who use ice. Not only do they
find that crystalline methamphetamine users are more prone to dependence, they conclude
that, as a result, members of this population are ‘hard to treat’ (McKetin et al., 2006, p. 203).
They further argue that increased levels of dependence will be ‘likely to contribute to the
complex nature of psychopathology encountered when treating crystalline methamphetamine
users’ (p. 203). Thus, despite the loose eligibility criteria, the authors inscribe crystalline
methamphetamine users generally as prone to addiction and as complicated and difficult
people to treat. Given the problematic categorisation of participants in the research these
conclusions seem to offer little insight into the nature of crystalline methamphetamine or the
people who use it, but contribute instead to the enactment of ice users as a specifically
pathological and difficult group of drug users.

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Topp and colleagues (2002a) also address the use of ice in Australia and make claims
regarding its harms. This text draws on data collected via the Illicit Drug Reporting System
(IDRS)10 in order to assess the impact of crystalline methamphetamine. Key informants (KIs)
are a key data source for the IDRS; they are defined as those having professional ‘contact
with a minimum of 10 different drug users and/or weekly contact with drug users in the 6
months preceding the interview’ (Topp et al., 2002a, p. 343). In this particular article, the
interviewed KIs (who are quoted extensively) included ‘general health workers, treatment
workers, law enforcement officers, outreach workers and drug users group representatives’
(Topp et al., 2002a, p. 343). They report the following finding:
All KIs who commented on side effects agreed that those methamphetamine users
accessing the more potent forms tended to experience greater psychological and
physical damage related to their use. These users were consistently described as more
chaotic, more paranoid, more aggressive, more agitated, more damaged, harder to
engage, more unkempt, more ‘hardcore’, ‘messier’ and generally much harder to deal
with than users of methamphetamine powder. It was also agreed unanimously that the
psychological and physical health declines among users of the potent forms of
methamphetamine were far more rapid than among users of methamphetamine
powder (speed). (Topp et al., 2002a, p. 346)
While the opinions of workers in the AOD field are undoubtedly important, strong and
unqualified claims are made here about the putative effects of crystalline methamphetamine.
For example, what is meant by the use of pejorative adjectives such as ‘chaotic’, ‘more
damaged’, ‘messier’ and ‘hardcore’ to describe people who use crystalline
methamphetamine? These terms have no technical meaning or application in the AOD field
and, in this instance, serve only to enact the ice user as a subject to be feared. It is difficult to
understand why the authors have included such subjective descriptions, which serve only to
materialise a frightening subject — that of the ice user. Later in the article, Topp and
colleagues offer a caveat of sorts with the statement:
although key informant reports provide a sensitive measure of emerging drug trends,
they are also necessarily anecdotal and subjective. (Topp et al., 2002a, pp. 346-347)
Nonetheless, the opinions of the workers have been inscribed and so act to construct an
understanding of crystalline methamphetamine as a dangerous drug, and crystalline
methamphetamine users as an unmanageable population of service users.

                                                            
10
See Dwyer and Moore (2010) for a critique of the IDRS methodology.

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The legitimacy given to KI opinions by literary inscription is demonstrated by their repetition

in other scientific texts. In a later article, Degenhardt and Topp (2003) argue that crystalline
methamphetamine users would be likely to report similar or higher rates of side effects than
users of powdered methamphetamine. To bolster their argument, they cite the publication
discussed above (in which they are the first and second authors) and state that:
This [finding] would be consistent with findings of the IDRS, whose key informants
(persons with regular, recent contact with drug users) noted that compared with powder
methamphetamine users, users of crystal meth were more likely to develop problems
more quickly (Topp et al, 2002). (Degenhardt & Topp, 2003, p. 23)
Thus, through self-citation, inscription and repetition, the varied opinions of a disparate group
of people, the IDRS key informants, some of whom may have had little sustained contact
with methamphetamine users and perhaps developed adversarial relationships with them
(such as police), become scientific ‘fact’. These claims are derogatory in nature and enact
highly marginalised subjects, who are represented as more problematic than other drug users.
In this sense, the authority granted to these statements through publication is particularly
concerning.

Conclusion
The substance ‘methamphetamine’ has been constituted in scientific texts as a hyper-
stimulant — dependence-producing and harmful, with crystalline methamphetamine
inscribed as a specifically potent and destructive form of the drug. My intention in exploring
these claims has not been to reveal the truth about the nature and effects of this drug; rather, I
have sought to explore the scientific practices through which methamphetamine is
transformed from a matter of concern into a matter of fact (Latour, 2004). In doing so, I have
traced some of the work involved in establishing these claims as scientific facts. I have also
sought to underline the contingency of facts, as contradictory statements come to light and
rhetoric is employed to support various claims and beliefs about the drug. Through careful
scrutiny of the scientific literature, it is possible to make visible the contradictions and
political choices being made in the haste to generate knowledge about this drug. While
science claims to document an anterior reality, it is evident that the materiality of
methamphetamine has been inscribed to reflect a dominant hinterland of understandings
concerning illicit substances. Because of the existing discourses, practices, substances and
institutions that constitute the field of illicit drug use, it is difficult for science to make
methamphetamine otherwise. If dependence is redefined to include psychological aspects,

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then methamphetamine can be understood as a drug of dependence. If methamphetamine use

is inscribed according to the dependence/non-dependence binary, the diversity of patterns of
use and experiences are ignored. Only the practices of methamphetamine consumption that
lead to dependence can be described. Indeed, dependence itself can be described and
understood through its linkages to a network of pathologies. Invariably, the state of
dependence is characterised by increased pathology as is consumption of allegedly more
potent forms of methamphetamine — specifically ice. Thus, these ways of studying
methamphetamine enact those who use the drug in pathologised and pejorative ways, and
reify the drug itself as a potent substance that results in insidious and specific harms.

The ‘facts’ of methamphetamine contribute to the evidence base upon which

methamphetamine policy and practice draws. As Fraser and Moore (2011) have argued, this
is not a simple process; these documents in turn problematise methamphetamine and, in the
case of policy at least, reproduce it as simultaneously a known and dangerous drug and
poorly understood and documented. Additionally, the facts of methamphetamine contribute to
the wider hinterland of drugs, and the four claims examined in this chapter are readily found
in texts and resources concerning methamphetamine as well as in public discourse.
Sometimes these claims are referenced explicitly, such as when a federally funded treatment
guide (Jenner & Lee, 2008) advocates the use of the SDS (Topp & Mattick, 1997a) as a tool
for the assessment of methamphetamine dependence. However, more broadly these claims
are not explicated but underlie statements such as the following:
A large proportion of ATS dependent people will experience psychological problems
including anxiety, depression and psychosis. (Ministerial Council on Drug Strategy,
2008, p. 6)
This statement, found in Australia’s national ATS policy, is only possible because of the
scientific work that has inscribed methamphetamine in specific ways. As such, this work
contributes to discourses that ‘undergird’ policy, practice and attitudes that stigmatise and
scapegoat people who use drugs (Tupper, 2012, pp. 481-482). In this way, although the
production of methamphetamine ‘facts’ purportedly aims to document methamphetamine-
related harm, it also contributes to the pathologisation and further marginalisation of people
who use the drug, impacting on the ways in which these individuals constitute and understand
themselves (Pennay & Moore, 2010).

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Yet, as STS scholars have argued, there are always other possibilities. If the ‘facts’ of
methamphetamine are indeed made — are merely one version of reality among many — then
it follows that there must be other ways of inscribing the materiality of methamphetamine
that do not rely on the diagnosis of dependence or the prevalence of psychotic and violent
behaviour amongst those who use the drug. In making this claim, I do not ignore the material
effects of methamphetamine but seek to understand these effects as contingent. Moreover,
when investigating drugs such as methamphetamine, researchers need to be acutely aware of
the possible political effects of their work, taking responsibility to ensure that their methods
and conclusions do not pathologise and marginalise already vulnerable populations. This
might entail a shift from the investigation and surveillance of drugs and those who consume
them to a focus on the assemblages of drug use; that is, to the ‘embodied, emotional, affective
and material human and non-human interactions’ (Jayne, Valentine, & Holloway, 2010, p.
549) that come together in the act of drug use.

In later chapters of this thesis I take up the challenge to consider drug use as an assemblage
rather than as emerging from the actions of a pathologised subject. In doing so, I reveal other
‘versions’ of methamphetamine, showing how the materiality of this object can be contested.
Moreover, I show how scientific enactments of methamphetamine shape the practices of
consumption and service provision, demonstrating the political effects of reifying
methamphetamine as a toxic drug. In the following chapter, I shift from scientific literature to
other authoritative texts — those produced in the fields of AOD policy, treatment and media
— to interrogate the drug-using subjects they materialise. In doing so, I explore the ways in
which methamphetamine, as it is reified in scientific literature, is taken up in the broader
sphere and how this shapes our understandings of people who use it.

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Chapter 5: Extreme ‘absolutes’: Methamphetamine‐using

subjectivities in policy, treatment and media texts

Introduction
In the previous chapter, I began addressing the first part of my research question by
examining the ways in which methamphetamine and methamphetamine-using bodies are
constituted in scientific, policy, treatment and media discourse. I presented post-structuralist
and STS arguments that scientific knowledge is, like any form of knowledge, enacted and
contingent. I then used theoretical tools from this body of work to analyse some of the ways
in which methamphetamine is materialised in scientific literature as a specifically potent,
addictive and harmful drug. I argued that scientific texts are not merely reports of scientific
practices that describe the pre-existing substance ‘methamphetamine’. Rather, publication is
scientific practice (Law, 2004) and along with an array of other activities — ranging from
clinical assessments of methamphetamine users to observations of rats injected with
methamphetamine — it ascribes various properties to methamphetamine, making it ‘real’ in
particular ways. To make my argument, I traced some of the ways in which the materiality of
methamphetamine has been reified in scientific literature, illuminating political choices and
contradictions in this body of work, and demonstrating the contingency of methamphetamine
‘facts’. I then used theoretical concepts from STS to argue that facts are only very limited and
political representations of reality, and to posit that the singular way in which
methamphetamine has been inscribed is shaped by the available scientific and AOD
hinterlands. I contended that inscribing methamphetamine as a highly addictive and potent
substance requires positioning people who use this substance as pathological and/or
transgressive, and as addicted or at risk of addiction. In the case of ice users, these individuals
are hyper-aggressive and hardcore. I also argued that considering the materiality of
methamphetamine as a matter of concern (Latour, 2005) rather than as the sum total of
various scientific facts might lead to a more nuanced understanding of the drug and less
pejorative ways of perceiving the individuals who use it.

I now build upon this argument, addressing how methamphetamine-using bodies are
constituted in authoritative texts from the fields of policy, treatment and media. I shift my
focus from scientific literature to these areas in order to address how the issue of
methamphetamine consumption is produced and reproduced in a wider public sphere. This is
necessary because while scientific knowledge is considered to underpin all truth, in its ‘raw’
form (such as scientific reports and journal articles) it is accessed by a relatively small group

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of professionals. In order to explore the ways in which methamphetamine is more generally

constituted and the political effects of this knowledge, it is necessary to consider the way in
which these truths are replicated and constituted more broadly. Exposing the ways in which
methamphetamine-using bodies are constituted in authoritative texts is an important step in
addressing my research questions. In this chapter, I argue that these bodies have limited
ontological possibilities — that they are shaped by epistemic assumptions. Then, in the
empirical chapters that follow, I show how people who use methamphetamine and harm
reduction and/or treatment practitioners may draw upon, resist and/or subvert these dominant
constitutions of methamphetamine-using subjects and, in doing so, illuminate various aspects
of the ontological politics of this drug.

Before I present my argument, however, I briefly outline the texts I explore in my analysis,
how they function as ‘practice’ and why they are authoritative. I also present a key theoretical
concept that I will use in this chapter; that is, the idea of embodiment as produced through,
and productive of, practice.

Authoritative texts as practice

Policy, treatment and media documents are authoritative as they are produced by powerful
bodies and/or institutions such as government, the medical profession and media
corporations. Their validity is also established because they are reputedly based on fact;
policy and treatment are ‘evidence-based’ (see, for example, Jenner et al., 2006a; Ministerial
Council on Drug Strategy, 2011), while media reports on ‘reality’. In the same way that the
act of peer review and publication is constitutive of scientific practice (Latour & Woolgar,
1986), the production of policy, treatment and media texts similarly constitutes practice in
each of these fields. To ‘do’ policy one must undertake activities such as consultation,
negotiation and research. A key policy practice, however, is the production of written texts
that are then referred to as ‘policy’ (Bacchi, 2009). Likewise, the practice of AOD treatment
involves many activities including the provision of pharmaceuticals, the assessment and
categorisation of individuals, counselling and detoxification. Central to the practice of
treatment is the production of treatment guides or manuals. These texts are the culmination of
existing evidence; they define ‘best practice’ in terms of treatment provision. The practice of
media, like policy and treatment, comprises myriad procedures. A fundamental aspect of
media practice is the production of images, text and sound for public consumption —
including television news reports and documentaries (Bräuchler & Postill, 2010). Media
practices evoke compelling realities as they are embedded within strong narratives (such as

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film or documentary) and because they are often visual. They are also circulated more widely
than policy or treatment texts and, in this sense, the media can be considered as a series of
powerful performative practices.

In order to examine the way that policy, treatment and media texts constitute particular
methamphetamine-related subject positions, I have selected texts that are of particular
significance in their field, widely circulated and typically generated through federal
government support. The policy text that I examine is the National Amphetamine-Type
Stimulant (ATS) Strategy 2008-2011 (Ministerial Council on Drug Strategy, 2008). As
national policy, this strategy is central to way in which methamphetamine use is addressed in
Australia. It is the culmination of a comprehensive national consultation and involved the
establishment of a project management group and three reference groups made up of
Australian experts in the areas of law, research and health (Ministerial Council on Drug
Strategy, 2008, p. 9). While the strategy pertains to ATS generally (psychostimulant drugs
that include meth/amphetamines as well as 3,4-methylenedioxy-N-methylamphetamine
(MDMA or ‘ecstasy’), rather than methamphetamine specifically, a word count suggests its
focus is mainly methamphetamine. The term ‘methamphetamine’ or ‘meth/amphetamine’ is
used 23 times in the document itself and there are nine bibliographical references concerning
its use. The terms ecstasy or MDMA are used ten times in the document and have three
bibliographical references.

The treatment texts I analyse to explore the constitution of methamphetamine-using

subjectivities are: Treatment approaches for users of methamphetamine: A practical guide
for frontline workers (Jenner & Lee, 2008); A brief cognitive behavioural intervention for
regular amphetamine users: A treatment guide (Baker et al., 2003) and the website
meth.org.au (archived at webcitation.org/60KYl4pTL). The treatment guide for frontline
workers (Jenner & Lee, 2008) is a comprehensive manual that was funded through the
National Drug Strategy. It is authored by two experts in the area of methamphetamine who
have published numerous reports and articles on treatment (see, for example, Jenner & Lee,
2008; Jenner & McKetin, 2004; Jenner & Saunders, 2004; Lee et al., 2007; Lee, 2004; Lee,
Pohlman, Baker, Ferris, & Kay-Lambkin, 2010; Lee & Rawson, 2008). The cognitive
behavioural intervention (Baker et al., 2003) is a guide to undertaking a brief CBT
intervention with stimulant users and is also a National Drug Strategy publication. The
research used as a basis for this text was published (see Baker et al., 2005) and has
contributed to the evidence base that posits that CBT is the preferred response to

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methamphetamine use (see, for example, Lee et al., 2010). Meth.org.au was a website
established for people who use methamphetamine, along the principles of self-help and
incorporating CBT strategies. While no longer live, the website was active between 2007 and
2014. It was established and managed by Turning Point Alcohol and Drug Centre using
national government funds.

I also examine a series of manuals for frontline workers about how to manage
methamphetamine users, including ambulance officers (Jenner, Spain, Whyte, Baker, Carr, et
al., 2006b), emergency departments (Jenner, Spain, Baker, Carr, & Crilly, 2006a) and police
officers (Jenner, Baker, Whyte, & Carr, 2004). While these are not strictly treatment manuals,
they do concern the management of methamphetamine users in health services and/or when
experiencing a severe health-related issue such as psychosis. For this reason I have included
them in my analyses, and also because as a series of documents they are an unprecedented
response to illicit drug use, whereby the use of a specific drug is seen to require a suite of
instruction manuals on managing and controlling a unique group of drug users.

Finally, I examine a seminal media report on methamphetamine, The Ice Age (Carney, 2006),
an ABC documentary televised on the investigative journalism program Four Corners. I have
selected this particular report as it was the first significant media report on the purported
resurgence of methamphetamine in the 2000s and because, as a well-regarded and respected
current affairs program, Four Corners is an authoritative media source. Rather than seeking a
wide range of texts from each field, I have selected texts that are central to the way in which
methamphetamine use is governed, made or known in a particular arena. I now outline the
theoretical approach I use to discuss the subjects constituted within the selected documents.

What can a body do?

To reveal the extreme absolutes of methamphetamine-using subjects materialised in policy,
treatment and media texts, I employ a Deleuzian11 interpretation of subjectivity and
embodiment as interpreted by Ian Buchanan (1997). Several scholars have used Buchanan’s
work to explore the relationship between medicine, health and bodies (see, for example, Fox
& Ward, 2006; Potts, 2004). Buchanan (1997) focuses on the capacity of the body to form
specific relations and links to other bodies (p. 80). He argues that considering the question
‘what can a body do?’ as constitutive is a way to think of the body as ‘the sum of its
                                                            
11
 I use the term ‘Deleuzian’ here, however, in doing so I acknowledge that crucial to Deleuze’s work on
subjectivity were his publications with Felix Guattari including A Thousand Plateaus (1987) and Anti-Oedipus;
Capitalism and Schizophrenia (1983). 

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capacities’ (Buchanan, 1997, p. 75). Focusing on what bodies can do, including their capacity
to form relations, entails focusing on practice. A body is not prior to practice; it is
recognisable through practice and changes as practice shifts. Thus, identity and personhood is
not external to, or antecedent to, practice/action, it is produced through practice, including the
connections and relationships people form.

Buchanan’s (1997) interpretation of Deleuze’s theory of embodiment enables an interrogation

of methamphetamine-using subjects enacted in policy, treatment and media texts that moves
beyond a pre-existing, sovereign subject. This reconfiguration of the body is a beneficial way
to consider the drug-using subject. It requires thinking of:
practices of self for themselves instead of interpreting them according to the dictates
of a previously stipulated clinical condition. (Buchanan, 1997, p. 75)12
This is a politically liberating way of considering embodiment, particularly for those
individuals who engage in highly stigmatised activities such as methamphetamine use. A
conventional ‘Euro-American’ (Law, 2004, p. 24) account of the body considers drug users
as pathological and/or transgressive individuals. These individuals have these particular
characteristics prior to practice, and practice is assumed to be a response to these
characteristics. Buchanan, however, uses Deleuzian insights to argue that practice makes
bodies with pathological and/or transgressive capacities; thus bodies are constituted and
capacitated through practice. Key to recognising bodies in this way is to scrutinise practice
and identify the capacities of the bodies produced. Therefore, I ask ‘what can a body do?’ of
the methamphetamine-using subjects constituted in authoritative methamphetamine
documents. I attend to their capacities and the practices that enact these capacities. I look at
differences between the various bodies that emerge in these texts, but also note their common
thread which is shaped by the current ‘conditions of possibility’ (Law, 2004, p. 35).

In the sections that follow, I discuss some of the ways in which policy and treatment texts
enact hyper self-controlled, knowledgeable and self-aware methamphetamine-using subjects.
I note the slippages evident in the enactment of these ‘active’ subjects and the tensions that
arise when they interact with the substance ‘methamphetamine’. I then track
                                                            
12
 It should be noted that Buchanan (1997) and Deleuze and Guattari (1987) offer a bleak interpretation of the
‘drugged body’ (Malins, 2004). Nonetheless, the theoretical tools offered by these scholars are helpful for
understanding drug use in a way that moves beyond the pathological subject as the focus of investigation and for
studying the practice of drug use itself as other than the actions of a deviant subject. Malins (2004), Keane
(2002) and Duff (2007) have all demonstrated ways in which the theoretical insights of Deleuze and Guattari
and their understanding of subjectivity can be applied to develop a more nuanced and complex understanding of
drug use. 

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methamphetamine-using subjectivities enacted in binary opposition to self-controlled users.

These are drug-using subjects who are anxious, depressed, psychotic and chaotic, found in
policy, treatment and media texts. I examine the way in which these drug users are
constituted as resistant or even as objects of disgust.

ATS policy: Knowledgeable, self‐controlled bodies

I first look at the way/s in which The National Amphetamine-Type Stimulant Strategy 2008-
2011 (Ministerial Council on Drug Strategy, 2008) enacts knowledgeable and self-controlled
methamphetamine-using bodies. As I have argued previously in this chapter, while the
strategy as a whole is directed at ATS, methamphetamine is its main concern. The strategy
evokes multiple practices to address ATS use, including law enforcement and treatment.
However, the central aim of the ATS strategy is to:
Reduce the availability and demand for illicit amphetamine-type stimulants and
prevent use and harms across the Australian community. (Ministerial Council on Drug
Strategy, 2008, p. 1)
Policing practice is central here, as indicated by the commitment to reduce availability of
ATS. However, the aims to reduce demand and prevent use and harms involve providing
knowledge so that the Australian public is informed about ATS. The primacy of this practice
is signalled by the first listed objective of the strategy:
Increase the Australian’s community’s knowledge about amphetamine-type
stimulants and raise awareness of the problems associated with their production and
use. (Ministerial Council on Drug Strategy, 2008, p. 1)
This information is made available with the expectation it will be used to ‘prevent and
reduce’ (Ministerial Council on Drug Strategy, 2008, p. 27) problems associated with ATS.
Thus, all Australians are expected to act upon ATS-related knowledge to prevent and reduce
harm, including ATS users themselves.

The provision of information with the expectation that an individual will act upon this
information constitutes the neo-liberal citizen. These are citizens that self-regulate according
to dominant doctrines of health, individuals that actively take responsibility for their well-
being making choices that maximise their health (Rose, 2007). Making available health and
harm reduction information to people who use drugs is an ongoing strategy to address illicit
drug use in Australia (Moore, 2004; Moore & Fraser, 2006). While not denying the worth of

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such activities, these practices are shaped within the current neo-liberal episteme, where even
drug users must take responsibility for their own well-being and knowledge.

The role of the individual drug user in the ATS strategy is thus to absorb and act upon
information, thereby reducing ATS-related harm. For instance, Priority Area 1 of the strategy
concerns identifying how much people know about ATS and then addressing any gaps in
knowledge. To do so, this text promotes the use of ‘social marketing and targeted strategies
to raise awareness of the risks associated with ATS use’ (Ministerial Council on Drug
Strategy, 2008, p. 17). Some of the messages that the policy promotes are the risks of
combining ATS use with alcohol, the social unacceptability of ATS use, the risks of ingesting
drugs containing unknown chemicals, mental and physical risks, and treatment options
(Ministerial Council on Drug Strategy, 2008). Social marketing and the provision of health
promotion in this context is a fairly traditional method of harm reduction, and the strategy
also aims to find new ways to provide ATS users with knowledge to assist them to reduce
harm. For instance, in Priority Area 4, ‘Problems associated with ATS use’, the strategy notes
the need to:
Develop, trial and adopt innovative strategies for ATS users, to provide information
about risks associated with ATS use, recurring ATS problems, understanding
treatment options and seeking help. (Ministerial Council on Drug Strategy, 2008, p.
27)
While ‘innovative’ methods are suggested, the content of the messages relayed are consistent.
People are to be informed about the ‘risks’ of ATS use, potential problems that may arise and
where to seek help.

These practices, innovative or not, materialise ‘harm reduction’ bodies that, given the correct
information, have the capacity to manage their ATS use, preventing and reducing risks and
seeking help or treatment if necessary (Fraser & Moore, 2008; Moore, 2009). The provision
of information in this way may be useful to many individuals, but it also has particular
effects. Moore (2009) finds that harm reduction practice obscures the environments in which
drug use takes place. He argues that while people may have the requisite knowledge to
alleviate harm or risk, the networks that produce their drug use may limit their capacity to
implement this knowledge (Moore, 2009). By making these elements of drug use absent, sole
responsibility to alleviate drug-related harm resides with the individual. Also, the ‘harm
reduction’ body makes drug use a rational exercise. Enacting this body assumes, for instance,

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that people will change their drug use practices if they are aware of the risks. This assumption
ignores the multiple reasons that people engage in drug use. There may be instances where
people’s drug use is driven by a desire to experience risk and danger (Fraser & Moore, 2008).
Neglecting some of the very reasons that people seek to use drugs, such as risk and pleasure,
means that the messages of harm reduction do not reflect the lived experiences and desires of
people using drugs.

In critiquing the practice of harm reduction, I do not intend to negate it. There are obvious
benefits to providing people who use drugs with information and resources that may assist
them to mitigate any potentially harmful effects. Thus, it is helpful to consider Keane’s
(2003) argument that harm reduction is usefully conceptualised as an assemblage of practices
and technologies with varied outcomes. Here, the practice of providing information to reduce
harm constitutes a methamphetamine-using body with the capacity for knowledge. Yet,
myriad events, objects, subjects and spatial and temporal considerations at play in the event
of drug consumption will affect whether that knowledge is able to be deployed. This
acknowledges the significance of the provision of information concerning the safer use of
drugs while shifting responsibility for implementing this knowledge from the individual
consuming drugs. Harm reduction bodies, then, may be knowledgeable, but the
environmental and social circumstances of their drug use are also implicated in their capacity
to put this knowledge to use and in socially approved ways. So, while as a strategy harm
reduction has value, unless we consider agency as dispersed throughout the assemblages of
drug use, we risk enacting these subjects as individually responsible for drug-related harm
(Fraser, 2004).

‘Active therapy’: Treated methamphetamine‐using bodies

Having established that the national policy document concerning methamphetamine use in
Australia enacts bodies with the capacities of the neo-liberal citizen (with its emphasis on
harm reduction), I now turn to the practice of treatment as it emerges within three significant
treatment texts. While methamphetamine harm reduction bodies are perhaps similar to drug-
using bodies enacted through harm reduction strategies more broadly, ‘treated’
methamphetamine bodies are very specific, as they are hyper-agentive. I trace this specificity
in this section.

As with harm reduction strategies, the provision of treatment for methamphetamine use is an
integral part of the Australian Federal government’s response to this drug. The national

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strategy aims to ‘establish an adequate, effective and accessible range of ATS treatment
options’ (Ministerial Council on Drug Strategy, 2009, p. 2), and government-funded
guidelines concerning methamphetamine are available (see, for example, Jenner & Lee, 2008;
Lee et al., 2007; Smout, 2008). Thus, there is a significant body of state-funded, evidenced-
based methamphetamine treatment literature in Australia that deserves attention when
considering the methamphetamine-using subject. Predominant in this literature is the practice
of CBT, so in order to address treated methamphetamine-using subjects I examine CBT and
behavioural therapies in general, as well as the closely related practice of self-help. I then
compare the treated methamphetamine-using body with that of another highly stigmatised
drug body — the heroin-using body — to explore how the materialisation of these entities is
shaped by our understandings of addiction and how, in turn, the way we understand different
types of addiction shape the practices that address drug use.

Scientific literature finds behavioural therapies to be a promising intervention for

methamphetamine use (see Baker et al., 2005; Lee et al., 2010; Lee & Rawson, 2008;
Rawson et al., 2002). Reflecting this evidence base, Treatment approaches for users of
methamphetamine: A practical guide for frontline workers (Jenner & Lee, 2008) sanctions
CBT as the preferred strategy to address methamphetamine use. In the introduction to this
monograph, the authors state:
Numerous high-quality studies have suggested that psychosocial treatments,
especially cognitive behaviour therapy (CBT), should be a standard intervention in
methamphetamine treatment. CBT also assists with mental health problems, such as
depression and anxiety, which are common among methamphetamine users. (Jenner
& Lee 2008, p. 2)
Accordingly, while numerous treatment responses to methamphetamine use are outlined in
the manual — such as brief intervention, counselling, residential rehabilitation and self-help
groups — CBT is highlighted. For instance, in a summary of available treatments for
methamphetamine the manual states:
Cognitive behaviour therapy has been evaluated most extensively and is effective
for a range of problems related to methamphetamine use, including mental health
problems such as depression and anxiety. (Jenner & Lee, 2008, p. 8, bolding in
original)

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Thus, the practice of CBT is promoted in this manual as the preferred standard response to
methamphetamine use and its purportedly related issues — depression and anxiety.
However, the bodies enacted by CBT practice are shaped by the assumptions of neo-
liberalism and have political implications. The aim of this practice is to change the erroneous
ways in which people think:
Cognitive behavioural approaches are short-term, focused, talking therapies that aim
to identify and address common errors in thinking and subsequent behaviours that
lead to, and maintain, problematic drug use. (Jenner & Lee, 2008, p. 58)
Here, using drugs problematically is linked to erroneous cognitive processes — resulting in
problematic behaviour. These are citizens that cannot make the correct choices. The
statement made above assumes that psychotherapy — in this case CBT — is a technology
that can rectify this state. In this light, CBT is a practice that can transform non-citizens into
functional, choosing citizens:
Selves unable to operate the imperative of choice are to be restored through therapy to
the status of the choosing individual. (Rose, 1999, p. 231)
Moreover, by considering problematic drug use as the result of dysfunctional thinking, this
statement responsibilises the methamphetamine-using subject. The subject is evoked here as
the sole actor in the practice of drug consumption. This means that other elements that may
have some bearing on problematic drug use, such as poverty, homelessness, lack of family
support and a general dearth of social and economic resources, are ignored. CBT bodies thus
assume responsibility (and blame) for their problematic drug use as this is apparently driven
solely by dysfunctional thought patterns (Proctor, 2008).

While this treatment guide (Jenner & Lee, 2008) espouses CBT as the preferred response to
methamphetamine use, it does not outline or suggest specific CBT techniques to apply when
working with clients. Rather, workers are directed to find CBT practitioners in their area (see
Jenner & Lee 2008, p. 59). An earlier publication, A brief cognitive behavioural intervention
for regular amphetamine users (Baker et al., 2003), however, details a brief intervention
based on CBT principles. The intervention was developed through research with
amphetamine users and is designed specifically for them. Although the intervention is
directed at amphetamine use (presumably amphetamine sulphate), the report of the
intervention notes ‘[t]here has been a world-wide increase in the use of amphetamines,
particularly methamphetamine’ (Baker et al., 2005, p. 100). This statement suggests that

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methamphetamine is also a drug of concern. Nonetheless, the term ‘amphetamine’ is then

used throughout the article. As noted in Chapter Four, while methamphetamine is often
delineated from amphetamine as a ‘different’ and more harmful drug (see, for example,
Baker & Dawe, 2005), it is also collapsed with amphetamine when necessary, particularly in
cases where there is limited evidence on methamphetamine. This being the case, the research
reported in the intervention described in Baker et al. (2003) has contributed to the general
evidence base concerning methamphetamine (see, for example, Lee & Rawson, 2008;
Shearer et al., 2009) and is even cited as an intervention ‘specifically for methamphetamine
users’ (Lee & Rawson, 2008, p. 311; Shearer et al., 2009, p. 104). Having noted this slippage,
in the discussion that follows I refer to the substance being addressed by the intervention as
‘meth/amphetamine’.

A brief cognitive behavioural intervention for regular amphetamine users: A treatment guide
(Baker et al., 2003) contains guidelines for a two- or four-session brief intervention to address
meth/amphetamine use, including detailed instructions for practitioners and client
worksheets. Sessions typically involve going over ‘homework’ and ‘diaries’ from the
previous session, and going through the reasons and triggers that might cause one to use
meth/amphetamine, talking about these in detail and then setting goals for the next session.
An example, of what takes place within sessions and the type of homework required is found
in the following text introducing the second session:
Completing an urge diary over the past week will have given the client insight into the
trigger situations that lead them towards experience of a craving. They will have
practised identifying the elements of the trigger situation itself, along with their
responding thoughts, feelings and behaviours. Now it is time to put those observations
to use in helping them to better manage their craving situations. By learning
techniques to cope with each aspect of the client’s experience of a craving, they can
be more confident of ‘surviving’ that situation without acting on their urge to use
speed. (Baker et al., 2003, p. 38)
Here, the client is required to document their cravings and urges to consume
meth/amphetamine and then to scrutinise these in order to identify the ‘elements of the trigger
situation’. They are expected to then use this information about themselves to exercise self-
control.

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The practice of assessing and managing one’s thoughts, environments and ‘trigger situations’,
along with the obligation to complete tasks such as diary keeping, is truly ‘active therapy’
(Baker et al., 2003, p. 12). If we then consider practice as constitutive of particular bodies
(Buchanan, 1997), a meth/amphetamine CBT-treated body constitutes itself through
scrutinising its own desires, thoughts and actions with the aim of exercising self-control. This
practice is no doubt appealing to many people who use meth/amphetamine, in that it provides
them with the means to embody themselves as self-controlled individuals. However, CBT has
received critical attention primarily for the ways in which it acts as a technique of
governance. For instance, Rose (1999, 2007) argues that behavioural therapies are practices
that teach people to self-regulate in accordance with dominant norms and ideologies, where
‘thought works on thought itself’ (Rose, 2007, p. 101). Thus, rather than being a collaborative
and self-empowering practice, CBT involves the client acquiescing to a more authoritative
body of thought — that put forward by the therapist (Proctor, 2008). Ultimately, clients are
expected to internalise the techniques conveyed to them by the therapist and become ‘the
surveyors and regulators of their own thoughts’ (Proctor, 2008, p. 252). In this way, subjects
reconstitute themselves as self-scrutinising, controlled individuals via normalising techniques
made available by their therapist.

In terms of meth/amphetamine use, the active CBT body may seem preferable to the
compulsive figure evoked by addiction and beneficial to individuals who use
meth/amphetamine. However, as a practice, CBT responsibilises drug users to the point
where all problems that they experience are located within erroneous thought patterns. This
then masks the complexities of drug use and the way in which various networks and
assemblages can produce problematic drug use. Further, while ostensibly a practice whereby
the client achieves self-empowerment, CBT can also be conceived as a technique of
government, as subjects assimilate values and norms espoused by their therapist and learn to
embody themselves in ways consistent with dominant ideologies.

Self‐help and ‘expert drug users’

Having considered the practice of CBT, I now turn to self-help. This is a highly active and
self-driven practice. It mirrors the principles and assumptions of CBT — with a key
difference; direct contact with a therapist is not required. Thus, this is a practice that enacts a
highly active and controlled body. Self-help in the AOD sphere is usually associated with
twelve step abstinence-based groups such as Alcoholics Anonymous (AA), Narcotics
Anonymous (NA) and Crystal Meth Anonymous. The practice of self-help within the twelve

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step movement is facilitated by a group fellowship involving mentoring and the attendance at
regular meetings with fellow ‘addicts’. For the purposes of this discussion, however, I do not
address self-help in the specific context of groups such as AA and NA but via the internet, an
increasingly common location for self-help advice. I use Rimke’s (2000) and Rose’s (2007)
understanding of self-help (and perhaps how this practice is more typically thought of in the
wider sphere) as the individual pursuit of the ‘restoration of the self’ (Rose, 2007, p. 101).
This approach to self-help assumes that it is underpinned by neo-liberal values such as
‘choice, autonomy and freedom’, and relies on ‘the principle of individuality and entail[s]
self-modification and “improvement”’ (Rimke, 2000, p. 62).13

The website meth.org.au provides a clear example of self-help in relation to

methamphetamine, as signalled by the slogan on its homepage: ‘Meth.org.au helping meth
users to help themselves’. In order for users to help themselves, meth.org.au provides general
information on methamphetamine, CBT strategies to manage thoughts/cravings and measure
progress, and tools for self-diagnosis. Much of the information provided is harm reduction
information — that is, advice or information that focuses on the potential harms of
methamphetamine use, rather than on preventing methamphetamine use. However, in
addition to this information, the website contains techniques and tools that oblige the user to
self-categorise and self-reflect. One of the sections on the site is entitled ‘Take free test’. This
is a self-diagnosis exercise in which individuals can determine if their methamphetamine use
is ‘problematic’. To do this, the site uses the Alcohol, Smoking and Substance Involvement
Screening Test (ASSIST) (World Health Organisation ASSIST Working Group, 2002). As a
screening tool, the ASSIST could be administered by a clinician as part of treatment practice.
Yet, via meth.org.au, it is self-administered in order to assess one’s drug use and determine
whether it is problematic or not. This is an example of Rimke’s (2000) observation that while
ostensibly ‘self-treatment’, self-help projects are informed by ‘external forms of textual
authority and expert knowledge’ (p. 62). Thus, in order to interpret one’s own
methamphetamine use, a tool created and used by ‘experts’ is provided. It is not sufficient to
merely think one’s methamphetamine use is problematic; this must be validated through the
use of an expert tool.

Based on the results of the ASSIST questionnaire, users of meth.org.au can decide which part
of the website is most appropriate for them. This might be a section on how to manage
                                                            
13
 For an analysis of twelve step self-help in relation to Rose’s theories of individualisation and autonomy, see
Keane (2000).  

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unhelpful thoughts, how to maintain cessation from methamphetamine use or where to seek
professional help. Almost uniformly, these sections involve a high level of activity. For
instance, in the section on ‘Managing unhelpful thoughts’, users are asked to categorise what
type of thinker they are (‘castrophiser’, ‘personaliser’ and so on) and then to actively work to
change this. As the following statement demonstrates, this process involves identifying
unhelpful thoughts and then distancing oneself from these thoughts in order to better
understand them:
Ask yourself ‘Which type of negative thought did I just have?’. Label your thoughts
as ‘catastrophising’, ‘personalising’, ‘jumping to negative conclusions’, ‘black/white
thinking’, or ‘shoulds/oughts’. When you separate yourself from the thought and give
it a label, it’s amazing how quickly it loses its power over you. (meth.org.au)
The practices outlined here involve not only the capacity to assess whether specific thoughts
are negative, but to then be able to categorise them. This obliges users of meth.org.au to
‘learn new ways of self-reflection, self-assessment and insight’ (Rose, 2007, p. 101) in order
to control their methamphetamine use.

On examination of meth.org.au, it is apparent that self-help is very similar to CBT in that

both practices are technologies that enable subjects to re-constitute themselves through
thought and behaviour modification, guided in this practice by experts (albeit at a distance, in
the case of self-help). Indeed, it could be argued that the expectation of CBT — that clients
will become their own therapist — is taken to its logical conclusion with the practice of self-
help. CBT and self-help bodies, similar to harm reduction bodies, offer people a way of
considering drug users as capable, active and empowered human beings, challenging
preconceptions about these individuals. Yet, the flip side of these active bodies is that a
regime of self-scrutiny must be maintained in order to stay ‘treated’. This involves
consistently evaluating one’s thoughts, monitoring trigger situations and managing cravings.
It is a life of:
constant self-doubt, a constant scrutiny and evaluation of how one performs, the
construction of one’s personal part in social existence as something to be calibrated
and judged in its minute particulars. (Rose, 1999, p. 243)
Moreover, the evocation of the sovereign subject through the practices of CBT and self-help
requires the point of intervention to be the erroneous thought patterns of this subject. This
obfuscates the myriad subjects, objects, places and spaces that come to play in the event of

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drug use. It may also hide inequalities that contribute to problematic drug use such as poverty
and homelessness, effectively placing responsibility on individuals who experience these
inequalities to change the way they think and behave in order to manage their drug use
effectively. So, while appealing in some ways, the CBT/self-help subjects are unencumbered
by the assemblages of existence (which may include homelessness, unemployment and
incarceration) and are able to make choices and direct themselves in ways that may not
reflect the lived experience of individuals who use drugs.

In critiquing the practices of CBT and self-help, I am not arguing that these particular
treatment interventions are unhelpful. But it is also important to remain sceptical of the active
CBT/self-help subject and to expose its limitations (Moore & Fraser, 2006). Does any
individual have the capacity to undertake the consistent self-reflection and self-work required
by these practices? Is the active, self-controlled, treated body specific to methamphetamine
and, if so, why? I explore this point further in the section that follows by comparing
methamphetamine and heroin treatment practices.

Active/passive treated bodies: Comparing methamphetamine and heroin

treatment
While treatment practices directed at methamphetamine use enact a hyper-agentive body, this
is not the case for the treated heroin-using body. This is an important point for two reasons.
First, heroin and methamphetamine are often compared in terms of their ‘addictiveness’ and
destructive potential (see, for example, Darke et al., 2008; McKetin et al., 2005a) and,
second, use of both drugs is alleged to result in addiction. Despite these commonalties,
examining treatment guides for heroin (O'Brien, 2004) and methamphetamine (Jenner & Lee,
2008), both funded through the Australian Commonwealth Department of Health and
Ageing, shows that very different treatment methods are espoused for each drug. Examining
evidence-based treatment guides for these drugs and describing the different capacities of the
bodies they constitute illuminates the limited and contradictory ways we have of thinking
about addiction.

Broadly speaking, problematic methamphetamine use is considered treatable via the practice
of CBT (Jenner & Lee, 2008). While there has been significant research into a suitable
pharmacological agent to treat methamphetamine use, to date this has been unsuccessful.
Heroin use, however, is treated primarily via pharmacotherapies in Australia and
pharmacotherapy maintenance is considered ‘best practice’ in the scientific literature

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(Mattick, Breen, Kimber, Davoli, & Breen, 2003; Mattick, Breen, Kimber & Davoli, 2014).
Accordingly, the guide for heroin use, Treatment options for heroin and other opioid
dependence: A guide for frontline workers (O'Brien, 2004) does not put forward CBT, or any
other form of behavioural therapy, as a viable treatment for problematic heroin use. It focuses
on the provision of pharmacotherapies, using three approaches: detoxification, substitution
and abstinence. Detoxification involves the use of buprenorphine (O’Brien, 2004, p. 7).
Substitution therapy involves the provision of methadone or buprenorphine (O’Brien, 2004,
p. 12) and abstinence involves the use of naltrexone (O’Brien, 2004, p. 16). The heroin
treatment manual notes that ‘counselling and support services’ (O'Brien, 2004, p. 18) are
possibly beneficial to those using heroin, but states that these should occur in conjunction
with other forms of treatment:
Most people agree that counselling on its own will probably not be enough to change
dependent heroin use. Counselling and support services as a part of other treatments,
however, can be more effective (e.g. substitution treatment with methadone or
buprenorphine and counselling). (O'Brien, 2004, p. 18)
The significant point in this statement is that counselling is an adjunct to substitution
treatment and not a stand-alone treatment practice. This is very different from the
recommendations found in the methamphetamine treatment manual, in which talking
therapies alone are considered the most effective and suitable form of treatment for this
methamphetamine use.

It is also interesting to note the emphasis on psychiatric co-morbidity in the

methamphetamine treatment manual (Jenner & Lee, 2008) compared to the heroin treatment
manual (O'Brien, 2004), and the link between this purported co-morbidity and the practice of
CBT. CBT is mentioned several times in the methamphetamine treatment manual as
efficacious for the treatment of methamphetamine, as well as for anxiety and depression
(Jenner & Lee, 2008, pp. 2, 6, 8, 58). Examining the scientific literature, however, reveals
that people who use heroin are also reported to have high levels of these psychiatric disorders
(Brienza et al., 2000; Darke & Ross, 1997; Havard, Havard, Teesson, Darke, & Ross, 2006;
Lejuez, Paulson, Daughters, Bornovalova, & Zvolensky, 2006), with one study concluding
that the high levels of depression and anxiety among heroin users had ‘clinical implications’
(Darke & Ross, 1997, p. 140). Yet the treatment text for heroin use contains very few
mentions of depression and/or anxiety and no recommendation to actively treat these

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disorders. Rather, it is stated that entering treatment may assist one’s emotional health,
including depression and anxiety (O'Brien, 2004, p. 3).

While there is very little mention of comorbidity in the heroin treatment manual, the
treatment text on methamphetamine has an entire chapter on ‘Recognising and responding to
a person with mental health problems’ (Jenner & Lee, 2008, p. 29). This is most likely related
to the claim that methamphetamine use is associated with psychosis (an issue explored later
in this thesis), but the chapter includes separate sections on anxiety and depression. Here,
statements are made such as ‘Depression commonly occurs among methamphetamine users’
(p. 36) and ‘It is common for methamphetamine users to experience some of these [anxiety]
symptoms as a direct effect of the drug’ (p. 38). These statements, along with others
mentioned previously concerning the efficacy of CBT with regards to depression and anxiety
disorders, enact these disorders as central to the treatment of methamphetamine use (Jenner &
Lee, 2008, p. 2). And yet the evidence that informs these assertions is tenuous. For example,
Baker and Dawe (2005) observe:
There has been remarkably little investigation of the course of amphetamine use and
co-occurring psychological problems. (p. 89)
These authors also note ‘diagnostic uncertainty’ (p. 89) concerning depression and anxiety
among amphetamine users, as symptoms of these disorders may be confused with the side
effects of amphetamine use, rather than indicative of a stand-alone diagnosis. In relation to
methamphetamine specifically, there is strikingly little evidence in relation to comorbidity,
and what evidence exists is based mostly on research with amphetamine users (see, for
example, Hall, Hando, Darke, & Ross, 1996; Vincent, Schoobridge, Ask, Allsop, & Ali,
1998). In citing these examples, I am not trying to assert whether rates of depression and
anxiety are high among people who use methamphetamine. I do, however, wish to call
attention to the centrality of these disorders to the treatment of methamphetamine, and their
complete absence with regards to the treatment of heroin. This is so despite high levels of
depression and anxiety reported among people using heroin and the problematic and
uncertain relationship between methamphetamine use and anxiety and depression.

Thus examining practices in the two treatment documents for methamphetamine and heroin
reveal bodies with very different capacities. Heroin-using bodies are medicated, and the
pharmacological agents they consume address their cravings, manage their withdrawal
symptoms and/or block the effects of their heroin consumption. These bodies are not obliged

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to manage erroneous thought patterns, or address their depression and anxiety; instead they
are made docile and compliant by the actions of the pharmaceuticals they ingest. They are
‘disciplined and addicted — but heroin-free — subjects’ (Bourgois, 2000, p. 184).
Methamphetamine-using bodies (as I have argued previously) are active in treatment,
collaborating with their therapists in order to change the way they think and the associated
behaviours. Moreover, these bodies are also obliged to address adjunct disorders such as
depression and anxiety.

Yet, while treatment practices enact bodies with different capacities, both heroin-treated
bodies and methamphetamine-treated bodies are ostensibly being treated for the same
disorder — addiction. Tracing how this concept is mobilised in these two sets of treatment
practices brings to light its multiplicity and the contradictory ways in which we constitute
drug use. An assumption that underpins addiction in the current conditions of possibility is
that it is a compulsive activity in binary opposition to voluntarity (Sedgwick, 1992). Thought
about in this way, the heroin-treated body is not obliged to address its compulsivity.
Addictive practices — such as desiring a drug and taking drugs regularly — are not treated,
but rather the body’s compulsive desire for heroin is sated with a form of legitimate
medication. Methamphetamine-treated bodies, however, are obliged to address their
compulsivity with practices that are highly voluntaristic. For methamphetamine use to be
treated successfully, users must transform themselves from compulsive, addicted individuals
to active and self-controlled individuals by monitoring and changing their thought patterns.
However, given that both heroin and methamphetamine are considered highly addictive, how
is it that methamphetamine-addicted bodies are constituted as specifically active and able to
exercise high levels of voluntarity in their treatment? Investigating the assemblages of
treatment illuminates the theories and tools that constitute methamphetamine and heroin-
treated bodies in such different ways.

Key tools that shape, and are shaped by, the concept of addiction are inscription devices such
as the DSM-V (American Psychiatric Association, 2014) and the SDS (Topp & Mattick,
1997a). These are tools which emphasise the psycho-social dimensions of addiction rather
than its physical dimensions (Keane, 2002) and, as I have argued in Chapter 4, have enabled
the constitution of methamphetamine as a substance of addiction (Topp & Mattick, 1997b).
The ‘psycho-social’ nature of methamphetamine addiction is most logically addressed
through ‘psy’ based treatments such as CBT (Jenner & Lee, 2008, p. 2). Heroin addiction, on
the other hand, is inscribed as recognisable through primarily physical signs and hence the

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dominance of heroin treatment practices that involve the substitution of acceptable opiates
that ease physical withdrawal symptoms, either for the purposes of detoxification or
maintenance (O'Brien, 2004). Thus the concept of addiction is a multiple object, variously
constituted by different sets of theory and assemblages of drug consumption and drug
treatment. In heroin treatment assemblages, the purportedly physically addictive properties of
opiates and pharmacological agents such as methadone enact docile, treated bodies. In
methamphetamine treatment assemblages, the emphasis on the psycho-social dimensions of
addiction and a lack of pharmacological tools with which to treat this drug enacts active
treated bodies, with adjunct psychological pathologies.

Moreover, while the treatment assemblages for heroin and methamphetamine appear to
constitute a conventional mind/body dualism, recent developments in the area of brain
science suggest a more singular understanding of addiction. Keane (2012) argues that the
divide between the physical and psychological dimensions of addiction has been seemingly
rendered obsolete with the rise of a neuroscientific paradigm within addiction science. In
neuroscientific accounts of addiction, it is argued that changes in the brain’s neural pathways
are markers of addiction, and that these are consistent irrespective of the drug or behaviour to
which one is addicted (Keane, 2012). Nonetheless, in spite of this new way of
conceptualising addiction, Keane (2012) states that:
The scientific authority and institutional power of the brain disease model of addiction
and its neurochemical perspective has not been translated into the clinical process of
diagnosis. (p. 359)
This statement also applies to the broader treatment practices directed at heroin and
methamphetamine addiction. If addiction is a brain disorder then it should follow that
treatment practices are, to some extent, uniform, and applied irrespective of the drug or
behaviour involved. Yet, as evidenced by the difference between the way heroin and
methamphetamine are constituted through treatment, this is not the case. Instead, while
methamphetamine treatment focuses on cognitive strategies, there is no requirement for
heroin addiction to be treated in this way; it remains a singularly somatic disorder.

Keane (2012) also notes the strong significance attached to the physical signs of addiction,
even with the rise of psycho-social and neurological explanations of addiction. This is
evidenced by the continuing centrality of the physicality of heroin addiction as well as by the
commitment to discover an appropriate pharmacological intervention for methamphetamine

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use (see, for example, Elkashef et al., 2008; Heinzerling et al., 2010; Shoptaw et al., 2008). A
lack of success in this area means that despite understanding methamphetamine as a highly
destructive and addictive drug, we are unable to use pharmaceutical agents to intervene upon
methamphetamine addiction. Instead, we are obliged to ‘make’ methamphetamine users
active in their treatment – with all the capacities that entails. Yet the dangerous properties of
methamphetamine remain, and these are problematic to the evocation of active and self-
controlled methamphetamine-using subjects. I discuss some of these tensions in the section
that follows.

‘Active’ methamphetamine‐using bodies: Points of tension

Methamphetamine is reified as a highly addictive and destructive substance. It reportedly
results in individuals experiencing dependency, mental and physical health disorders, and
engaging in violent behaviour (Darke et al., 2008). These characteristics all signal a low level
of self-control and thus it becomes difficult to reconcile the hyper- active, self-controlled
subject constituted through treatment, CBT and self-help practices with methamphetamine
consumption. In this section I discuss some of the tensions evident in the materialisation of
active, self-controlled drug-using subjects in policy and treatment texts, noting how tenuous
these subjects are as they encounter ‘methamphetamine’.

As part of a Federal Government campaign to educate the public about the dangers of ATS
use, between 2009 to 2011 a set of posters was displayed around Melbourne at bus and tram
stops and in phone booths. One poster in particular, concerning the use of ice, illustrates the
tension between the active, self-controlled methamphetamine-using body and the destructive
capacities of methamphetamine (see www.webcitation.org/6Sxg4qrlp). The poster features a
grey-faced man, perhaps in his early thirties, in a shirt and tie sitting at his work desk. The
slogan ‘Ice will destroy his career. Then his life’ is written across this image. The man’s
clothes and immediate environment signify that he is a professional. As someone with the
capacity to work in a business environment, presumably earning a high income, he has the
attributes of the neo-liberal citizen. Further, as he is also using ice, he is enacted as a high-
functioning and agentive user. However, the man’s physical expression (he is slumped,
holding his head in his hands), and most obviously the text, indicate the precarious nature of
this subjectivity. It is inevitable that he will succumb to the destructive properties of ice,
despite his obvious high-functioning capacities. The image and text convey the message that
these capacities dissipate in the face of ice use.

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Tensions between the way in which methamphetamine has been enacted in public and
scientific discourse, and the manifestation of agentive methamphetamine-using subjects, are
also evident at the website meth.org.au. In particular, two sections that deal with cravings
illustrate these tensions. In the first section, entitled, ‘Want to help yourself?’, behavioural
strategies are suggested to deal with cravings, including imagining a craving as a wave. The
concept of craving is explained to users of the site in neurological terms:
Being exposed to things that you’ve associated with meth can cause a little squirt of
dopamine a brain chemical messenger (neurotransmitter) involved in the control of
physical movement, thinking, motivation, and feelings of pleasure or reward to be
released in anticipation of the main event (meth) and the brain WANTS MORE. This
is why it’s hard to get meth out of your mind for the first few minutes of a craving.
(meth.org.au, capitalisation in original)
Here, the users of meth.org.au are enacted as knowledgeable and self-aware individuals who
can understand a neurological explanation of what happens in the brain during a craving, and
then can critically assess and control this squirt of dopamine when it occurs. Moreover,
methamphetamine itself is described in terms of the residual effect it may have on neural
pathways rather than as a particularly destructive and dangerous substance.

However, another section of meth.org.au, entitled ‘Don’t give up’, addresses urges to use or
cravings in a different way. This section of the website states:
If you do slip up and have some meth (or more than you’d planned) don’t beat
yourself up about it. The meth monster will probably try to sabotage you with
messages like ‘I might as well keep using since I can’t stay off it’. But the truth is,
you CAN…you HAVE…and you can STAY stopped or cut down. Tame the meth
monster by thinking ‘OK, I’ve had some meth but it’s just been this once and I don’t
have to have any more. I’m doing well and this is just a minor blip on the radar’.
(meth.org.au, capitalisation in original)
In this case, the urge to use is not the result of a squirt of dopamine, but rather the ‘meth
monster’. Methamphetamine as the meth monster has the capacity to compel people to use it,
and cravings are no longer the actions of the neural pathways, but attributed to a malign agent
— the meth monster itself. When enacting the figure of the meth monster, the text both
reinforces the idea of methamphetamine as a destructive and evil substance, with inherent
agency and, given that monsters are fantasy figures from childhood, materialises drug users

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as childlike. Thus, while meth.org.au is a self-help resource enacting bodies with the capacity
for self-treatment, able to understand the brain model of addiction and self-aware to the point
they can ‘surf’ their craving ‘waves’, there are slippages that suggest these active, self-
controlled bodies are susceptible to change. Methamphetamine’s materiality has been
inscribed in such a way that it can become a meth monster; faced with the meth monster, the
agentive subject’s capacities change and he or she becomes instead a childlike figure
attempting to tame the monstrous properties of methamphetamine.

It appears then, that while policy and treatment practices materialise active, self-controlled,
knowledgeable methamphetamine-using bodies with the capacities of the neo-liberal ideal,
these can be difficult to sustain given the addictive and destructive properties of
methamphetamine. Thus, these bodies are perpetually susceptible to losing their capacities
and being re-constituted in perhaps more familiar ways — as addicted, as having lost
everything and as childlike.

Resistant, anxious and paranoid bodies

Calling attention to some of the slippages apparent in the materialisation of self-controlled
methamphetamine-using bodies leads us to the more familiar figure of the addicted,
compulsive, methamphetamine-using body — that is, those bodies lacking the capacity to
exercise self-control, avoid harm and actively treat themselves. These subjects include those
that require professional assistance to fulfil the obligations of the neo-liberal subject, those
that are resistant to treatment, or anxious and paranoid, and those that are subsumed by
methamphetamine. In the discussion that follows, I examine the ways these bodies are
enacted through policy, treatment and media texts. I also consider some of the tensions
evident in the constitution of these bodies due to the neo-liberal assumptions that inform
health and AOD practices.

I have argued previously in this chapter that the Australian ATS policy (Ministerial Council
on Drug Strategy, 2008) materialises agentive drug-using bodies through the practice of harm
reduction. However, the figure of the non-agentive, drug-using subject also emerges through
national ATS policy. For instance, the ATS strategy seeks to develop an evidence base in
order to ‘manage severely dependent ATS users who are resistant to standard interventions’
(Ministerial Council on Drug Strategy, 2008, p. 29). A hyper-pathologised subject is enacted
by this statement, one that is ‘severely dependent’ — with the lack of volition that this
implies — and so unsuited to the usual interventions. The term ‘manage’ intimates that these

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bodies require a level of supervision or direction consistent with a body of reduced capacity.
At the same time the term ‘resistant’ suggests a body that is actively uncooperative. This
body thus works against its own best interests by resisting interventions. This has the effect of
locating the failure of standard interventions to work within the dysfunctional, ‘resistant’
subject and obscures other reasons for the failure of interventions, such as the nature of
interventions themselves.

Other incarnations of ATS-using subjects with compromised agency can be found in the ATS
strategy. The strategy document observes that:
the nature of many ATS problems means that a proportion of those who enter
treatment may be experiencing anxiety and/or paranoia, and also find it difficult to
establish and maintain relationships with clinicians. (Ministerial Council on Drug
Strategy, 2008, p. 32)
This statement does not clarify what ‘the nature of many ATS problems’ are, or how they
relate to individuals experiencing ‘anxiety and/or paranoia’. Yet, the subject that emerges has
reduced capacities in that it experiences mental disorders and, due to these, it struggles to
form relationships with professionals. Again, the implication is that the defective subject (not
resistant in this case, but anxious and/or paranoid) is responsible for a lack of engagement
with treatment and clinicians, rather than the treatment or clinicians themselves.

Thus, while a predominantly active subject is enacted in ATS policy — due to its emphasis
on the practice of providing information to individuals with expectation they will act upon
this information in the interests of their health — subjects of compromised agency are also
enacted within this policy. The limited capacities of ‘severely dependent’ and ‘anxious and
paranoid’ ATS-using bodies render them unsuitable candidates for standard treatment
interventions. As such, poor treatment outcomes are able to be considered as a result of the
dysfunctional ATS-using body, rather than other aspects such as the treatment itself. This
means that the assemblages of AOD treatment — the spaces, clinicians, doctors, treatment
guides, pharmacotherapies and other objects and subjects that produce the treatment
encounter — are obscured.

Similar to policy concerning methamphetamine, treatment practices directed at the use of this
drug also enact both active and non-active/resistant bodies. The national treatment guide for
methamphetamine (Jenner & Lee, 2008) recommends that CBT should be standard practice
in the treatment of this drug and, in doing so, materialises methamphetamine bodies that are

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highly self-aware and reflective. Yet this manual also recommends practices that enact bodies
with reduced capacity. For example, workers are advised that although the way
methamphetamine works is complex, they must be able provide their clients with an
understandable explanation:
The way in which methamphetamine works is complex, but it is extremely important
for workers to understand how this drug works in the body so they can inform their
clients….The end of this section contains a suggested plain language explanation that
can be used by workers to help clients better understand the effects of
methamphetamine. (Jenner & Lee, 2008, p. 15)
The information that workers are to provide to clients includes the following:
Methamphetamine causes the brain to release a huge amount of certain chemical
messengers, which, as you probably know, make people feel alert, confident, social,
and generally great….Think of a glass full of ‘happy’ messengers, so when people
have been using methamphetamine for a while the glass empties and no matter how
much methamphetamine they use they just can’t get the rush they want and will still
feel awful. (Jenner & Lee, 2008, p. 17)
In the above information for clients, technical language is eschewed for childlike descriptions
of drug use. This enacts a body without the capacity for understanding the more complex
information needed to act upon on his or herself. It notes, however, the extreme importance
of the individual having access to this knowledge. These are bodies obliged to understand
themselves in increasingly neurobiological terms (Rose, 2007). It is not enough to know that
one may build up a tolerance after taking methamphetamine for some time; the individual is
expected to comprehend (albeit in a limited way) what occurs at a neurobiological level and
to use this information in the interest of his or her health and well-being.

The textual evocation of this methamphetamine-using body reveals some of the tensions
between subjects with little or no capacity to act correctly upon themselves and the neo-
liberal assumptions that underlie health practices (Lupton, 1996). The bodies that emerge in
the practices outlined above are not able to fully assume the status of a neo-liberal citizen, as
they do not have the capacity to understand complex information about themselves. Yet, with
assistance from treatment practitioners they are still required to fulfil the obligations of the
neo-liberal citizen. These obligations include understanding exactly what happens when they
take methamphetamine to enable informed decisions.

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Violent and toxic bodies

In addition to resistant and anxious bodies, authoritative texts also enact methamphetamine
users as violent and toxic. A suite of publications concerning the management of
methamphetamine toxicity for front-line professionals not working specifically in AOD,
including ambulance officers (Jenner et al., 2006b), emergency departments (Jenner et al.,
2006b) and police officers (Jenner et al., 2004) is available through the National Drug
Strategy website (nationaldrugstrategy.gov.au). These publications enact methamphetamine-
using bodies very much at odds with the active and self-controlled user. This series of
publications is indicative of the specificity of how we understand methamphetamine and
those who use the drug. No other drug has prompted a series of similar publications by an
Australian government body, testament to the way in which methamphetamine has been
inscribed as a toxic drug that induces violent behaviour.

These three texts are all premised on the assumption that management of severely affected
people using methamphetamine will involve addressing violent and/or psychotic behaviour.
The text for ambulance officers explains:
Control of behavioural disturbance is the first priority. Calming communication to de-
escalate potentially dangerous situations is recommended if a patient becomes hostile
or violent in the pre-hospital setting. (Jenner et al., 2006a, p. v)
Guidelines for addressing this behaviour include talking calmly to the affected individual,
avoiding eye contact, avoiding restraint (if possible) and, as a last resort, sedation with
midazolam (a commonly used intravenous sedative). In addition to being hostile and violent,
methamphetamine-using bodies materialised in these guidelines are also indistinguishable
from mentally disturbed bodies. This is evident in the following statement:
It is often difficult for paramedics at the scene to accurately determine if an individual
is intoxicated with psychostimulants or suffering from an acute mental health
disorder. For this reason these guidelines recommend that both situations be
responded to in the same way. Specifically, both are considered to be a medical
emergency. (Jenner et al., 2006a, p. 7)

Here, the severity of the methamphetamine-using body is made clear, as managing this body
constitutes a ‘medical emergency’.

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In addition to being characterised as violent and psychotic, methamphetamine users are also
enacted as ‘toxic’ in these publications. Police guidelines outline the difference between
intoxication and toxicity as follows:
Individuals experiencing psychostimulant intoxication can often demonstrate a range
of behaviours related to the stimulating effects of the drug including mild paranoia,
rapid speech, irritability and agitation. However, when a person is toxic or has a
poisonous level of psychostimulant in their system, a range of behaviours including
escalating psychosis, acute paranoia, aggression, marked agitation or violence may be
evident. When in a state of toxicity, an individual’s behaviour may pose a significant
risk to the physical safety of themselves, bystanders and police officers. (Jenner et al.,
2004, p. viii, emphasis in original)
Asserting that a person is toxic is used here to delineate a state beyond intoxication. In this
state, it appears a methamphetamine users may engage in a range of frightening behaviours
and require intensive management. Thus, methamphetamine-using bodies in these texts are
enacted in binary opposition to the agentive body materialised in CBT practice. These are
specifically violent, toxic and possibly insane bodies.

Subsumed, disgusting and depraved bodies

By examining policy and treatment texts I have shown that two opposing spheres of
methamphetamine-using bodies — active and self-controlled compared to anxious, resistant
and violent — are enacted within these documents. Further, these bodies are enacted in
extremes — they are hyper-controlled, and at the same time hyper-violent and psychotic. I
now turn to the field of media, in order to further examine the extreme absolutes of
methamphetamine. Here I find a familiar figure of drug use, that of the chaotic and out-of-
control ice-using body. This body has compromised agency. It is unable to exercise volition
as its actions are driven by the drug ice itself. It is an important body to consider when
discussing the way we constitute people who use methamphetamine, as media texts reach a
very broad audience.

The Ice Age (Carney, 2006) is a documentary focusing on the use of ice in Australia and the
harms that may occur. To do this, it features a group of people who experience a high degree
of social and economic deprivation, including homelessness, estrangement from family,
incarceration, poverty and mental illness. This group of ‘hardcore ice addicts’ is followed
around the streets of Sydney and is filmed buying and using methamphetamine and other

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drugs. A key figure in the documentary is ‘Matty’, an individual who is filmed living on the
streets, confessing to various criminal acts, taking drugs and being heavily intoxicated. The
footage of Matty (as well as other participants) is so revealing it is difficult to comprehend
the circumstances under which these individuals would have given consent to being filmed. It
is perhaps their social marginalisation and vulnerability, rather than their being representative
of typical ice users, which has resulted in their participation in the documentary.

A feature of the documentary (signalled by its title) is the emergence of the substance ice, a
specifically dangerous, destructive and addictive substance, and a threat to the Australian
population. This is made clear from the opening statement of the report:
It's more destructive than any other drug Australia has ever seen. It's cheap and it's
highly addictive. It's not heroin, but ‘ice’ or crystal methamphetamine, the most
potent amphetamine ever to hit our streets. Its powerful high can last for days or
weeks. In Australia, there are now more ice addicts than heroin addicts. (Carney,
2006)
This strongly worded passage evokes an emerging catastrophic drug problem: a cheap drug,
that is so potent its users can be ‘high’ for weeks. And to clinch the characterisation of ice as
extremely addictive, it is compared to heroin — a popular media benchmark for assessing
how dangerous a drug is (see, for example, Bartlett, 2006; Hayes, 2006).

Following this statement, scientific authority is used to authenticate the reporter’s assertions
regarding ice. Professor Ian McGregor, a psychopharmacologist, is interviewed and states:
Methamphetamine, in my experience, looking at both animal studies, studies of
laboratory animals and addict populations, it's one of the most addictive drugs that we
know, and it's by virtue of its ability to produce this huge surge in dopamine levels.
(Carney, 2006)
Later, McGregor says:
So, if dopamine's constantly being over-produced and over-released, then the brain
will down-regulate the receptors that dopamine binds to, so you'll alter the function of
the brain. So, you end up with a bit of an abnormal brain as a result of
methamphetamine. (Carney, 2006)
As McGregor is a scientist, his assertions are difficult to refute. This is made evident by his
title, but also by the content of his statements. He uses technical language and imagery,
referencing brain science. Thus, from the outset of the documentary, the substance ice, or

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methamphetamine, is enacted as a threat to society, neurally damaging to the individual and

addictive. Inscribing ice in this way leaves little doubt as to the capacities of ice-using bodies.
These bodies will be necessarily addicted, but also high and brain-damaged.

A strong theme within this documentary is the way in which ice (and heroin) takes over
human existence. Ice-using bodies are enacted in this text as wholly enmeshed within
addiction itself. An example of this is provided in the telling of Mick’s history:
This is the only life Mick has ever known. He started his addiction with heroin when
he was just 13. Now 36, he’s been in and out of jail for the last 13 years. (Carney,
2006)
In this statement, ice, heroin and incarceration are the sum total of Mick’s existence. These
elements apparently trump any other connections, relationships or practices that Mick has
engaged in during his life. And indeed, Carney goes on to assert that drug use can subsume
personhood. Talking about two participants in the documentary Carney states, ‘for Mick and
Matty, drugs have created and completely defined their identities’ (Carney, 2006). Here,
Mick and Matty’s subjectivity — how they experience the world — is reduced to their drug
use, rather than any other experiences they may have had. Their identities are shaped entirely
by their drug use; they are solely drug bodies. As drug bodies they live in a ‘drug cycle’ and
their day-to-day life is described as follows:
They live in a drug cycle of about two weeks. For the first week, they take ice and
barely sleep or eat. The following week, they crash and sleep until the next welfare
cheque. Then the cycle starts again. (Carney, 2006)
The methamphetamine-using subjects enacted within this text are thus controlled and
subsumed by ice so that everything they do, and everything they are, is related to ice and
addiction.

As well as being controlled by ice, the documentary portrays methamphetamine bodies as

‘grotesque’ objects of disgust and depravity (Moore, 2008, p. 357). Documentary participants
are filmed rummaging through rubbish, picking at themselves, living in squalor, and speaking
incoherently while ‘under the influence’ of methamphetamine and other drugs. A doctor
working at an accident and emergency department in inner-city Sydney describes a ‘very
extreme case’ where a patent masturbated for 16 hours in full view of staff and other patients
(Carney, 2006). ‘John’ is interviewed, who ‘is convinced that he is infected with ice bugs,

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parasites that he believes were living in a bad batch of ice he injected years ago’ (Carney,
2006). John states:
As you can see, there's something under the skin and it's coming through. All up here,
my leg. I've been using that wash, and as you can see, they come up. This, when it
was at its worst, was real pussey [sic] in the centre. And you used to be able to
squeeze it, and little spores would come out. And they had this red stuff around them,
which was very sticky. (Carney, 2006)
With these images, the documentary enacts ice-using bodies as disgusting and depraved. In
doing so, a group of people who are obviously socially marginalised are further estranged
from ‘normality’. As objects of disgust, these people do not evoke a response of empathy, but
revulsion, serving to further entrench their marginalisation. The participants of this
documentary are individuals entangled with phenomena such as sleeplessness, psychosis,
poverty, masculinity and other drug use. Yet, The Ice Age constitutes them as fuelled by
methamphetamine — othering their complexity, rendering them easily understandable.

To conclude, the ice-using bodies enacted in The Ice Age are brain-damaged, subsumed by
ice, living a drug cycle and engaging in disgusting and depraved acts. These bodies are failed
neo-liberal citizens. They are the binary opposite to the self-managing harm reduction,
treatment and self-help bodies enacted in neo-liberal health practices. This is reflective of the
chaos/stability binary that Fraser and Moore (2008) argue is a mainstay of illicit drugs
discourse. The authors argue that this binary entails that drug users are chaotic and non-drug
users are not, or that some drug users are chaotic and other drug users are orderly (Fraser &
Moore, 2008, p. 744). In doing so, the authors argue that:
The notion of chaos operating in drug related discourse tends to…uncritically
promote neo-liberal norms. (Fraser & Moore, 2008, p. 748)
Thus, drug users (or certain types of drug users) defined as chaotic are at odds with the neo-
liberal order, where rationality and self-control are essential to constituting oneself as a self-
governing citizen. In the same way, the non-agentive ‘anxious’, resistant’, ‘subsumed’ and
‘disgusting’ methamphetamine-using bodies discussed above are dichotomous to those that
are enacted through practices such as harm reduction, CBT and self-help. And yet, as I have
argued earlier, drug users considered ‘orderly’ — these active, self-reflective
methamphetamine-using subjects — are always at risk of lapsing into ‘disorder’.

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Methamphetamine, as it is currently inscribed, leads us to regard every user as having the

potential to become as grotesque as the bodies evoked by The Ice Age.

Conclusion
In Chapter 4 I argued that the drug methamphetamine is constituted in scientific texts as a
hyper-stimulant — as toxic and destructive. In this chapter, I have built upon this argument
and shown that methamphetamine bodies are enacted in extreme absolutes in authoritative
texts. Methamphetamine-using subjects are materialised as specifically anxious, violent and
chaotic and yet, paradoxically, these bodies are simultaneously enacted as specifically active
drug users, able to be self-reflective and controlled. Foregrounding practice and asking what
these bodies can do reveals that they have different capacities but are shaped by the same
assumptions — the centring and valorisation of the agentive, knowing and self-controlled
subject, the fear of methamphetamine itself and disgust at the addicted subject.

The binary opposition of drug-using bodies in the neo-liberal episteme has been previously
elucidated in the literature (see, for example, Sedgwick, 1992). I have built upon these
insights in this chapter by making visible the specificity of methamphetamine-using bodies
and by tracing the connections that make this specificity possible. I have shown how the
materiality of methamphetamine is inscribed as a particularly insidious drug; one that is
highly addictive and, at times, compared to heroin in order to evoke its destructiveness. Thus,
front-line worker manuals enact methamphetamine users as hyper-violent and toxic bodies
and the media constitutes ice users as barely human. Yet, because of an absence of a
pharmacological equivalent to OST and diagnostic tools that problematise particular practices
and ways of thinking, we are able to simultaneously constitute methamphetamine users
treatable via CBT and self-help — highly active and self-reflective forms of intervention.

In revealing the extreme absolutes of methamphetamine-using bodies, I have also illuminated

the slippages and tensions involved in their enactment. Practices such as CBT and self-help
enact methamphetamine-using subjects capable of self-reflection and self-control. These
subjects, however, are always at risk of losing their volition due to the destructive and
addictive properties attributed to methamphetamine. They then materialise as
methamphetamine-using subjects that are resistant, anxious, paranoid and/or subsumed by the
drug. These bodies are failed neo-liberal citizens. This shows the political nature of these
bodies — that is, the choices, assumptions, contradictions and ‘conditions of possibility’ that
shape these bodies. These bodies are not pre-existing, inevitable manifestations of

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methamphetamine use. They are constituted through practices that are, in turn, shaped by the
ways we think about drug use, unable to exercise self-control and, in the extreme, living on
the margins of society.

The extreme absolutes of methamphetamine use are insufficiently complex ways of

understanding drug use. Without diminishing the experiences of people who use
methamphetamine and who find that it has harmful or negative effects on their lives,
methamphetamine (and other drug) use is often for pleasure, and not unequivocally a
dangerous and addictive practice. This is attested to by the significant proportion of the
population who have used this drug yet suffered few problems. Further, in considering ways
to reconceptualise or produce bodies that use this drug, it is helpful to move beyond neo-
liberal assumptions that locate agency within the sovereign subject and considering drug use
as solely an individual practice. Drug use is more productively thought of as an assemblage,
where a confluence of objects (including the drug methamphetamine, syringes to inject or
pipes to smoke), subjects (people using the drug, people selling the drug, treatment providers,
police), spaces (a self-help website, a treatment service, a toilet in a nightclub where it is
injected, but also the sounds, sights and sociality of these spaces), organisations
(governments that make this drug illegal — yet also provide harm reduction information, a
police force that enforce laws, the medical profession that define drug use as a pathological
practice) and so on, come together to produce and re-produce drug use. Conceptualising drug
use in this way de-centres the subject, showing the dynamic effect of all these phenomena in
drug assemblages.

However, what does conceptualising methamphetamine use as an assemblage and

subjectivity as fragmented mean for someone seeking treatment? For someone who considers
themselves addicted to methamphetamine? For someone who has experienced psychosis
when consuming methamphetamine? For someone who sells methamphetamine? For
someone treating a person who uses methamphetamine? These are questions that I address in
the following chapters, where I consider the accounts of people who consume
methamphetamine, and people who treat methamphetamine consumption. In shifting to my
empirical data, I illuminate the ontological politics of methamphetamine-using bodies. I show
how hegemonic assumptions shape the day-to-day practices around consumption and
treatment. At the same time, I show how these are resisted and subverted.

   

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Chapter 6: Consuming methamphetamine: Accounts of

methamphetamine use

Introduction
To this point, my thesis has addressed the enactment of methamphetamine and
methamphetamine-using subjects in scientific, policy, treatment and media texts. In this
chapter I move from these authoritative discourses to my interview data and how people who
use methamphetamine constitute themselves. In Chapter 4 I argued that scientific discourse
enacts methamphetamine as a specifically potent, addictive drug. In Chapter 5 I argued that
policy, treatment and media documents materialise methamphetamine-using bodies in two
spheres of absolutes: knowledgeable, self-controlled, reflective bodies and anxious, resistant,
violent, toxic and chaotic bodies. Moreover, these are extreme absolutes; that is, despite the
enactment of methamphetamine as a highly destructive substance, people who use
methamphetamine can be constituted as highly functional, self-controlled individuals. At the
same time, users are evoked in texts as uniquely toxic — violent and psychotic. While
dualistic, these bodies have a common thread: the valorisation of the sovereign subject and its
capacity to exercise choice and autonomy, and abhorrence of the addicted subject. I have
argued that enacting methamphetamine-using subjects in these absolutes masks the
assemblages of drug use, producing drug use as the act of a self-contained individual. This
has the political effect of placing responsibility for drug use on individuals, legitimising them
as objects of surveillance, blame and vilification.

I now shift from tracing the enactments of methamphetamine and methamphetamine users in
authoritative texts to exposing how these may come to bear on the ways individuals who use
methamphetamine constitute themselves. To explore the ontology of methamphetamine-
using-bodies, I spotlight the relationship between the ways consumers embody themselves
and the absolutes enacted by scientific, policy, treatment and media discourse, showing how
hegemonic ideals are (re)produced and subverted in accounts of methamphetamine
consumption. I also attend to the material—semiotic networks that constitute
methamphetamine-using bodies, challenging the valorisation of choice and free will in the act
of drug taking. I argue that individuals do not have inherent qualities but that these networks
capacitate bodies in particular ways. Active practices and attributes such as self-control and
the ability to make the ‘right’ choices are shaped by the social and material connections an
individual is able to make. Likewise, feeling out-of-control or ‘taken over’ by

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methamphetamine and other uncontrolled practices emerge from the relations an individual
forms, and the assemblages they are enmeshed within, rather than a deficiency of will. I also
show how methamphetamine-related practices are more complex than the absolutes that
shape drug use allow, with individuals simultaneously understanding themselves as in control
and addicted, as careful and hedonistic or as psychotic and reasonable. This is reflective of
the complexity of drug use and of the multiple ways in which people incorporate broad
understandings of drug use in their lives, both embracing and subverting these. By
investigating the ontological politics at play in the constitution of methamphetamine-using
bodies I study methamphetamine use as a matter of concern (Latour, 2004). That is, I
recognise the inherently political nature of realities and, rather than seeking to reveal facts
about methamphetamine use, show instead the complexity of drug use and the political
effects of dominant ways in which we currently understand drug users.

Embodying multiple selves through practice

To consider how methamphetamine consumption practices constitute particular bodies I draw
upon the work of Mol and Law (2004), who argue that we ‘do’ our bodies through practice:
We all have and are a body. But there is a way out of this dichotomous twosome. As
part of our daily practices, we also do (our) bodies. In practice we enact them. If the
body we have is the one known by pathologists after our death, while the body we are
is the one we know ourselves by being self-aware, then what about the body we do?
What can be found out and said about it? Is it possible to inquire into the body we do?
And what are the consequences if action is privileged over knowledge? (p. 45)
Mol and Law (2004) explore embodiment in the context of hyperglycaemia, a condition
experienced by people with diabetes. They argue that in the current episteme there are two
ways of knowing the body: ‘objective, expert, public’ knowledge, and ‘subjective, private
and personal’ knowledge of the body from the inside (Mol & Law, 2004, p. 48). They find
that attempts to address the dominance of expert public knowledge (see, for example,
Sullivan, 1986) seek to integrate and extend personal knowledge, and thus the dichotomy
between public and personal knowledge remains. To address the distinct knowledge domains
of the public and the private, and to better comprehend embodiment, Mol and Law (2004)
assert we must shift our focus from the accumulation of knowledge to the foregrounding of
practice.

Mol and Law (2004) understand embodiment as dynamic. Like Buchanan (1997), they reject
the idea of a pre-existing subject, considering the subject as continually made and re-made
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through practice. Further, these scholars note that not all practices are possible — they are
shaped by and emerge from the neo-liberal episteme. In addressing the subject as constituted
through practice, these scholars draw upon the Deleuzian idea of becoming, where
embodiment is always in flux and produced through multiple assemblages. In order to
comprehend embodiment, the assemblages through which people ‘do’ themselves must be
taken into account. This involves tracing myriad relations between human and non-human
entities that produce, and are produced by, drugs, drug use and drug bodies. This way of
thinking about embodiment has implications for how accounts of people using
methamphetamine are addressed and allows me to explore the ontological politics of
embodiment; that is, the open and contested nature of identity. The practices identified in
accounts are thus considered in light of how they enact becoming ‘selves’, rather than as the
symptomatic behaviours of an anterior pathological and/or deviant subject.

Attending to the connections and relations formed between human and non-human entities
also allows me to show that these are productive of individual capacities and attributes. Using
STS theorists, Duff (2012) argues that the relationships between things capacitate bodies and
that shifting relationships result in differing bodily capacities:
agency is a function of the slow development of network relations such that each
actor’s agentic capacities differ according to the character of these relations (Latour
2005: 63–65). While the development of novel associations necessarily transforms an
actor’s specific capacities, such capacities are dependent on the ongoing maintenance
of these relations. If relations are disrupted or suspended, if relationships break down
or actants fail, then the actor’s individual capacities will also decline. Relations may,
in this way, be described as conduits or mechanisms for the production, distribution
and utilisation of agency (Law 2002). (p. 149)
Here, Duff is clear that capacity and agency are shaped and produced by the relations
individual can form and to which they have access. Implicit in this argument is the
assumption that individuals engage in an array of practices, and embodiment is multiple.
These multiple selves are, of course, limited — they are more than one, but less than many
(Law, 2004). They are always shaped by current conditions of possibility and the limited
ways in which we can understand ourselves. At the same time, they are also capacitated by
the localised assemblages they are enmeshed within and their connections to significant
social and economic resources.

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In this chapter, I move from scientific, policy, treatment and media discourses to my
interview material in order to explore the ways in which the unique dualistic
methamphetamine-using bodies enacted in authoritative texts shape accounts of
methamphetamine consumption. I first discuss practices that produce drug ‘expertise’ and a
high level of control in drug taking. I then examine the ways in which participants ‘do’
themselves as addicted and as taken over by methamphetamine, or driven by traumatic
events. In doing so, I make visible the messiness and complexity of methamphetamine using
practices arguing they emerge from material—semiotic networks, rather than a result of
individual attributes. .

The neo‐liberal subject? Expert, knowledgeable and self‐controlled

drug‐using practices
In this section I discuss the expert, knowledgeable and self-controlled methamphetamine-
using practices identified in participant accounts. These are practices that materialise bodies
that express the attributes and capacities of the neo-liberal citizen. These include making
methamphetamine, researching and understanding methamphetamine both neurally and
chemically, and ‘extreme’ methamphetamine use. To elaborate on these practices, a case
study of ‘Wizman’, an ‘expert’ user, is presented. Following this case study, practices that
involve research and ‘expert’ consumption of methamphetamine are discussed. Then,
‘extreme’ methamphetamine-using practices are addressed. Finally, I consider how
methamphetamine consumption practices materialise through the multiple networks within
which people are enmeshed.

Wizman: An expert, self‐controlled and addicted biocitizen

Wizman, 14 a 22-year-old man from inner Melbourne, was employed casually at a call centre
at the time of our interview. His account of methamphetamine consumption was shaped by
neural and chemical understandings of the drug rather than being a strictly lay account of
drug taking, and drew upon scientific discourse to explain his methamphetamine use and
subsequent addiction. In this sense, Wizman was an expert methamphetamine user and the
localised practices he engaged in — knowing methamphetamine both chemically and
neurally, making methamphetamine and treating himself for addiction — were highly active.
Yet he also drew upon broader narratives of addiction and decline. In this way his account
both reproduced and challenged existing discourses.

                                                            
14
 Wizman was the pseudonym chosen by this particular interviewee. 

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Wizman positioned himself as an expert in the area of methamphetamine in the first text
message he sent me:
Hi nichola [sic]… I’d like to assist you in your studies on speed/ice use in Australia. I
have used extensively on and off and consider myself an expert on the matter. Feel
free to contact me if youd [sic] like to meet up for a coffee and gain some insight.
Wizman reinforced his status as an expert early in our interview by informing me of the way
in which methamphetamine worked neurally:
What happens when a human ingests meth is the meth molecule basically mimics the
action of a neurotransmitter called dopamine in your brain, so dopamine is linked in
normal behaviour to basically, to pleasure and to, what’s the best way to describe it;
it’s basically the reinforcement molecule in your brain. So, in normal activity —
eating good food, spending time with people you love, sex — all produce dopamine
which produces this pleasure response, but then also links you into a pattern of
behaviour.
Later, Wizman explained how he became addicted to methamphetamine use exclusively in
neurobiological terms, saying that injecting methamphetamine (as he did) led to addiction
more quickly than snorting or eating the drug:
Whenever dopamine is released in the brain it reinforces whatever behaviour has
produced the dopamine. When you ingest methamphetamine and it mimics this action
and you get a massive increase in the concentration of dopamine in your brain, it’s
like basically you’re ingesting pure chemical reinforcements. So if you were to take
the drug orally and have that, as I said, that slow gradient of increase of dopamine in
the brain it’s not as behaviour-reinforcing as having that spike that you get from
smoking or injecting. So that’s really, neurologically, where it comes down to.
These statements draw upon scientific explanations of the impact of methamphetamine on the
brain. Moreover, in this statement, methamphetamine itself moves beyond a substance to
become a ‘pure chemical reinforcement’. Here, Wizman enacts the drug as wholly a neural
phenomenon. In this sense Wizman embraces scientific discourse, using it to understand his
experience of methamphetamine and to embody himself as a methamphetamine expert.

In addition to expertise in the area of neurochemistry, Wizman knew how to manufacture

methamphetamine. At the age of 16, he had set up a small methamphetamine lab in his
backyard. Then, by extracting pseudoephedrine from over-the-counter pharmaceuticals and

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synthesising it with red phosphorous and iodine, he made methamphetamine powder (speed).
Wizman kept this secret from his parents and manufactured and injected speed almost daily
from the ages of 16 to 18, while attending school. Talking about this experience, Wizman
stated that he was a very good chemist, but that ultimately manufacturing methamphetamine
for his own use was ‘a bit of a pitfall’. Nonetheless, in addition to having a neurochemical
understanding of himself, Wizman also had an expert understanding of how to manufacture
the chemical methamphetamine. Through these practices, he enacts himself as a highly
agentive, expert user.

Wizman relates practices whereby he embodies himself as an expert and active

methamphetamine-using body — he makes the drug, injects it without harm and knows what
is happening neurally when he uses it. Yet, he draws upon conventional tropes to understand
his drug use. In his account, Wizman relates a narrative of addiction, denial and recovery, in
his own words, a ‘cliché’. For instance, Wizman says he was in ‘denial’ about how his
addiction to methamphetamine was damaging his life:
At the height of my addiction I was convinced that I didn’t have a problem at all and
it was only when I stopped using for about a week or so and then my sort of
neurochemistry came back to normal I realised how much I’d fucked up.
He also describes the grief that his methamphetamine use caused his parents, as well as the
depression he experienced, saying:
I was basically, yeah, suicidal and then obviously I had to confess to my parents about
everything that I’d been doing, and that destroyed them and so I fucked up the home
and I felt as though I’d just gone to rock bottom, beyond the point of no return.
The narrative of hitting ‘rock bottom’ is one common to drug use accounts and a leitmotif of
the twelve step movement. Wizman engages with this particular cliché, yet he does not
completely embrace it. He draws upon the concept of addiction, but also clarifies that he is a
person with the capacity to stop using drugs. He points out: 
The interesting thing about me is I understand that a lot of people just simply cannot
stop using hard drugs and I can see why, just because of the pleasure or the escapism
or whatever but twice now, with heroin and with meth, I’ve just said to myself that’s
the end of that, I’m not doing that anymore.

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Wizman enacts his body here as self-controlled; he is able to stop using heroin and
methamphetamine. He thus embodies himself as both able to make the right choices and as
addicted, subverting the voluntarity/compulsive binary (Sedgwick, 1992).

Further, while Wizman employed the narrative of addiction, denial and decline, for the most
part he saw his addiction in terms of his neurochemistry. He considered it as something he
could address through research and taking supplements such as ‘omega three oils and
tyrosine’. By enacting his addiction in this way, Wizman again subverts the conventional
subjectivity of an addict, constituting himself as a biological citizen (Rose, 2002). He
describes his depression (after he stopped taking methamphetamine) as solely related to his
neurochemistry:
I wasn’t unhappy because I had disrupted my family or abandoned my friends or
neglected myself…I was depressed…just because I had caused a neurochemical
imbalance in my brain. It didn’t have anything to do with any other environmental
effects. It was that I had strictly depleted the dopamine receptors in my brain and I’d
down regulated them so they weren’t fully functioning.
Wizman therefore rejects the assumption he should be remorseful about his behaviour as an
addict. He enacts his depression as a result of his (damaged) brain chemistry. Later in the
interview, Wizman clarified that feeling depressed was a mixture of the social ramifications
of using speed heavily for two years in addition to neural depletion. Nevertheless, in terms of
treating his addiction and depression, Wizman sought to restore his brain to a ‘natural state’.
Thus his ‘recovery’ from methamphetamine addiction involved rebalancing his brain
chemistry, rather than activities associated with an addiction narrative such as counselling or
making amends to those he had wronged. These recovery activities were self-initiated —
Wizman treated himself — further embodying himself as an expert in the area of
methamphetamine use.

The ways in which Wizman draws upon scientific discourse and the idea that addiction is a
neurological disorder in order to embody himself mirrors some of the insights offered by
kylie valentine (2007) and Scott Vrecko (2006). Both scholars use Ian Hacking’s (2002)
theory of ‘making up’ people to explain how people draw upon broad discourses to
understand themselves — to ‘make up’ themselves. Valentine (2007) points out that localised
practices are also essential to understanding the ways that people embody themselves. Yet, at
the same time, people employ broader cultural understandings around these practices to enact

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themselves. In this case, the localised practices Wizman engages in are expert and self-
controlled, but he is still compelled to draw upon meta-narratives of addiction to identify
himself and understand his drug use.

Vrecko (2006) uses Hacking’s work to assert that an effect of understanding addiction
neurologically is that people can then embody themselves in less pejorative and limited ways.
For instance, cravings to use alcohol or other drugs are evidence of being ‘endorphin
challenged’ (Vrecko, 2006, p. 302), not proof that one is, and always will be, an addict. In
Wizman’s case, embracing a neural and chemical enactment of methamphetamine does two
things. First, he establishes himself as an expert body, able to manufacture the drug and
understand its effects. He also remains in control — attending school, keeping his activities
secret from his parents and then making a choice not to use ‘hard drugs’. These practices
reject conventional understandings of drug-using bodies as compulsive and chaotic. Second,
he provides a neurological explanation of his addiction and the subsequent restoration of his
brain to its normal state. So while he uses an addict subjectivity to tell his story, he is also a
biological citizen; he is both self-controlled and an addict. By embodying himself this way,
Wizman subverts binaries such as voluntarity/compulsivity and controlled/chaotic that
structure our understanding of addiction. Additionally, the figure of the addict contributes to
Wizman’s expertise, as he has actually experienced addiction as well as being a lay expert in
the science of methamphetamine.

Knowledgeable and controlled practices: Researching methamphetamine

Wizman offers a particularly intriguing account of expert methamphetamine consumption
practices, but other participant accounts also provide examples of expert and knowledgeable
practices involving this drug. Several participants had researched methamphetamine and
other drugs extensively in order to ascertain their safety and find out how to get the most
enjoyment out of them. This involved reviewing mainstream information such as scientific
literature but also engaging in online illicit drug forums (such as bluelight.ru). James, a 20-
year-old student, had been diagnosed with Attention Deficit Disorder (ADD). He had
researched the pharmaceuticals that had been prescribed for his ADD and drew a parallel
between this activity and taking methamphetamine:
It’s the same for like taking drugs and stuff, I know it’s like, there wasn’t really a
point where someone [said] like, ‘Oh yeah, have this random substance’, ‘OK’, it was

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like I knew about it beforehand, I’d researched it beforehand and an opportunity came
up and I was like either ‘yes’ or ‘no’.
James suggests in the above quotation that it would be foolhardy of him to take an illicit drug
(or even a licit drug) without having done background research. This knowledge then
provides him with the capacity to decide whether he will consume a particular drug.

As a result of research into methamphetamine James concluded it was a useful stimulant. He

said of his research outcomes:
Mostly it just sounded like super coffee [laughs]. That’s the best way to put it…that’s
pretty much what it was for me.
In keeping with his opinion of methamphetamine as an ultra-effective stimulant, when
describing his use of methamphetamine James mostly talked about its usefulness in keeping
him alert. He found it essential, for instance, to cope with a job that required him to work
night shifts:
when it got to night shifts I was like, ‘this is ridiculous I can’t do this’! And then I was
like ‘oh wait hang on, super coffee’. And then yeah, it worked quite well with shift
work and I swear to God, like with the cycles that you keep, everyone there probably
takes some sort of drugs to stay awake.
He also used methamphetamine to ‘sober up’ and stay out after drinking alcohol:
I’ll go to a friend’s house and we’ll just be drinking all night and I’ll be really drunk
and then someone else will call me and be like ‘hey, do you want to go out’ and
normally I’d go ‘oh no, I’m just going to go home and go to bed’ but if I’ve got speed
or something, if I take that it’ll just kind of balance me out so I’m not slurring,
staggering drunk, but I’m still drunk and can go out, you know a bit more composed.
So it works well for that too.
The practices of use that James recounts enact methamphetamine as a ‘super coffee’; a
substance that enables him to get through his night shift or to go out after drinking alcohol.
Even though he uses methamphetamine to party, its function is to keep him composed. This
practice is very similar to that noted in Pennay’s (2013) research with young party drug users
in Melbourne, who also consumed methamphetamine to stay in control.

For James, the decision to take drugs is the outcome of a rational process where he uses
methamphetamine to stay in control and stay awake. Through these practices, James
embodies himself as a knowledgeable and controlled user. His choices are informed by

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rationality, rather than these choices being driven by desire, impulse or compulsion.
Additionally, methamphetamine is enacted as a useful tool — ‘super coffee’ — a very
different object to the toxic and addictive substance inscribed in mainstream scientific
literature. While this might seem counterintuitive given that James researched
methamphetamine previously, James was accessing websites where subversive discourses
around drugs and drug use are found. Websites such as blulight.ru are frequented by expert
drug users who challenge dominant discourse concerning drugs, but may also use scientific
discourse to make their arguments (Barratt, Lenton, & Allen, 2013). Moreover, James was
prescribed ADD medication (methylphenidate, marketed as Ritalin™) — a drug chemically
similar to methamphetamine. He had therefore experienced using a stimulant for functionality
and taking methamphetamine was perhaps simply an extension of this.

Claire, a 25-year-old student, also engaged in the practice of researching drugs before
consuming them, but with a slightly different intent. She considered herself a studious nerd
who wanted to experiment with drugs;
I was a nerd and I did a lot of study, I didn’t really party at all. And then I got curious.
Prior to experimenting with drugs, Claire researched them in order to figure out which ones
would be the most pleasurable:
I actually thought like if I tried any drug I just — I researched them all and I just — I
ordered them, and I thought which ones I would enjoy the most.
Thus, Claire’s initiation to drug use was extremely controlled. She researched drugs to find
out which ones she thought she would enjoy and procured these. While Claire, like James,
engages in research prior to consuming drugs, she states that this practice is for subversive
ends; to ‘party’ and to gain enjoyment. In this sense, while ostensibly responsible, this
practice has multiple outcomes. Researching drugs in a controlled manner may produce safer
drug use, but might also produce a better high and more pleasurable drug use. This is self-
controlled, responsible practice with, at times, a hedonistic intent.

As expert and controlled users, James and Claire — like Wizman — draw on broader
discourses of personal responsibility and the obligation to make the ‘right’ choices. They thus
enact themselves as neo-liberal citizens. In this sense they disrupt the violent and chaotic
methamphetamine-subjectivity enacted in the media and other discourses. As expert and
knowledgeable drug users they reflect the methamphetamine-using bodies that are enacted
through harm reduction, CBT and self-help practices. In Chapter 4, I argued that by

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constituting rational, choice-making, drug-using bodies these practices obfuscate the lived
experiences of people who use drugs and how their choice-making capacity may be
constrained by drug-using environments. James and Claire’s drug using practices illuminate
how assemblages may also materialise knowledgeable and controlled drug-using bodies.
These participants were both students, with access to and knowledge of resources such as
computers, the internet and academic databases. Through these resources, relationships were
formed with other people interested in methamphetamine (and other illicit drugs) and
information was shared. These particular networks of actants (computers, the internet, drugs)
and actors (other people interested in learning about drugs, and James and Claire who as
students had research skills and an understanding of themselves as individuals capable of
research and learning), created the possibility for active and controlled drug-using practices.
James and Claire were able to embody themselves as knowledgeable and in-control drug
users because of their relationship to machines such as computers and their familiarity with
scientific literature and the internet. The connections they make with drugs are mediated
through these ‘things’; they are expert users.

‘Excessive experience’: Extreme drug taking

The practice of ‘extreme’ drug taking was another way in which participants ‘did’ their
bodies as expert and controlled methamphetamine users. Participant’s accounts indicated the
practice of ‘extreme’ drug taking was productive of a strong-minded subjectivity. Some
participants talked about going on binges of methamphetamine and other drugs (particularly
alcohol), and of pushing their mental and physical limitations during these binges. One
participant, Paul, aged 20 and unemployed, describes a period where he consumed GHB and
methamphetamine daily:
It was different yeah, full on.
What do you mean full on?
It was like on the edge, do you know what I mean? You could tell that you were
pushing the limits sort of thing, yeah.
How can you tell you’re pushing the limits?
I don’t know. It’s just; your body just starts to shut down, all sorts of things.
What, you think you’re about to collapse or something?
Yeah.
But do you feel good or?

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You do feel good, yeah.

Paul describes a fine line between his body shutting down and feeling good. He uses the
phrase ‘pushing the limits’ to encapsulate what was happening when he took drugs in this
way. This term is commonly used in association with individuals undertaking endurance or
extreme sports, such as marathon running and big wave surfing. These individuals are
typically viewed with a mix of admonishment and admiration: admonishment in that they put
themselves at risk due to the fine line between their physical feats and serious injury or death,
admiration in that they display qualities of fearlessness, strength of will and determination —
qualities that are valorised in the neo-liberal episteme. In pushing his body as far as it can go,
to the point that he risks collapse or his body shutting down, Paul enacts his body as
expressing the hyper-agentive capacities of an endurance athlete, such as fearlessness and
determination to go to ‘the edge’.

Andy, a 25-year-old builder, also described extreme drug-using practices. He related

occasions where he consumed methamphetamine and other drugs for seven days without
sleep, attending music festivals and hanging out at friends’ houses. Andy volunteered that he
enjoyed the feeling of sleep deprivation as though it was another drug:
You just feel, you feel kind of good, like just really slow, kind of, I don’t know, sort
of ‘erhh’, it’s like walking around, oh I can’t be fucked, you know, it takes you half
an hour to get up a set of stairs but once you finally like get there, I dunno, it’s hard to
explain.
Andy appears to embrace extreme sleep deprivation, a side effect of bingeing, to the point
where it becomes an enjoyable part of the drug use experience. Andy commented that he had
never hallucinated when experiencing sleep deprivation and said:
You’re on all kinds of other drugs so you don’t know, I haven’t gotten that far yet to
hallucinate but just, I don’t know.
Through noting that he has not yet reached the stage where he might hallucinate, it seems
getting to this point is a goal rather than something to be avoided. Thus, like Paul, Andy is
interested in pushing himself to the limit — a valued attribute in mainstream society —
through drug use.

Pursuing extreme drug taking has parallels with Slavin’s (2004a) research with gay men
living in inner-city Sydney. Slavin (2004a) argued that his participants engaged in ‘excessive
experience’ (p. 445) when taking methamphetamine and that this necessarily involved

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breaching the boundaries of safe or acceptable drug use. Seeking excessive experience, and
the risk it involved, was an intrinsic part of the pleasure of methamphetamine use. Likewise,
Andy and Paul are seeking an experience beyond what most would consider safe or
acceptable drug use. But for these participants this is part of the pleasure of drug use.

Extreme methamphetamine-using practices enabled participants to constitute themselves as

strong-minded individuals. Andy considered extreme drug-using practices as only suitable for
some individuals. He cautioned:
A lot of people can’t handle it like, it all depends on the mind of the person, you know
a lot of people aren’t designed to take that much drugs.
Michael, a 27-year-old unemployed painter, gave an account of extreme methamphetamine
use that, like Andy’s, suggests only certain people have the capacity to undertake this type of
use:
Over the years I learnt to control it, you know what I mean, and the gear
[methamphetamine] back when I started was a lot stronger, a lot more potent than
what it is now. And now like, me and my mates, like we just smoke
[methamphetamine] flat out and it does nothing, we don’t get the paranoia, we don’t
get the, it’s more for your weak, narrow-minded people that turn like that. If you’re
easily influenced, you’re weak-minded, like ice is not a drug for you because you’re
going to lose the plot and the paranoia is going to set in. And you’re going to start
doing stupid stuff, you know what I mean, being erratic and just out of control.
Michael is explicit that smoking a lot of methamphetamine is not for ‘weak’ people. Through
engaging in the practice of smoking ‘flat out’, he enacts an active drug-using body that is in
control and mentally strong enough not to ‘lose the plot’. In this particular drug-using
assemblage, Michael’s body expresses its capacities through the substance
methamphetamine, embracing its material effects — such as wakefulness and its ability to
combine with other drugs. It also demonstrates particular attributes, such as strength of
character, through overcoming, or controlling, these effects. In this assemblage, ice is enacted
as a potentially dangerous drug, requiring a strong mind to control it.

The practices described above involve the ability to master and control methamphetamine.
They allow participants to embody themselves as individuals with strong minds and high
levels of endurance, qualities typically expressed in endurance bodies and elite sport bodies
and thought to be absent in drug bodies. As discussed in Chapter Two, Kate Seear and

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Suzanne Fraser (2010a) provide a case study of the elite athlete Ben Cousins (a self-
acknowledged methamphetamine addict) in order to problematise the
voluntarity/compulsivity binary. Through Cousin’s account of how he understands himself,
his methamphetamine use and his athleticism, Seear and Fraser (2010a) interrogate this
binary, arguing the two concepts are not exclusive with Cousins considering aspects of his
practice as an athlete compulsive. They find that:
For Cousins, the ‘truth’ of himself is that he is both compulsive and voluntaristic, with
each reliant upon the other for its existence (Seear & Fraser, 2010a, p. 449).
The extreme practices of methamphetamine use described above reflect this point, even
without participants engaging in other practices characterised by high levels of voluntarity.
Paul, Andy and Michael engaged in what they considered a compulsive activity (consuming
methamphetamine), with Andy considering himself as having an ‘addictive personality’. Yet,
the drug-taking practices they related enact them as simultaneously driven to take the drug,
but also with the requisite physical and mental strength to push themselves to the limit,
remaining in control of effects such as paranoia. In this way they embodied themselves as
both compulsive and voluntaristic. While the insight offered by Seear and Fraser (2010a) is
that compulsivity was integral to Cousin’s practice as a professional athlete, the participants
in my research illustrate that the practice of methamphetamine use itself can involve high
levels of voluntarity, while at the same time involving elements of compulsion. These
practices demonstrate that drug use is more complex than the voluntarity/compulsivity binary
allows.

Patterns in expert, knowledgeable and controlled practices of methamphetamine

consumption
To this point I have discussed some of the expert, knowledgeable and controlled practices in
participant accounts, including neural and chemical understandings of methamphetamine,
researching methamphetamine and extreme methamphetamine use, showing how these
practices both draw upon and subvert dichotomies that underpin drug use — such as
controlled/chaotic and voluntarity/compulsivity. I have also aimed to illustrate some of the
ways these practices are produced through material—semiotic networks, rather than being
driven by the inherent characteristics of particular individuals. Building upon this particular
insight, I now discuss commonality among participants whose accounts featured
knowledgeable and controlled methamphetamine consumption practices. These participants
tended to have strong connections and relationships to social resources (such as family

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support), economic resources (such as a steady income, home ownership) and educational
resources (for instance, some were undertaking or had been awarded a university degree).
This is not to say that those people without access to these resources did not think of
themselves as agents or engage in knowledgeable and controlled practices (as demonstrated
by Michael and Paul, both of whom were unemployed and had limited formal education).
Broadly, however, they were less likely to have access to resources that enabled them to
constitute themselves as self-controlled agents with a significant degree of power and control
in their lives. These resources were linked to, and productive of, other identities that are
typically considered to have a strong degree of responsibility and self-control such as
‘professional’, ‘student’, ‘parent’ and ‘middle-class’. I argue that managing these multiple
identities and their obligations, as well as the responsibility and power that these identities
enacted, contributed to more controlled drug-using practices. In this section, I use the
accounts of two participants to illustrate these arguments.

Kelly, aged 26, was a professional and the mother of Ben, a four-year-old boy. She injected
methamphetamine almost daily. In the past, Kelly had been an active member of the dance
scene and had engaged in extreme drug use, but her drug consumption practices had changed
over time. Kelly had to use drugs very discreetly because of her identity as a professional and
a mother. She hid her use from her parents, her son and the families she came into regular
contact with due to her son’s attendance at pre-school. She also hid her use from her
employer knowing that she would lose her position immediately if her methamphetamine use
came to light. Consequently, Kelly mostly used methamphetamine at home with her partner.
A night of methamphetamine consumption would often involve a mundane activity such as
watching television. She also used methamphetamine during the day but never enough so that
it was obvious she was drug-affected.

Kelly’s account suggests that managing her various selves has shaped her practices of
methamphetamine consumption, shifting from binge use and partying to using in a more
discrete, measured way. Having to change and conceal her methamphetamine use had both
negative and positive effects for Kelly. A negative effect was that she knew if her drug use
was discovered she would be judged on that practice above any other activity she took part
in:
Yeah, that is the main negative for me is um, well you know, it’s all of the good
things that I do in my life, I feel if anyone knew about this part of my life I would be

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judged on this more or above anything else that I do and like no one knows I do this,
you know. It’s a very private thing.
Here, Kelly feels that it is unfair her methamphetamine use could obscure all the other ‘good’
she did in her life. It is evident that for Kelly, this possible judgement is the worst thing about
using methamphetamine. This particular insight makes visible the political effects of
inscribing methamphetamine as a highly addictive drug and users as chaotic and violent.
Kelly is more worried about the social harm she would experience if she were to be
discovered, rather than the purported physical or psychological harms found in scientific
discourse. In this sense her account also provides a subversive alternative to scientific
discourse, as she fails to mention any significant negatives to methamphetamine use apart
from the social consequences. That is, she is not primarily concerned with the toxicity and
addictiveness of methamphetamine but with being ‘found out’.

Yet, while Kelly found it ‘negative’ that her methamphetamine use jeopardised her multiple
selves, she was clear that her roles as a mother and professional had changed the way she
used methamphetamine in a positive way:
I mean back then I didn’t care what anyone thought about me and I was young and I
was free and I didn’t have Ben… I didn’t care if I wouldn’t go home for three
weeks… I’d leave and say ‘I’ll see you tonight’ and I wouldn’t go home for three
weeks and I was being really irresponsible and stupid. But now I’m older and I do
care what people think about me and I have responsibilities and a family and a child
and bills and… a job and just responsibilities that I didn’t have back then…if I acted
that way now, I just wouldn’t let myself, I just couldn’t let myself act like that
because…I’m walking a different walk.

If you hadn’t have had Ben would you still be doing that?

No I’d probably be dead.

Really?

I don’t know. Maybe. I don’t know where I’d be if I didn’t have Ben. Honestly I
don’t.
Kelly’s account illustrates how the obligations of her multiple selves enact the way she used
drugs with various effects. Her multiple selves meant that her methamphetamine use was a
lot more stressful than in the past, primarily due to fear of discovery and threat it posed to her

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other identities. However, at the same time, her identities as an employee and parent enabled
Kelly to curtail her drug use and to use in a way she considered less harmful. Kelly’s account
also shows how changing drug use practices are driven by the localised networks drug-using
bodies are entangled within. Kelly’s increasing responsibilities, her professional peers and
her family were part of the material—semiotic networks that produced a change in the way
she consumed drugs, rather than this change being driven entirely by Kelly’s willpower or the
drug ‘methamphetamine’. Moreover, these networks contributed to a sense of self-control,
illustrated by Kelly stating that she ‘couldn’t let myself act like that’ referring to ways in the
past that she had used drugs. But as well as enacting herself through localised practices, Kelly
also draws upon broad cultural narratives concerning gender and motherhood (valentine,
2007). As a mother it is unacceptable that she uses a drug such as methamphetamine and this
has also shaped her changing drug practices. Thus, due to her multiple selves — enacted
within localised assemblages and through drawing on broader understandings of the self —
Kelly experienced a sense of self-control over her drug use.

Likewise, Gordon, a 31-year-old professional who worked in finance markets, also described
the way his multiple selves shaped his methamphetamine use. Gordon enacted his body as an
extreme drug user, on occasions taking methamphetamine all weekend. For instance, he
described a period over a Friday and Saturday night as follows:
[I] got a couple of grams and had… three or four hours on the pipe…I came home,
went to a friend’s house, maybe two pm on the Friday, smoked some more speed with
maybe four people there, someone’s…birthday. Um, smoking joints, took some
MDMA pills, had a trip,15 bit more speed and then like, then the trip just kicked in, so
it was sort of, you know, headlights for about six to eight hours, and then it was
probably three, four am, pretty much run out of all our drugs. 
During the week, however, Gordon worked in money markets, sometimes taking
methamphetamine to fulfil that role but in a manner so as not to appear drug-affected. He
described his use at work in the following statement:
If I’ve had a big night the night before or something, and you’re hung over as all
buggery, just a quick hit will straighten you out, or you’ve been up all night studying
and haven’t had any, and you wake up and you’re still tired… you might just have a
little, like just a little snort or something, just to get you up and ready, sort of thing.

                                                            
15
 A ‘trip’ is a colloquial term for a hallucinogenic drug.  

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Here Gordon describes a very different practice, one through which he enacts himself as a
capable ‘work body’. Gordon was also a member of an amateur sports team who played at a
reasonably high level. Again, sometimes he took methamphetamine to help him get through
practice, similar to the way he might take methamphetamine prior to work. Thus while
Gordon did not delineate his actual methamphetamine consumption — taking this drug
socially, for work and for sport — he did delineate his practices of consumption, ‘doing’
himself as an extreme drug using body or work or sport body where appropriate. Within these
shifting assemblages, Gordon constitutes himself in different ways and methamphetamine is
also enacted in multiple ways. Its materiality is shaped through Gordon’s work, sport and
social assemblages, expressive of a range of capacities, including competency and
professionalism in the case of a work body, energy and physicality in the case of a sport body
and intoxication in the case of a party body.

Like Kelly, the multiple ways Gordon constituted himself had both positive and negative
effects on how he understood his methamphetamine use. Gordon was very conscious of the
consequences for his professional standing if he was caught consuming methamphetamine or
other illicit drugs, yet this concern was not straightforward. He talked about waiting
nervously at dealers’ houses for methamphetamine or cocaine to arrive and being very aware
of the other people he was waiting with:
These other guys who have probably been in jail before, have been through the
system and some of them don’t even work and stuff, so what do you do? Like, if the
police knocked on my door and said, ‘We’re going to tell your employer that we’ve
found you with two grams.’ Like, you’d have to weigh up pretty quickly what you
wanted to do.
Gordon worried that the police would be able to force him to reveal his dealers if he was
caught, as he felt he had more to lose than people who did not have jobs and had already done
time. Yet, while his identity as a professional caused Gordon to worry about ramifications of
his use, it also made his use more exciting. He stated:
Yeah, bit of a buzzer…getting it for your mates. Like there’s that ego thing as well.
Like you’re the guy that everyone comes to….certainly there’s an ego element to it.
And you’re driving around with an ounce…in your glove box, or something, and
it’s…miles away from my other world…that I’m in, that professional, clean cut, you
know, business, sort of world.

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Thus, while a threat to his ‘straight’ identity as a professional, Gordon found the practice of
methamphetamine use, and buying and selling other illicit drugs (such as cocaine), was also
enhanced because of this identity. These practices gave Gordon kudos as ‘the guy that
everyone comes to’ as well as a thrill because, in his ‘clean cut’ world, they are extremely
transgressive.

Kelly and Gordon’s accounts are illustrative of the ways in which methamphetamine use is
produced by, and produces, the many ways individuals constitute themselves. The multiple
selves of these participants required them to consume methamphetamine in certain ways and
in certain environments. Their professional identities gave both Kelly and Gordon the money
to use methamphetamine without the need to resort to criminal activity (although Gordon did
occasionally deal cocaine to friends), but also obliged them to exercise considerable control
over when and how they used methamphetamine. Their accounts illustrate how multiple
selves are entangled, and how particular subjectivities may oblige some individuals, more so
than others, to hide their methamphetamine use.

Participants engaged in a range of knowledgeable and controlled using practices, enacting

methamphetamine-using bodies with the capacity to make choices and exercise volition.
Examining these practices, and the assemblages of which they are part, suggest that
participants both reproduced and subverted the dualistic ways in which drug users are
enacted. Participants engaged in highly controlled practices (such as making
methamphetamine and conducting research before drug use) not always to avoid harm, but
sometimes to increase the pleasure of undertaking drug use. Extreme drug users pushed their
body to the limit through consuming large amounts of methamphetamine for a long time,
‘doing’ bodies with capacities such as self-determination and fearlessness, attributes highly
valued in wider society. Moreover, engaging in knowledgeable and controlled practices did
not exclude participants from considering their methamphetamine use as compulsive or
themselves as being addicted or having addictive personalities. Thus, compulsive practices
and a sense of agency — the voluntarity/compulsivity binary (Sedgwick, 1992) — were
simultaneously evoked through the practice of methamphetamine consumption.

Further, attending to the networks that produce drug use reveal the ways practice is shaped by
assemblages of material, social and spatial resources and how bodies are capacitated within
these assemblages. In the case of knowledgeable and controlled methamphetamine
consumption, these assemblages included access to computers and the internet, research

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skills, a professional career and corresponding income, and family support. Thus, self-
controlled practices were made possible through particular relationships and connections
between drug-using subjects, and their relationships and connections with certain
environments, objects and subjects. Assemblage thinking shows how agency is facilitated by
and dispersed within these assemblages rather than driven by the self-contained agentive
subject, and that subjects are capacitated by the objects and environments with which they are
able to make connections (Duff, 2014; Fraser, 2004). Moreover, methamphetamine use is
more complex when examined in light of the way individuals manage multiple selves. It was
evident from participant accounts that the various networks and connections in which people
were enmeshed were productive of self-control and obliged them to make the ‘right’ choices
and thus to manage their drug use in particular ways.

Uncontrolled methamphetamine consumption practices

In addition to practices that enacted knowledgeable and controlled bodies, participants
described practices of methamphetamine consumption that were less controlled.
Methamphetamine is enacted in scientific discourse as an addictive drug. Thus, consumption
of this drug is considered a compulsive activity, where the properties of methamphetamine
are considered to drive people to use again and again. The drug-using body with
compromised agency is therefore a familiar one, and one that was often evoked in
participants’ accounts. In these cases, subjects ceded their power or choice-making capacity
to their addictive personality, trauma or the drug methamphetamine itself. I now describe and
discuss some of these practices evident in participant accounts. In doing so, I move beyond
accounts of drug use that centre on the addicted and compulsive subject. Instead, I show how
practices that evoke a lack of control or choice-making are produced through material—
semiotic networks, rather than as a result of an individual’s lack of willpower. Similar to
expert, knowledgeable and self-controlled practices, I also show how the concepts of self-
control and choice are messy and not easily delineated from their binary opposites. The
practices explored are: knowing oneself as an addict, being ‘taken over’ by
methamphetamine and linking trauma to the use of methamphetamine. I also describe a
participant’s experience of methamphetamine-induced psychosis to show the complexity of
this state in terms of ‘self-control’.

‘I’ve got an addictive personality’

Most of the accounts of participants in this research featured the concept of addiction, and
many readily ceded agency to the substance ‘methamphetamine’. Most participants said that

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they felt compelled to use the drug and saw themselves as addicted to it or as having an
addictive personality. For instance, William, a 42-year-old unemployed truck driver,
considered himself addicted to methamphetamine:

You could smash something and you know, it depends on how you feel, because
you’ve got to have it. And that’s how I consider being an addict, if you can’t go
without it, you know, no matter what it is; whether it’s alcohol, drugs, you smoke, you
know. If you cannot go without it, and if you’re having this problem, you know, every
single day, that’s how I consider an addict, which I considered myself as, because I
couldn’t go a day without it.

Here, William describes himself as an addict as he needed to take methamphetamine daily.

Further, he implies a violent reaction if he is unable to get the drugs he needs. He thus enacts
his body as having limited capacity to exercise free choice. He acts in order to consume drugs
and may become violent if he cannot.

Madison, a 25-year-old hairdresser, did not consider herself addicted to methamphetamine

but still saw herself as without control when it came to taking this particular drug because of
her ‘addictive personality’:
If someone put it [methamphetamine] in front of me, then it’s, like, you know, ‘Do
you want some of this?’ I’ve got an addictive personality, so if someone goes, ‘Do
you want some?’ I’d be, like, ‘Yes.’
Andy also reported having addictive personality. He said:

I think the people who take drugs are people who have like a certain personality, like
an addictive personality, so no matter what they’re going to get addicted. You know
like, it’s basically, if someone, it’s like me, like I didn’t really want to get into speed
at all, I don’t even like the drug but for some reason I just can’t stop smoking pipes
and now…I really don’t even like it that much.
By constituting themselves as having addictive personalities, Madison and Andy effectively
relinquish their volition with regards to taking any drug or other compulsive practices; an
addictive personality means one has the potential to be addicted to anything. Moreover, Andy
suggests that an addictive personality can compel one to engage in practices one does not
even enjoy.

As I have noted, a lack of volition is a feature of the way in which drug use and drug users
are enacted within the neo-liberal episteme (Sedgwick, 1992). Without wishing to dispute the

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accounts offered by participants, or negate the feelings of compulsion they may have
experienced, addiction and addictive personalities are very readily available yet simplistic
explanations of more complex desires and situations. The dominance of the
voluntarity/compulsivity binary does not offer people who use drugs the opportunity to
consider their use in a more nuanced way. If there was greater recognition of alternative and
more sophisticated ways of understanding drug use, such as those offered by Helen Keane
(2002, p. 35) and Kate Seear and Suzanne Fraser (2010a, p. 450) it is possible that individuals
might embody themselves without drawing on the absolutism that underlies dominant drugs
discourse.

‘I thought I was King Kong’: Taken over by methamphetamine

While some participants felt they were powerless over methamphetamine because of personal
attributes (such as having an addictive personality), others felt powerless over
methamphetamine due to the properties of methamphetamine itself. Several participants
suggested that they felt as though methamphetamine controlled them, taking away their
ability to exercise volition as they normally would. For these people, the practice of
consuming methamphetamine led to the embodiment of a different and in some cases
inauthentic self. For instance, Sebastian, a 30-year-old student, found that once he started
taking methamphetamine his priorities would change without him even realising it. He stated
that he had recently taken some speed over his university break:
I had some speed [methamphetamine] and, over like this…like a break, and then
because it’s your whole mental state, I guess, your priorities, everything just as soon
as you have it changes without you sort of noticing that shift and…things will
go…out of control really quick.
In this instance Sebastian went back to university after the break, but related the above
incident as an example of how easily his life could get ‘off track’. Sebastian found that the
practice of consuming methamphetamine led to a ‘mental shift’, leading to things becoming
‘out of control’.

While Sebastian attributes his mental shift entirely to methamphetamine use, examining the
various networks that produced Sebastian’s drug use enables other interpretations of this
shift. Sebastian lived with two fellow students in a very run-down house, with little in the
way of study resources. He had no desk or study space and only a mattress on the floor in his
bedroom. The house he lived in was located next to a government housing estate with an

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established illicit drug market. Sebastian had taken both methamphetamine and heroin for
over 10 years. He was prescribed Xanax®, a benzodiazepine, which he often sold in order to
supplement his student benefit. He had only recently enrolled in university (for the first time)
in his late 20s. The networks within which Sebastian was enmeshed — the immediacy of the
illicit drug scene, his unfamiliarity with study, the lack of study resources in his home
environment and his precarious financial situation, produced tenuous links to his university
existence and were also productive of ‘out of control’ practices such as getting ‘off track’. So
while Sebastian considered himself as driven by methamphetamine use — without at times
even noticing — it is possible to offer alternative accounts of his use. These might consider
how his fragile connection to basic student resources also shaped his actions.

Like Sebastian, Ross, aged 38 and on a disability support pension, gave an account of
methamphetamine consumption that featured uncontrolled practices, during which he felt
taken over by the drug. Ross described himself as a ‘standover man’, explaining that he
would go to houses where he knew the occupants had alcohol and other drugs and through
threat and intimidation take their ‘stash’. He said that he was able to do this because he
became a different person ‘on the ice’:
I just, it just made me become that person, the ice. Before that I was never like that.
Ross’s ice body was ‘invincible’, with the capacity to demand and take what it wanted:
The ice made me feel like I was invincible, so mixed with alcohol I thought I was
King Kong, I just demanded their drugs off them and most people would hand it over
because they didn’t want the conflict.
Although Ross engaged in a practice that was highly aggressive — seeking out people with
alcohol and other drugs and standing over them — he ceded his choice-making to ice. This
drug was the agentive force within his ice body. Ross’s actions were not admirable by any
means, as he himself noted. Locating the source of these actions in the properties of drugs,
particularly ice, helped Ross to tell a story of his drug use in which he was not a villain,
without obscuring or hiding the unpleasant practices he undertook to obtain the drug.

Ross, like Sebastian, was an individual with limited access to material, economic or social
resources. While his practice of ‘standing over’ people was highly unethical and unlikeable,
he had few relationships and connections that availed him of alternative ways to procure
drugs. Whereas participants such as Kelly and Gordon had incomes which allowed them to

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pay for drugs, Ross had very limited income. As he explained, this contributed to his
becoming a standover person:
I grew up in West Heidelberg so I sort of like become sort of like a standover
person...Somebody that goes in to somebody else’s house and tells them to give me
their drugs and stuff like that because I couldn’t afford them.
Here Ross links both the environment of West Heidelberg — a Melbourne suburb
characterised by high-density government housing and people living on low incomes and
government benefits — and his lack of income with becoming a standover person. Later in
the interview it became apparent that violence was common to the many assemblages Ross
was enmeshed within. His father had been violent to him as a child; the people he grew up
with were ‘gangsters’. Ross was also homeless and had few friends. He had very little contact
with his family, saying that ‘they won’t even come and bring me a packet of smokes’. This is
not to excuse the violent and objectionable practice of standing over people, but to
demonstrate how the resources one is connected to can produce particular types of drug use.
The material—semiotic networks within which Ross was enmeshed were embedded within
an environment where violence was not uncommon and which was characterised by a general
lack of basic resources. This contributed to the materialisation of an ice body with the
capacity for violence and intimidation.

‘I’ve never really lived in society’: How trauma shapes drug use
Participants also constituted themselves as driven to take methamphetamine through the
concept of trauma. Trauma is commonly linked to drug use, with a significant amount of
research attributing and/or linking the experience of trauma to drug use (see, for example,
Jacobsen, Southwick, & Kosten, 2001; Messina et al., 2008; Reed, Anthony, & Breslau,
2007; Stewart, 1996). In this body of literature, trauma and traumatic events are sometimes
used to serve as explanations for drug use — and lay understandings of this condition may
(re)produce this linkage (Hacking, 2002). Thus, it is not surprising that participants in my
research often linked trauma to drug use. In these cases, the experience of traumatic events
was thought to render an individual more susceptible to problematic drug use. In this section I
address accounts of trauma, looking at the ways in which the understanding of trauma shapes
drug use practice.

Kate, aged 39 and parenting a young son, directly attributed her methamphetamine use to a
traumatic event. Kate and her son lived in ‘the walk ups’, state housing accommodation

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within a larger state housing estate. Kate was ‘bashed’ (physically assaulted) one night by a
female neighbour and as a result found she could not sleep without nightmares. Because of
this, Kate had begun taking methamphetamine — mostly in the form of ice —to avoid sleep.
She explained:
I tried the ice six months ago. I was on the amphetamines, I got assaulted with an iron
bar in my own car park, I live in the walk ups…. I got attacked by a steel bar by a
…girl who was very filled up in tablets, Xanax. Um, she bashed me with the iron bar,
I’ve got 12 slashes down my legs, all bruised, my elbow popped out…

So you were really stressed after it?

Oh yeah and to this day I have put an intervention order on her, done everything that’s
supposed to be possibly have to be done um …Now because I couldn’t sleep, I did
sleep but not all night, I kept having bad nightmares about reoccurrence of what’s
happened to me…I couldn’t sleep so I got addicted to the ice.
Kate clarified her methamphetamine use was not to experience a high but just to stay awake.
She said:
It was more of a booster, not to go to sleep; just it was trying to make me stay awake
so I can stay awake and not have any more nightmares.
She also explained that it helped her manage having to face her assailant:
It [ice] blocks out a lot of problems for me. If the girl went past me and I was on ice I
wouldn’t shiver or shake or anything like that.
Kate had experienced a violent and distressing event, particularly disquieting as it had
happened in the immediate vicinity of her home. In her account, this event is the root cause of
her problematic methamphetamine use — use that had resulted in her having to go to a
‘detox’.

Kate enacts herself as a body with reduced capacities due to a traumatic event. In her account,
it is not her choice to take methamphetamine; rather, she is compelled to take it to stay awake
in order to manage the trauma she has experienced. Furthermore, she enacts
methamphetamine as a substance that gives her the capacity to manage her trauma. Its
properties allow her to stay awake and give her the courage to face her assailant.
Methamphetamine enables her to redefine her traumatised self as a controlled and strong
person. Her drug-using assemblage — ice, traumatised body, small living space close to

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assailant, young son, motherhood — constitutes methamphetamine as a drug that allows her
to be in control and manage a situation in which she has little power or choice. In this way,
Kate’s account subverts traumatic discourse, where victims of trauma self-medicate. She is
not using methamphetamine to forget her trauma, but rather to capacitate her traumatised
body and manage her circumstances. That said, Kate also draws upon a self-medication
narrative, explaining that taking methamphetamine allows her to ‘block out’ problems. Thus,
her enactment of the concept of trauma in relation to her drug use is messy, both subverting
and embracing dominant understandings of this concept.

There is no question that Kate’s experience of being severely physically assaulted was
horrific, leaving her feeling scared and vulnerable in her own home. However, while Kate
uses the narrative of trauma to explain the drivers of her methamphetamine use, other
relationships and connections shape her drug consumption. Kate identified strongly as a
mother, stating ‘I’m a mother’ when asked what she did for a living. She lived with her
youngest son who was attending pre-school. However, ten years previously, when she had
been using heroin heavily, she had lost custody of an older son and daughter. The
relationships Kate has with various institutions such as Centrelink16 and child protection
services, and her identity as a mother, are important when considering her particular account
of drug use. She does not consume methamphetamine for pleasure (a selfish practice) but to
self-medicate and stay awake due to the aftermath of a traumatic event. This enables her to
manage her day-to-day life, including her responsibilities as a mother. By enacting her
choice-making capacity as constrained by a traumatic event, Kate protects her identity as a
mother, a very necessary practice in her case as she has previously been scrutinised and found
to be lacking in this role.

Ross was another participant who linked his methamphetamine consumption to traumatic
events — in his case a traumatic childhood. He explained that he experienced a violent
upbringing and that this led to his drug consumption:
I’ve been taking drugs, like I said, for 28 years nearly, one drug or another, I think. In
them 28 years I’ve only had, like, 12 months clean and yeah, once I took the ice, it
was like again, it made me feel invincible; it made me forget what had happened to
me. ‘Cause like the first 10 years of my life my father used to bash us with pool cues,
broom sticks, you name it, whatever you can think of, that’s what my old man had

                                                            
16
 Centrelink is the Australian government body that distributes welfare payments. 

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done to us. So yeah, whatever I could do to escape that, because I never learnt how to
deal with it, only way was to take drugs. So I seem to have gone from one drug to
another drug to another drug, to three different drugs to just continuous, just yeah. I
found it very hard and I’m finding it hard now because I’ve never lived, I’ve never
really lived in society, in reality, I’ve always just existed, I’ve never really lived it.
Ross’s experience of parental violence has powerfully affected the way he understands
himself as an adult. He suggests that not having ‘dealt’ with this violence is the root cause of
his drug use. But more disturbingly, he says that he has never had access to, or felt he has
lived in, the ‘real’ world. Ross did not clarify what he meant by reality, but possibly he means
that he has never had access to participation in the mainstream world, because of lack of the
basic requirements to do this, such as paid employment, somewhere to live and a supportive
family.

Ross also saw value in sharing his experiences. Towards the end of his interview after I
thanked him for his time, Ross replied:
That’s all right, it’s going to help me to recover so you know, the more I release some
of the crap that I’ve been through I think the easier I’ll be able to get, get on with my
life.
Here, Ross considers being able to talk about his past as a form of release that is part of the
recovery process. This is reflective of Nikolas Rose’s (1999) argument that public
‘confession’ from survivors of trauma has become integral to subjectivity. He asserts that the
‘speaking out’ of one’s hidden hurts is considered therapeutically valuable and part of the
ongoing process of uncovering one’s authentic self (Rose, 1999, p. 269). Ross embraces these
assumptions in his account where he implies that, through the confession of traumatic events,
he will address the problematic and self-destructive practices in which he engages. Yet, it is
apparent that these practices are produced through the particular assemblages within which
Ross is enmeshed. These are assemblages that have tenuous, if any, connections, to the
mainstream. The assumption that talking about his past is therapeutic and will help him ‘get
on’ with his life may obscure what Ross lacks — meaningful connections to education,
employment and social support.

Kate and Ross’s accounts of trauma are further illuminated by Ian Hacking’s (2002)
assessment of this concept and the way in which it shapes embodiment. He argues that
trauma is used to categorise people with the outcome of creating ‘victims’:

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Traumatology has become the science of the troubled soul, with victimology one of
its bitter fruits. (Hacking, 2002, p. 18)
Here, Hacking posits that the diagnosis of trauma has become the standard way to understand
those experiencing psychological distress. Hacking (2002) has concerns about the ways
trauma ‘figures in the constitution of selves’ (p. 19), arguing that once labelled as traumatised
‘the person is known about as having a kind of behaviour and sense of self that is produced
by psychic trauma’ (Hacking, 2002, p. 19). Being in possession of traumatic memories
creates a ‘new moral being’ as the experience of trauma can be used to explain current
actions and behaviour (Hacking, 2002, p. 20). Thus, the traumatised subject is unable to
exercise sufficient control and make the right choices due to their embodiment of traumatic
events. In the case of both Kate and Ross, understanding themselves as victims of trauma
provides a narrative to explain their methamphetamine use. Yet, it may other the complex and
multiple assemblages they are enmeshed within, and how these constitute other selves. These
selves — a mother or an individual who has never lived in ‘reality’ — also shape the
practices of methamphetamine use.

Valentine and Fraser (2008) also add insight to the issue of trauma, specifically in relation to
drug use. These scholars examine conventional understandings of problematic drug use as
both socially mediated and associated with deprivation. While noting that the research that
produces these understandings is valuable in many ways, these scholars argue it can be
problematic. For instance, they suggest:
Associating problematic drug use with trauma and a fractured self can easily shift to a
reinscription of users as deficient; where problematic drug use represents proof of
trauma and nothing else. (valentine & Fraser, 2008, p. 411)
Moreover, they claim that defining drug use as inevitability linked to trauma risks denying
people who use drugs the capacity for pleasure. In turn this could rob drug users of:
their capacity to narrate their own accounts of how and why they use drugs, and to
present alternative narratives to those of science, treatment professionals, and their
friends. (valentine & Fraser, 2008, pp. 415-416)
Kate and Ross embraced the concept of trauma, explaining their drug use in these terms. And
yet, in other ways their accounts subvert the idea that drug use is about self-medicating to
deal with trauma, with both participants taking methamphetamine to capacitate themselves:
Kate as wakeful and alert, and Ross as threatening and a standover man. Thus, trauma does to

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some extent limit the capacity of these individuals to ‘narrate their own accounts’. However,
by subverting this concept, they also provide an alternative and more complex account of this
concept’s relationship to drug use.

A final point to make about uncontrolled methamphetamine consumption practices is that

there were common features among participants whose accounts featured these practices.
Generally, participants who described uncontrolled drug use practices, such as feeling
compelled to take drugs and taken over by drugs, were recruited from an inpatient detox
treatment service. As a group, these participants typically had long histories of heavy drug
use. Most were unemployed, had limited education, and a relatively high level of state
involvement in their lives such as child protection services, parole requirements, law
enforcement, and state pensions and allowances. As I have argued above, in the case of
participants such as Kate and Ross, the networks in which they are enmeshed typically enact
constrained power and choice-making capacity, and express the lived effects of poverty and
social exclusion. Both of these individuals also had significant experiences of violence. Kate,
for instance, was living very near a person who had assaulted her; this was highly undesirable
but she was unable to convince the Department of Housing to move her. She was reliant on
this particular agency for housing and unable to relocate herself because she did not have the
economic means to do so. Her multiple selves — a single mother, a beneficiary of the single
parent payment, a state housing tenant — enacted through the assemblages she was enmeshed
within, had limited choice-making capacity and power. Kate considered her drug use as
driven by trauma rather than her own volition. Given she lacked the resources that produce
legitimate forms of power in Western liberal societies, such as education, income and
housing, it is not surprising she might cede her agency to trauma or to the drug
methamphetamine itself.

Psychosis – a controllable state of non‐control?

In this final section, I address the ‘uncontrolled’ state of psychosis in accounts of
methamphetamine consumption. I discuss psychosis in relation to the concept of control
primarily to illustrate that, in terms of drug use, it is messier than scientific discourse allows.
Here, I build upon the work of Robyn Dwyer and David Moore (2013) who have also made
this observation. Methamphetamine use is inextricably linked with psychosis and a large
body of scientific research identifies and reproduces this link (see, for example, McKetin et
al., 2006b). Yet, despite this body of literature, and the assumption in broader discourse that
methamphetamine causes and/or is related to psychosis, few participants in this research had

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experienced it. One participant, however, had experienced psychosis. Her account illustrates
how terrifying the experience of psychosis can be. It also describes the ways in which she
managed and ‘controlled’ psychosis.

Margot, aged 32, was a student living at home with her parents. She was a former heroin
user, who had used amphetamine sulphate ‘back in the day’.17 The first time she used
methamphetamine she found it more intense and euphoric than her previous experiences with
stimulants. At the time, she was living with her long-term partner and she went on to use
methamphetamine daily, mostly staying at home when she did. She explained her typical
activities while using methamphetamine as follows:
We were doing it in the house with just the four walls, but it was, yeah — it ended up
just, you know, every time we did it, it would be at home and, I’d just clean the house
— that was the big one — clean the house, listen to music, friends might come around
and do it too. And we’d just play endless games of backgammon, and that was about
it. Awesome [laughs].
At some point, Margot began to get very paranoid. She heard voices and suspected that she
was being filmed in the shower and her bedroom. She said of the experience:
The main thing was hearing things; hearing voices; hearing people there when there
weren’t. Thinking that there were people, like friends and family, inside the house or
hiding around outside the house, watching me. It gradually led to thinking there were
cameras in all the rooms. It was pretty horrendous. I ended up making a suicide
attempt in 2007, ‘cause it had just got too much, but I still kept using it, yeah.
Clearly, Margot’s experience of psychosis was terrifying. She experienced delusional and
frightening thoughts — that she was being watched and stalked by people she feared —
distressing to the point that she tried to take her own life. She lived, for a time, feeling
completely paranoid and fearful.

Through this experience, Margot remained in contact with her family. She explained she had
a ‘lightbulb’ moment when, after a particularly bad night of hearing voices, her mother took
her to a doctor. During the consultation, Margot realised that her mother thought she was
being delusional. This was the beginning of Margot’s treatment for what she terms
‘methamphetamine-induced psychosis’, which included taking anti-psychotic medication and
attending a stimulant-specific treatment service. She says of this realisation:
                                                            
17
‘Back in the day’ is a term meaning ‘in the past’.

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It was a shock when I first found out that I had psychosis, because, you know, it all
feels real. It feels entirely real, conspiracy theories you come up with and delusions all
feel real. Even now, I have memories now of things occurring which, of course,
didn’t, but they feel real. So when I think about them there’s a real emotion
attached…because it feels like they did happen. I still sometimes lie there at night,
going over things trying to pick whether there was anything about these instances that
could have happened.
Margot’s account of psychosis provides insight into how she managed this state. For Margot,
being diagnosed as psychotic was key. It enabled her to label her frightening thoughts as
delusional rather than real — a practice that she still continues. She also said that this
‘realisation’ did not immediately cure her and that even after diagnosis:
I’d come in and out of it, and that was one period where I realised that there was
something wrong, but then I just slipped back into it again and then, you know, maybe
for a few seconds I’d realise I was ill and then I’d slip back into it again. But, um, that
was the first, sort of, realisation, yeah.
Dealing with psychosis was also assisted by the way in which she was treated by the staff at
the main treatment service she attended. Margot could let staff at the service know that she
was having a bad day and hearing voices —experiencing psychotic symptoms — yet the staff
would still see her and speak to her as usual. Margot said:
The people there [at the stimulant-specific treatment service] had a real understanding
of psychosis and I could go there and I could say, you know, ‘Today I am feeling – I
am hearing things’….I could go in there and be honest and they wouldn’t just ring up
the CAT team18 just because I’d gone in there and said that I was hearing things.
There was a lot of trust there, which I didn’t have with any other doctors.
Margot demonstrates the messiness of a state like psychosis. She initially existed in a state of
paranoia, driven to a suicide attempt. Being told she was psychotic enabled her to sift through
her thoughts and label them as real or not real, and manage her psychosis — to the point that
she could call and make a treatment appointment even while experiencing voices in her head.
Importantly, her treatment providers, through their practices, enacted her as a controlled
psychotic person. They did this by simply continuing to provide treatment in the usual

                                                            
18
 Margot is referring to Crisis Assessment and Treatment Teams (CATT or CAT). CAT teams are known for
being called when an individual is deemed out of control because of psychological distress.  

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manner — a counselling session, for instance— rather than refusing to treat Margot in that
state.

Margot’s enactment of herself as a psychotic body rejects conventional understandings of this

body. Further, her account subverts the binaries of methamphetamine use as she is
simultaneously psychotic and self-controlled. Her psychotic body is not a violent and out-of-
control body — as is often inferred in authoritative literature (see Jenner, 2006) — but
controlled to the point that she can attend a counselling session. Thus, like the accounts
offered by Dwyer and Moore (2013), Margot demonstrates that the state of psychosis is
messy and multiple, and that through diagnosis, medication, connection with her mother and
her treatment encounters, she is able to enact herself as a controlled, psychotic body.

Conclusion
In the two previous chapters, I have argued that methamphetamine and methamphetamine
users are understood in very specific ways. Methamphetamine is constituted in scientific
literature as a uniquely dangerous and toxic drug. Methamphetamine users are constituted in
spheres of extreme absolutes — as hyper-controlled and aware and as hyper-violent and
toxic. In this chapter I have explored how these very specific ways of constituting the
subjects and objects of methamphetamine use shape accounts of consumption. To make
visible the politics of ontology, I have illuminated how people who consume
methamphetamine draw upon, or subvert, these absolutes through the ways they ‘do’ drug-
using bodies. I have also made visible the material—semiotic networks that constitute bodies,
showing that bodies are capacitated through these, and that attributes such as self-control and
the ability to make the ‘right’ choices are a result of the connections and relationship
individual are able to form. Addressing the practices of methamphetamine consumption in
this way is studying this form of drug use as a matter of concern. This means that the political
nature and effects of methamphetamine-bodies are brought to the fore, rather than
materialising further ‘facts’ about methamphetamine consumption.

Participants’ accounts indicated drug consumption practices were not clearly delineated in
absolutes — showing that these practices are complex and multiple. Methamphetamine use
may involve controlled, knowledgeable and expert practices. This entails people embodying
themselves as self-aware, self-knowing and risk-averse. In some respects, these practices
produced informed and less harmful drug use. In other instances, these practices supported a
hedonistic aim — to educate oneself about the most efficient ways to get high or to manage a

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seven-day drug binge. This disrupts a controlled/chaotic binary as controlled practices are
employed in the pursuit of intoxication and hedonism. Moreover, controlled drug-using
practices were not necessarily separate to knowing oneself as addicted; participants embodied
themselves as simultaneously compelled to take methamphetamine and as able to exercise
capacities such as strength of mind and self-control. Thus, while they drew upon broad and
very conventional understandings of addiction, their localised practices subverted these
understandings.

In the same way, practices identified in accounts as uncontrolled were also complex and
messy. These included enacting oneself as addicted and taken over by the drug, as well as
attributing behaviour and drug use to either traumatic events or the properties of
methamphetamine itself. These are recognisable subjects in drugs discourse, where drug-
using bodies are considered to be controlled by the drugs they use. In some cases, thinking
about drug use in this way helped to manage or explain a lack of choice-making capacity.
Yet, enacting oneself as compulsive and out of control — compelled to take
methamphetamine because of an addictive personality or traumatic life events — did not
exclude highly agentive practices. Methamphetamine was used in order to capacitate bodies
to be powerful: to cope with trauma or even to steal drugs. Moreover, further subverting the
absolutes of methamphetamine use, psychotic bodies in accounts were not necessarily out of
control. As one participant demonstrates, this state may be frightening but controlled — that
is, capable of dealing with hearing voices yet able to participate in active treatment practices
such as counselling.

Focusing on material—semiotic relations in accounts, it was evident that, in addition to being

complex and messy, controlled or uncontrolled practices were not due to personal attributes,
but produced through the various networks within which subjects were located. Thus,
controlled drug use was not the outcome of the choices of a rational individual, and
uncontrolled drug use was not the outcome of the actions of chaotic and helpless individuals.
Typically, those people who embodied themselves as controlled, knowledgeable users had
access to resources such as a university education, a supportive family, a profession and/or
financial security. For instance, those participants who actively researched the effects of
methamphetamine and other drugs were students with access to resources such as computers
and online forums. The young participant who manufactured his own methamphetamine had
chemistry knowledge and the space in his back garden to set up a ‘lab’. Further, attending to
material—semiotic networks show that uncontrolled, compulsive practices that participants

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enacted as driven by addiction or trauma were not indicative of a defective or flawed

subjectivity. Accounts of uncontrolled practices often emerged in assemblages lacking in
social, economic and educational resources, perhaps even characterised by violence. These
participants had limited access and connection to education, stable living conditions or home
ownership and family support. They had high levels of state intervention in many aspects of
their lives. The multiple ways in which they were able to embody themselves had common
features in that they had constrained ability to exercise power and choice.

Accounts of methamphetamine consumption and the different ways in which participants

were able to constitute themselves have implications for the way in which drug use is
addressed. If the drug-using subject is seen as the sole point for intervention with regards to
drug-related harm and other drug-related effects, then this others the networks and
assemblages that produce drug use. Yet, as the above discussion indicates, individuals are
embodied through these networks and their capacity to manage their drug use and their lives
is shaped by the connections and relationships they make. Having explored consumer
accounts and the assemblages of methamphetamine use, I now turn to the ways in which
practitioners respond to and constitute methamphetamine use. In the following chapter, I
explore the ways in which methamphetamine consumption is addressed through harm
reduction and/or treatment.

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Chapter 7: Addressing methamphetamine‐related harm: Accounts of

treatment and harm reduction practice

Introduction
To illuminate the ontological politics that come into play in the practice of drug consumption,
the previous chapter addressed the second of my research questions — how do consumers
and service providers draw upon, reject and subvert dominant discourse through consumption
and harm reduction/treatment practices? I interrogated the extreme absolutes that underpin
how methamphetamine and methamphetamine users are materialised in Western liberal
societies (Fraser & Moore, 2008; Keane, 2002; Sedgwick, 1992; Seear & Fraser, 2010a),
showing how these may come to bear on the practices of methamphetamine consumption. To
do this, I analysed accounts of methamphetamine consumption, arguing that people ‘do’ their
bodies in particular ways through this practice (Mol & Law, 2004). I found that respondents
embraced dominant discourses and the extreme absolutes of methamphetamine use in order
to perform particular drug-using bodies, including expert, extreme, addicted and traumatised
bodies. Yet, slippages, resistance and messiness were also evident, showing the limitations of
these absolutes and their political effects. For example, knowledgeable and controlled
practices, such as researching drugs, were carried out with a hedonistic intent, to party and
get high; engaging in expert and controlled methamphetamine-using practices was not
necessarily separate from knowing oneself as addicted. Thus, while participants evoked
extreme absolutes, their consumption practices simultaneously rejected and subverted these
absolutes. Accounts of methamphetamine consumption also illustrated the way individuals’
connections and relationships manifest or disallow particular capacities. Attributes such as
being knowledgeable about drugs and brain chemistry emerged from assemblages
characterised by resources such as education and access to tools such as computers.
Characteristics such as feeling powerless over methamphetamine emerged from assemblages
characterised by a lack of access to significant social and economic resources, which
constrained the choices individuals could make.

I now turn to the accounts of methamphetamine service providers in order to further analyse
how the binaries that underpin methamphetamine use shape harm reduction and treatment
practices, and the ontological implications of this. My argument uses analyses of ‘change’ to
understand these accounts. I chose this particular concept because it is central to AOD
treatment discourse and a constant theme in service provider accounts. I trace this concept,
examining some of the ways in which it is enacted within accounts, and its relationship to

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‘control’. The accounts that I analyse are drawn from interviews with workers at a range of
AOD organisations that offer harm reduction and/or treatment services to people who use
methamphetamine. While this chapter features accounts of service providers, in order to
illustrate some points I make about service provision, I also include service user accounts.

The AOD organisations involved in this research were diverse and targeted different groups
of people using drugs. Of all the services, only one was a specialist stimulant treatment
service. Treatment practices at this particular organisation were markedly different from
those at the other AOD organisations I researched. Treatment here was based upon talking
therapies and enacted clients as highly capable, choice-making individuals. These practices
draw upon the scientific and treatment literature on methamphetamine use (see, for example,
Jenner & Lee, 2008). Other AOD organisations involved in this research targeted groups such
as young people who use drugs, people who inject drugs, or people withdrawing from drugs.
While these services are accessed by people who use methamphetamine, they were also
accessed by people using heroin, cannabis and alcohol. Accounts of service practice were
therefore varied. Some services were inpatient, allowing people to detox from drugs for a
week or so, while others involved case management — that is, assisting people in various
aspects of their lives, such as accessing treatment, attending General Practitioner
appointments and finding housing and work. Some provided counselling and others a safe
space with access to general health care, food and harm reduction services, such as NSP, if
needed. While divergent, these treatment practices were shaped within the current conditions
of possibility and shared conventional assumptions about drugs and drug users. Moreover,
practices were shaped by issues such as funding and resources. All of these AOD services
were funded through government. Funding for government AOD services is typically tenuous
and parsimonious, constraining the level of support services can offer clients, particularly if
clients are experiencing economic and social hardship (MacLean, Berends, Hunter, Roberts,
& Mugavin, 2012; Ritter, McLeod, & Shanahan, 2013).

I consider the practice of service provision using insights from Gilles Deleuze and STS. That
is, I assume a body is more than, and not limited to, its physical presence (Buchanan, 1997;
Deleuze & Guattari, 1987); physicality is obviously necessary but not privileged. Bodies
emerge through desiring forces and the connections and relationships they make. Moreover, a
body is not prior to practice but emerges through practice (Mol & Law, 2004). AOD harm
reduction and/or treatment practice can be thought of as a range of ‘discrete assemblages’
(Duff, 2012, p. 145) with key temporal and spatial differences, and involving various objects

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and subjects that result in the emergence of multiple bodies with varying capacities. For
instance, the practice of an inpatient withdrawal service enacts a body with limited capacity
for control or power. This practice obliges the subject to withdraw from prior connections
and relationships and reside in a highly contained and regulated space for days or weeks. The
subject can be medicated if it is deemed necessary by the expert staff within the service. In
contrast, the practice of outpatient talking therapies, such as those based on CBT, attempts to
bring into being an active treated body. This practice obliges subjects to become self-
reflective and self-aware in order to modify their behaviour. Subjects are required to manage
their own time and space, making and keeping appointments with their treatment practitioner,
maintaining their existing connections and relationships, but learning how to manage these in
order to control, reduce and/or cease drug use. Considered in this way, harm reduction and/or
treatment practice is the active task of enacting and re-enacting bodies with varying
capacities.

In addition to conceptualising harm reduction and/or treatment practices as productive of

particular bodies, I draw upon a theoretical insight from Mol and Law (2004) with regards to
medical intervention. These scholars view medicine as:
[A] range of diagnostic and therapeutic interventions into lived bodies, and thus into
people’s daily lives. (Mol and Law, 2004, p. 58)
They argue that, in accordance with this assumption, the effects of medical interventions
should be evaluated by:
not only their effectiveness in improving one or two parameters, but the broad range
of their effects deserves self-reflexive attention. Not all of these effects should be
expected to be for the better. In articulating how it is doing, in considering the effects
of its activities, medicine would be wise to confront its own tragic character: medical
interventions hardly ever bring pure improvement, plus a few unfortunate ‘side-
effects’; instead they introduce a shifting set of tensions. (Mol & Law, 2004, p. 58)
This way of conceptualising medical intervention can also be applied to AOD service
provision. Few would argue that AOD harm reduction and/or treatment practices ever result
in ‘pure improvement’, and scholars have identified the tensions and paradoxical nature of
these interventions.19 Thus, my aim in analysing various harm reduction and/or treatment
practices is not to compare and evaluate services, assessing their suitability for people who
                                                            
19
See, for example, (Fraser & valentine, 2008) and (Holt, 2007) on methadone maintenance treatment and
(Moore, 2009) on harm reduction services. 

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use methamphetamine. Rather, in addressing accounts of service provision, I trace the

concept of change in order to illustrate the ways in which practice (re)enacts or rejects
binaries that underpin drug use, such as voluntarity/compulsivity, and also to consider the
effects of intervention in terms of the ‘shifting set of tensions’ they may introduce to people’s
lives (Mol & Law, 2004, p. 58). Moreover, noting the various ways in which change is
conceptualised, I also bring to light the ontological politics involved in the enactment of
treated bodies, analysing the constitution of these bodes in relation to dominant discourses
and the neo-liberal episteme.

To pursue the argument that follows, I first show how change is broadly understood in AOD
discourse. I then present accounts of service provision that evoke change as dependent on
individual attributes such as self-control and choice-making capacity. Related to this, I
discuss the development of individual capacity as the object of treatment. Finally I describe
alternative ways in which change emerges in accounts of service provision.

Change
The concept of change is central to harm reduction and treatment services for people who use
drugs, as these aim to intervene (and change) drug use practices in specific ways. An example
of the centrality of change to harm reduction practice is found in NSPs. Through engaging
with NSPs, people who inject drugs are expected to change their injection practices from
unsafe (such as sharing injecting equipment) to safe (such as not sharing injecting
equipment). This change is facilitated through the provision of clean injecting equipment and
advice from an NSP worker or written information supplied by the service. Through
undertaking the practice of safer injection, the drug user then ‘does’ his or herself as a
responsible injecting drug user. As drug use practices shift, change occurs. The body enacted
through the practice of using clean injecting equipment has changed from an irresponsible
drug user (sharing injecting equipment) to a responsible drug user (not sharing injecting
equipment) (Moore, 2004). As I argued in Chapter 5, a self-controlled and knowledgeable
drug-using body emerges from harm reduction practices (such as NSP), one with the capacity
to change one’s actions in accordance with the correct information and resources. Change,
then, is conceived as brought about by the individual’s capacity to act on the information
and/or services provided and, in this way, is central to harm reduction practice (Moore,
2004).

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‘Change’ is also integral to treatment discourse and an overt goal of treatment practice. A
well-known way in which ‘change’ is conceptualised in AOD treatment discourse is ‘the
stages of change’ (Greenwell & Brecht, 2003, p. 1103). This model was originally
conceptualised by Prochaska and DiClemente (1985) and is still widely used in the field of
AOD treatment. The model conceptualises drug use (or any addictive practice) in stages,
classifying people according to where they sit in terms of their ‘readiness for change’ (Jenner
& Lee, 2008, p. 55). In the federally funded guide for treating methamphetamine use,
Treatment approaches for users of methamphetamine: A Practical guide for frontline
workers (Jenner & Lee, 2008), the stages of change are listed as:

 precontemplation, where the person is not considering change

 contemplation, where the person has not yet cut down or quit, but is considering
change

 preparation stage, where the person has made a firm commitment to quit or cut down

 action stage, where the person has recently cut down or quit

 maintenance stage, where the person has cut down or quit for some time

 relapse, where the person has started to use again (p. 58)
The conceptualisation of ‘change’ produced through this model centres on the ‘readiness’ of
the individual using drugs. Thus, treatment practice can only result in client change in cases
when the client is ‘change ready’. For instance, in their guide to treating methamphetamine
use, Jenner and Lee (2008) state:
Harm reduction and brief advice are suitable approaches for those not considering
change. Those considering change can benefit from motivational enhancement,
education, counselling. Those in the preparation or action stage can benefit from
structured counselling, and those in relapse can benefit from motivational approaches
and skills building. (p. 58)
The assumptions that underlie this statement have the effect of removing treatment practices
from scrutiny. If the client does not change (and treatment has therefore not been successful)
this is not related to treatment practice but because the client is not at the correct stage of
change. This theory of treatment enacts drug-using bodies as anterior to treatment practice
with treatment outcomes dependent on the change readiness of these bodies rather than the
quality or suitability of practice.

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I argue, therefore, that both harm reduction and treatment practices assume the capacity for
change resides solely within the drug-using body. In order to reach a successful outcome,
both practices require a change-ready drug-using body — one that is amenable to learning
how to make the ‘right’ choices, which are ‘free’ and not driven by compulsion. The change-
ready body in this way mirrors that of the neo-liberal citizen. Given the centrality of this
active citizen in Western thought, it is unsurprising that locating capacity for change solely in
the treated body is mirrored in participants’ accounts of service provision. And yet, in
practitioner accounts, change also emerges as a more complex phenomenon. Sometimes
change was conceived as a result of individuals making the right choices, but chance,
environment, partners, homelessness and other aspects were also seen to play a role in
change. Some workers needed to see change in clients in order to find reward in their work,
and felt exasperation with clients that were not ready to change. Others expressly stated they
did not need to see change; some considered clients unchangeable and understood their
practice as providing respite. Thus, while harm reduction and treatment discourse reifies
change as dependent upon individual agency, service provider accounts complicate this
understanding as they understand change in multiple ways, even rejecting the need for client
change. Below, I trace some of the ways in which change is constituted in accounts of service
provision.

Change and individual capacity

In this first section, I present accounts of service provision in which the capacity to change
was considered an individual attribute. I discuss accounts of service provision from workers
at two services with distinct client groups, and consider the varying ‘set[s] of tensions’ (Mol
and Law, 2004, p. 58) that arise from considering change in this way. I then discuss the
concept of choice in relation to change and present an account of service provision in which
practice intervened upon the individual’s capacity to make choices, rather than his or her drug
use per se, arguing that this is a logical trajectory if change is dependent upon individual
attributes.
The first account of service provision I examine in relation to the concept of change was
provided by Eve, a nurse at a primary health care facility. This service was typically accessed
by people Eve described as:
Mostly males, probably over their 30s who are quite, they’ve got multiple complex
problems…most of them wouldn’t have, don’t hold down employment, so I think
that’s why they’re more likely to come to our service. A lot of them have a forensic

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history…most of them are older and they’ve been using [drugs] for quite some years
and with multiple problems like dual diagnosis, mental health issues as well.
Eve also said that her clients usually injected heroin, had a long history of drug use and were
often homeless. The primary health care service she worked for operated from a purpose-built
facility and provided a range of services including a large OST program, NSP, a health,
mental health and referral service; and a drop-in area where people could obtain tea, coffee
and food. The service was constructed so that the client area was an open space, with the
service manager and other workers’ offices surrounding it. The spatial implications of this
were that management were highly accessible to clients and staff. It also enabled a high level
of surveillance, particularly as most offices (including the manager’s) had glass walls. It
included private rooms in which clients could receive counselling or medical care, although
the waiting area for these services was also highly visible and located very near to the
reception desk and front entrance of the building.

The second account of service provision I consider in this section was provided by Tess, a
nurse at a stimulant-specific service. The client group that accessed this service had
significantly more resources than those at the primary health care service. Tess described her
clients as typically ‘self-motivated’. She also said that ‘a lot of them are working, they’ve got
high functioning positions’. The stimulant-specific service provided medical services but
focused on practices such as motivational interviewing and CBT. These practices are based
upon ‘best practice’ for methamphetamine use (Lee & Rawson, 2008). The stimulant-only
service was also purpose-built, situated within a general AOD service. It was separated from
the wider service and had a private waiting area, specifically so that people who used the
service could wait for their appointment away from the other clients (mostly people who used
alcohol and heroin). Rather than creating a space where clients were able to be seen and
surveyed (such as in the primary health care service described above) the intent was to create
a space affording clients privacy.

Change and the need to ‘prioritise’

Change resulting from individual capacity was central to both Eve and Tess’s accounts, and
yet this concept produced different sets of tensions because of the varying circumstances of
their clients. Eve’s account materialised change as related to the capacity of her clients to
prioritise. She explained:

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[You] see less change…like maybe a little bit of change and then back to where you
started again. Like they may start to, but then it just seems like more of a quicker
cycle from when they start…making a few changes and then they drop back into that
drug-taking cycle.
Is that frustrating for you?
It does get frustrating because I guess you feel like you’re doing all this work for them
trying to — whether it be making appointments and do stuff with their health and that
kind of stuff — and it’s just not their priority at the moment, like the priority is still
that drug-seeking kind of behaviour.
Eve later qualified that people were not required to want to change in order to access the
service:
They don’t have to want to change or work on their other stuff. Like to me, being
homeless…would be massive, but for them, their priorities are just a little bit
different. They might not be at that [stage], they’re not ready for change.  
With these statements, the capacity for change is evoked as an individual attribute, in that
change occurs as a result of the client’s ability to prioritise. Eve notes that her practice is
futile if the client’s priority remains ‘drug-seeking’ behaviour, reflecting the assumptions of
the stages of change model (Jenner & Lee, 2008, p. 58) in which successful practice is
dependent upon an a priori change-ready client.

There are tensions evident in Eve’s account between her concept of change, her clients as
choice-makers and the level of control and choice apparent in their day-to-day lives. The
assumption that the clients of the primary health care service prioritise drug-seeking
behaviour and are not ready for change constitutes them as individuals who are unable or
unwilling to make the right choices. Yet, by her own account, Eve worked at a centre
frequented by people who were extremely socially and economically marginalised:
I mean you’d love to be able to help them more, as in like when the people come in
for the pharmacotherapies and they can’t afford to start. There are agencies that can
help them out from time to time but it’s not a guarantee. And I guess the other thing,
like even down to like housing, housing is a massive thing. And at the same time you
refer them to other agencies and sometimes they come back, and they’re like, I’d
rather live on the street than where, you know, they’ve been referred to, because it’s
just not safe, and that kind of thing. I mean food and all that kind of stuff. We have

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food from time to time but it’s not something that we can keep up all the time for
them.
Clearly, Eve understood the dire financial and living circumstances of her clients, as well as
the limitations of the service at which she works and the way these financial constraints shape
her practice. She is also well aware of the dearth and quality of other services accessible to
her clients and is obviously frustrated by this situation. Yet, this understanding of the lived
experience of many of the clients of her service is at odds with Eve’s conceptualisation of
change. It is possible that Eve’s clients did prioritise better living conditions and quality of
life, but the immediate needs necessitated by the material and social deprivation they
experienced might have made this priority difficult to achieve. By describing her clients as
prioritising drugs over other more important needs such as housing, Eve locates the
responsibility for their situation in their inability to choose correctly, rather than the socially
and economically deprived networks they were enmeshed within.

Conceiving of change as the result of individual priorities and choices seems problematic for
a group of clients such as those that access the service at which Eve is employed, not least
because of their precarious connections to employment, housing and income. However, this
understanding was also reproduced in service user accounts —such as that given by Mr D, a
32-year-old client of Eve’s service. Mr D was an atypical client of the primary health care
service: he had some paid work and relatively stable accommodation, yet he had also
previously been homeless, used heroin and methamphetamine for many years, and survived
on a very low income. When asked whether it was possible for people using the primary
health care service to change, he said:
There is a choice in there at some point. What that choice is, and when it comes, I
don’t know, it’s different for everyone, everyday…I see that a lot, people that, you
know, they either do or don’t want to change. If someone doesn’t want to change
well, you know, what are we supposed to do? What, how much is anyone else
supposed to care, you know?
Mr D’s account enacts the individual as the locus of change; a person makes the choice to
change or not. If they do not want to change then it is questionable as to whether they are
worthy of care. Here, the emphasis is on wanting to change — whether one can change is a
moot point. The individual is judged on their aspirations for themselves. Indeed, Mr D’s
aspirations were significant:

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I’m trying to get my life together because I’m trying to start a business, I’m trying to
run a film and recording studio …I’m trying to be responsible …because you can’t
take drugs and work as a professional, you know.
Mr D clearly wanted the ‘right’ things; he aimed to own a small business, be professional, be
abstinent and be responsible. With these expectations of himself, Mr D claimed it was
possible to change. Like Eve’s account, Mr D’s account is underpinned by neo-liberal
assumptions about the capacity of the individual and enacts subjects as freely able to choose
or prioritise aspects of their lives. Both accounts demonstrate the political nature of neo-
liberal discourse — in that it others the lived experience of these clients and how the
networks within which they are enmeshed shape the choices and priorities in their lives.
These accounts also illuminate the resonance and power of the figure of the neo-liberal
subject — a citizen accountable through the choices he or she makes. Although Eve and Mr
D had intimate knowledge of the lived experience of homelessness and long-term injecting
drug use, they drew upon this figure to explain why people did not change. In doing so, they
responsibilise an extremely marginalised group of drug users, othering the role that access to
resources plays in the capacity to make the ‘right’ choices.

Changeable clients
The second account of service provision I use to consider change as the result of individual
attributes was provided by Tess. As I have noted above, the stimulant-specific service at
which Tess worked offered ‘active’ treatments such as CBT and motivational interviewing.
This was specific to this service and reflects treatment ‘best practice’ for methamphetamine
use (Lee & Rawson, 2008). The organisation was also notable in serving (reportedly) a
greater proportion of high-functioning people than did Eve’s primary health service. Tess
said of her clients:
They are working; they might be working in quite high positions. This is generalising
hugely, but probably if you did the stats….a larger proportion of them are in the
workforce. Maybe running their own businesses so they’re people that have probably
been quite capable in lots of ways at developing things and being self-initiating and
studying, at uni. They’re social; they’re more social in general. Probably…quite
receptive to support of therapy, the CBT type models, things like that perhaps. All of
those sorts of things, yeah.
This description of her clients is very different from Eve’s, and suggests that the two services
were accessed by client groups with different access to social and material resources. At the

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primary health service, clients had poor connections to housing and employment, and were
likely to have a prison history and to be long-term drug users. Tess’s client group had strong
connections to the workforce (often in positions of authority) and/or university, as well as
strong social connections. Whereas clients accessing the primary health service were driven
by their immediate needs, such as food and shelter, Tess’s clients had these needs fulfilled
and were looking specifically for treatment for their methamphetamine use.

Change was central to Tess’s treatment practice. For her, it was a rewarding part of her job,
as she explains:
I guess having that one-on-one contact with people about something that’s so
personal, it’s having such an impact on their lives, and the lives of the people around
them, and being part of that process of change…being around people at a time when
they are wanting to change too and yeah, thinking about change, thinking about
what’s happening in their lives.
This statement inscribes Tess’s clients as thinking and reflective bodies, aware of what is
going on in their lives, and wanting change. These bodies are recognisable as hyper-capable
methamphetamine bodies. Such bodies enact, and are enacted by, an active and reflective
practice. Tess describes her practice and her clients in the following statement:
So a service that’s really respectful…that’s engaging with people that are experienced
and know what they’re talking about, because they will test it out. And I think they
need to feel that you’ve got some level of knowledge and understanding, that you’ve
got something to offer as far as treatment, and a belief in what you’re offering — that
it works and it can work for them — a skill-based intervention to work on developing
their skills and their understanding.
Here, Tess explains that treatment practice is formulated with the expectation that clients are
knowledgeable and have high expectations of treatment and themselves. At the same time,
she shows how practice further capacitates these bodies through developing their skills and
understanding.

When describing treatment practice, Tess reflects some of the insights offered by Rose (1999)
concerning talking therapies or the ‘psy’ disciplines. For instance, Tess articulates that her
role in treatment is necessarily collaborative:

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I really try and think of it as collaboration with a person. You’re there along the way
to support…you know, and offering some direction, but bringing out what you can of
people.
Rose (1999) argues that talking therapies purport to be collaborative but involve clients
shaping themselves in accordance with dominant neo-liberal norms; this may be the
‘direction’ offered by Tess. Tess also refers to providing ‘tools’ for people to work with in
their own way:
So in that sense you know it’s the understanding that you’re providing that, an
opportunity for a person to, or some tools for them to use, to utilise in that way
whether they take that up or not, whether they decide in the end that’s where they
want to go, that’s their decision too.
Rose (1999) argues that talking therapies provide citizens with the tools needed to self-
regulate in accordance with dominant norms and ideologies. And ultimately, clients are
expected to take on the techniques or tools conveyed to them by the therapist by becoming
‘regulators of their own thoughts’ (Proctor, 2008, p. 252). These examples show some of the
ways that Tess’s practice reflects the observations about ‘psy’ therapies made by Rose (1999)
and enacts active and reflective citizens. As I will show below, these practices are congruent
with the way people accessing Tess’s service embody themselves and the material—semiotic
networks within which they are enmeshed. That is, through their strong connection to work,
family and so on, Tess’s clients have the capacity to make the ‘right’ choices and to be active
in treatment.

Tess’s treatment practice shares similar assumptions to that of Eve’s. Both service providers
aim to provide clients with an opportunity to change and whether clients take this opportunity
is for them to decide or ‘prioritise. Yet, Tess’s client group is very different from that of
Eve’s, and has access to significant resources that are perhaps more productive of the
capacity for change. Accounts from clients accessing the stimulant-specific service suggest
that they were able to use the tools provided through Tess’s practice to change and were very
satisfied with the service. For instance, Cat, a university graduate who managed an online
business, was a client at Tess’s service and said that she liked it because ‘everyone was
understanding and informative’. She said:

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It really does provide me with some insights, and actually, you know, helps me with
strategies and shit like that because I’ve found a lot of counsellors are pretty fucking
shit.
Sean, a 39-year-old artist and an athlete, also said that he found the service very helpful
because of the skills he had learnt:
I’m at this point where I wish I wouldn’t ever take it [methamphetamine] again but I
think that’s unrealistic. But I feel like I’m much more in control, like I’ve learned all
the situations that can trigger me craving it, and learnt so many different techniques to
stop me having access to it, so it’s not easy to get.
The strategies or skill-based interventions employed at the stimulant-specific service were
consistent with the way Cat and Sean enacted their bodies and their lived experience. While
these two individuals were experiencing drug use as problematic (as evidenced by them
accessing treatment), the networks and assemblages within which they were enmeshed
provided them with access and connection to a reasonable level of social and material
resources. Cat lived with her parents and managed a business. She was university-educated
and looking for a graduate position. Sean was a relatively successful artist, who was also well
known for his athletic ability.

Yet, while the practices of the stimulant-specific service enacted autonomous, self-reflective
treated bodies, the very act of accessing treatment requires one to ‘do’ oneself as a
compulsive drug-using body, at odds with the self-controlled subject. This was evidenced in
Cat’s experience of an inpatient withdrawal service. Cat explained that this form of passive
treatment did not help her:
You can’t just go and sit somewhere for ten days and then expect to be better when
you get out like, you know, you’re still the same person. So I don’t think that detox is
appropriate for me to quit because I just don’t see how it really helps.
As noted earlier, this particular treatment practice is characterised by highly regulated space,
where clients are expected to follow a routine as well as adhering to many rules. During Cat’s
stay, a staff member was rude to her because she had inadvertently broken a rule of the
service:
They were just so mean. Like I remember my ex came and we went… to have a
smoke outside and like, I didn’t realise we weren’t meant to be outside. And there was

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this nurse and she was just like yelling at me and I’m just like fuck, ‘I didn’t even
know I wasn’t meant to be here, like, you could just be nice about it’.
Yelling at clients because they have been unknowingly non-compliant is a highly
disrespectful practice and enacts them as disobedient and childlike. For Cat, this practice was
incompatible with the way in which she embodied herself and she left the service shortly
afterwards. This is not to say that it is common practice to belittle clients who inadvertently
break the rules at inpatient withdrawal services, but Cat’s account draws a stark line between
the ways in which she is constituted as a treated body by the stimulant-specific service and
the inpatient withdrawal service.

Sean also noted the tensions that arose in accessing drug treatment. He said that he found it
very difficult to attend the stimulant service because of the way it made him feel about
himself:  
It’s kind of freaky to go into this place where there’s like, you know, drug addicts and
stuff, it’s like, ‘oh my God, this is what’s happened to me?’ And you can see…other
people waiting around…And also just how it says ‘drug clinic’ out the front. If it were
a bit more private or something I probably would feel more comfortable.
Later he said of himself:
I felt really disappointed in myself….how has this happened to me, who’s supposed to
be so in control of everything that I’ve got to go and get drug counselling. I found it
very, I don’t know, a little bit disappointed in myself and embarrassed and humiliated
to think that I needed to get drug and alcohol counselling.
Sean was uncomfortable with the label of the service identifying him as the client of a drug
clinic as well as the ‘drug addicts’ with whom he had close contact when attending the
service. For him, attending drug treatment required that he embody himself as someone who
was out of control — and this was humiliating — but also at odds with the ways in which he
typically embodied himself.

As a practitioner, Tess was aware of the tensions that arose when self-controlled and
knowledgeable bodies encountered treatment. To address this tension, she explained that she
considered her clients as ‘people that have an issue with substances at that particular point in
time in their lives’ and that her clients were not required to ‘label’ themselves. Expanding
upon this she said:

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I think it probably comes back to some of their own personal characteristics and
attributes that stop them as far as thinking ‘well, that’s not me, I don’t see myself in,
as a druggie’. They will say that; ‘I’m not like that’.
With this statement, Tess enacts her clients as having worthy attributes. She also notes the
disjunct between the characteristics of her clients and those attributed to ‘druggies’.

In addition to the actual practices of treatment addressing the discomfort high-functioning

clients may feel when attending the stimulant-only service, consideration had also been given
to the design of the service space. The physical space of the clinic was separate and private. It
contained a table with magazines to read and a pot plant, as well as a couch. While clients
had to walk through the front entrance of the general AOD service, they could quickly go into
a confidential and pleasant space. Accommodating the unease people experienced at being
linked to the stigmatised body of the drug user is not a general feature of AOD sector as
evidenced, for instance, by the very different space of the primary health care service. This is
not to suggest that all services should offer the same practice; the methamphetamine
specialist service had different aims to that of the primary health care service. The specialist
service aimed to assist people to control, reduce or cease their methamphetamine use. The
primary health care service aimed to be a ‘one-stop shop’ for people who inject drugs —
primarily heroin — who had a much broader range of needs. However, the differences
between the physical spaces of these services illustrate the political nature of treatment
practice. The practices and spatial considerations of each service materialise very different
treated bodies. Clients of the primary health service are subject to high levels of surveillance,
visible to management when accessing a drop-in space, and to other clients when using
services such as the NSP and pharmacotherapy programs. These practices oblige clients to
embody themselves as drug users. On the other hand, clients at the specialist
methamphetamine service are afforded privacy and a safe space away from drug users. These
clients are not obliged to embody themselves as a druggie to access treatment. They are able
to understand themselves as a different type of drug user — one that can exercise self-control
and be compliant in a treatment environment. In this way, they are reflective of the bodies
enacted through active treatment practices outlined in Chapter 5.

Yet, while Tess’s practices enact a highly controlled user and considerable effort is made to
provide this group of clients with a private, quiet space to receive treatment, this is also a
group of drug users understood as uniquely violent and psychotic. When asked about the

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reputation of methamphetamine users, and whether this tallied with her experience, Tess
replied:
I think people were really wary about this group of people and they’re actually really
reasonable. They’ve been fantastic, and part of it, maybe that they’re protected from
that [being thought of as a violent methamphetamine user].
Here, she suggests that one of the reasons her clients’ behaviour is reasonable is because they
have been accorded a separate space and protected from the general AOD waiting area. This
is reinforced by Margot’s experience. Margot at various times experienced psychosis and said
of the waiting area:
it used to feel good being able to go and sit in that separate little room to
wait…mainly because I was feeling so jumpy and so…because I’d go in there hearing
things and stuff…. that’s probably common to quite a few methamphetamine users,
those experiences and there would be, probably, a lot of paranoia and feelings like
that going on. So I think it probably was a really good idea.
Margot found being able to have a quiet place to wait for treatment beneficial to the way she
felt, and thus helpful to being able to embody herself as a ‘reasonable’ client. Tess’s
observation and Margot’s assessment of the waiting area show how practice and space can
act to constitute particular types of treated bodies.

On a related point, Tess, noted that many of her clients had mental health problems:
At the moment we’re getting a range of people. Quite a lot of our people coming
through do have depression, anxiety, and they’ve experienced psychosis, they do have
those other mental health issues to quite a large degree as well. They seem to be able
to still access the treatment.
Thus, mental illness does not, in the case of the stimulant-specific service, disqualify people
from CBT or from being active, knowledgeable clients. This is congruent with Margot’s
experience (detailed in the previous chapter) where she describes being treated at the
stimulant-specific service while experiencing psychosis. So while Tess enacts highly
knowledgeable bodies through her treatment practice, at the same time these bodies may be
psychotic, anxious or depressed. This subverts some of the very conventional ideas around
mental illness and drug use. It manifests clients of the service, whether with additional mental
issues or not, as capable of undertaking CBT and of change. Clients are therefore enacted
through Tess’s practice as simultaneously controlled, active and psychotic.

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Both Tess and Eve enact their clients as capable of change. Yet, because of the various
assemblages within which these clients are enmeshed, the interventions produce different sets
of tensions. Eve’s clients experience significant marginalisation and have limited capacity to
connect with economic and social resources such as housing and employment. Tess’s clients
can make these connections and, in doing so, are able to appropriate the neo-liberal subject
even when depressed and psychotic. I now discuss an account which also enacts the neo-
liberal treated subject before further discussing its political implications and effects.

Change and choice

Linked to the concept of change as resulting from individual capacity is the treated body’s
capacity for choice. The capacity (or incapacity) to make choices driven by sufficiently pure
volition (Sedgwick, 1992), that are free but responsibilised (Rose), is central to our
understanding of citizens. Neo-liberal discourse assumes people who use drugs are typically
devoid of the capacity to make the right choices (Keane, 2002; Sedgwick, 1992). Their
choices are not made freely because they are driven by compulsion and addiction. A corollary
of this assumption is that drug treatment practice should improve the capacity to make the
right choices, and I now feature an account of service provision where this was the case. The
account is from Gillian, a senior case worker, and her treatment practice can be seen as
addressing her clients’ choice-making capacity.

Gillian’s treatment practices emphasised a ‘relationship-based’ approach, and her first

priority was thus to establish a relationship with the client. This involved being able to talk
openly with clients, to support them and link them with various services and resources.
Through this relationship, Gilliam aimed to ‘empower’ the client. Central to empowerment
was enhancing the capacity of the client to make the right choices and to change. As Gillian
explains:
It’s basically forming the relationship-based approach with the client where they’re
going to be able to feel safe enough to be able to talk to you, where they’re going to
feel empowered. It’s about empowering the client, looking for change. It’s about
providing support; it’s about showing them what other facilities are out there. I guess
at times it’s setting up a bit of a pyramid so that they know that they’ve got choice and
from there they will be able to figure out what’s going to work well for them.
The object of intervention here is the client’s attributes and the goal is to increase their ability
to make the right choices. This did not necessarily involve ceasing drug use, as Gillian said:

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It’s about giving them information so that they can make the right choices and harm
minimisation…like it might be about safe techniques in using. It’s about giving them
the choices so they can make smart choices for themselves.
Here Gillian’s treatment practice ‘does’ a harm reduction agentive drug-using body. This is a
body that can use drugs responsibly, making ‘smart choices’. Moreover, this is a body that
understands itself on a biological level, and as Gillian noted:
For me I like to work through with clients on getting them to understand chemically
what occurs because I think that’s important.
Why is that important?
I think that a lot of people might feel good in having it, but they’ve just got no idea of
what’s going on in their mind while it’s occurring and I think that to make the choices
that you need to make you need to have an understanding of what’s going on.
Gillian’s practice of informing her clients about what is ‘going on in their mind’ enacts these
drug users as biological citizens (Rose, 2007); as individuals who consider the choices they
make in terms of their neural implications.

Neo-liberal discourse understands addicted subjects as flawed and damaged because they
cannot make the right choices. Gillian’s treatment practices followed these assumptions
through to their logical conclusion. The object of treatment in Gillian’s practice was not drug
use per se but the client’s capacity to make the correct choices. Gillian provided clients with
the information required to make the right decisions but then took this a step further,
empowering her clients and increasing their capacity to act upon this information. These
treated bodies are not those enacted through CBT in that they are not required to scrutinise
their thoughts and change the way they think. Instead, they are bodies capable of being
empowered and supported to make the ‘right’ choices. They are appealing in that they are
rational, active drug users; once shown the correct choices to make, they will make them.
Yet, intervening in this way also produces a specific set of tensions. While increasing the
capacity of individuals to make choices may contribute to their sense of empowerment, it also
obliges them to take sole responsibility for the result of their choices. The client group that
Gillian worked with was young, often in state care and usually with minimal levels of
education and income. If, in supporting them to make choices, there is no consideration of the
way these choices are shaped through the networks and assemblages clients are implicated
within, it is possible that they could assume complete responsibility for their precarious
relationship to social and material resources. Thus, while undertaking to empower clients,

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effectively giving them a sense of agency, there are tensions between this goal and the lived
experience of Gillian’s young clients (Moore, 2009; Moore & Fraser, 2006). Gillian’s
practice others the drug assemblages within which her clients are enmeshed. These
assemblages may shape what she considers to be unsafe drug use, rather than this being the
result of her clients making the wrong choices.

While it is important to note the tensions in the way Gillian’s clients are evoked, this is not to
disparage her practice. AOD treatment practitioners are limited in what is achievable. Their
practices are shaped by the stated aims of their services, funding agreements, and connections
to other services that might provide support to clients. Given the circumstances of Gillian’s
clients, providing clients with information about drug use is an activity that has strategic
benefits (Moore and Fraser, 2006). Positioning clients as individuals with the capacity to
make the ‘right’ choices responsibilises them so that they are answerable for their
marginalisation. However, providing them with the information to make decisions that might
minimise risky drug use is a pragmatic way of supporting these individuals, given the
limitations of what is possible to accomplish though harm reduction/drug treatment services.

Risks and benefits of responsiblising methamphetamine treated subjects

In this section I have discussed how service providers conceptualise change as related to
individual capacity and the various sets of tensions that may arise. I also considered the
specificity of the stimulant-only service — noting how its treatment practices manifest a
uniquely active drug body. I have argued that considering change as related to individual
capacity is problematic for those people enmeshed in networks devoid of key social and
economic resources. Their lived experiences are ‘othered’ by the evocation of the neo-liberal
ideal. These individuals are seen as capable of prioritising and therefore as responsible for
where these priorities have led them. And while change is demanded of (and by) those
individuals who experience a sense of control and power in their lives, tensions arise in
treatment encounters. Entering treatment effectively means ‘doing’ oneself as a compulsive
and problematic drug user, a body at odds with the neo-liberal citizen. In some cases, practice
could accommodate the sense of discomfort individuals had with the treatment encounter.
This was done through strategies such as not labelling clients and creating a space in which
their comfort and privacy was foremost. Yet these considerations are not applied equally to
all people accessing treatment services, as other services subject clients to high levels of
visibility and surveillance. Further, a corollary of linking client change to individual attributes
and capacity is that these then become the object of treatment. Treatment practice intervenes

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to empower bodies to make the ‘right’ choices and enact change. While these treatment
practices provide a political alternative to those that enact drugged and passive bodies,
tensions also arise when the lived experience of individuals constrains the choices they are
able to make.

While practices that enact drug users as rational, autonomous beings can seem beneficial,
Moore and Fraser (2006) argue that there are risks with this approach. These risks are
illustrated in the accounts of service provision above. Further, Moore and Fraser (2006),
Sedgwick (1994), also argue that enacting the neo-liberal is also risky because the concepts
of free will and autonomy associated with this ideal are necessarily established with their
binary opposites — compulsion and addiction. Thus, the flipside of embracing the neo-liberal
subject is that it must always exist with failed neo-liberal subjects, leading to binary
categories such as good drug users/bad drug users. As an alternative to the neo-liberal
subject, Moore and Fraser (2006) argue that de-centring the subject and recognising a
multiple and fragmented subjectivity is a possibility, but that this too can be problematic,
reinforcing drug users’ marginalised status:
definitions of the subject as fragmentary, non-rational, always in a state of flux, may
be applied only to social groups that are already deeply marginalised, rather than to all
subjects, including the most ‘respectable’. This would likely reinforce popular
prejudice and stigmatisation, and may further entrench discrimination in legal,
employment, health and welfare contexts. (p. 3042)
Moore and Fraser (2006) do not propose a ‘correct’ way of thinking about the drug-using
subject in harm reduction, but seek to make visible the political nature of this subject. In
terms of methamphetamine treatment, their work is useful for reflecting on the political
nature of the treatment practices outlined above. My analysis of accounts shows that, like the
harm reduction subject interrogated by Moore and Fraser (2006), the subject of treatment is
also a figure underpinned by the assumptions of neo-liberalism. The work of Deleuze and
STS scholars such as Latour, however, allows me to address Moore and Fraser’s (2006)
concern regarding applying a fragmented subjectivity to an already marginalised population.
STS scholars provide us with a way to think about a fragmented or ‘becoming’ subjectivity in
a very empirical sense, considering the immediate connections and relationships that
constitute subjects. Using this insight, Duff (2014) argues this empirically driven way of
considering the world is beneficial to drug use interventions:

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The best research, the best policy advice, and the best harm reduction praxis never
ceases to concern itself with the real conditions of consumption; with the specific
circumstances in which bodies, spaces and substances interact in the event of AOD
use (see Fraser & Moore, 2011). As such, harm reduction ought to focus on the
assemblage rather than structure or context in its consideration of a means of
intervening in events of AOD use. (p. 638)
Thus, while subjects that emerge from assemblages are always ‘becoming’ — at the same
time, consideration is given to the real conditions of drug use and the relationships and
connections that capacitate these subjects. In terms of treated bodies, this enables a focus on
the resources that they are connected with. Thus, the subjects that emerge from assemblage
thinking are fragmented and non-rational. But focusing on these subjects in terms of their
relationships to materiality and how these relationships produce their drug consumption —
problematic or otherwise — shows that attributes such as rationality can emerge from
particular relationships, and that change is dependent on shifting relationship and
connections. Like Moore and Fraser (2006) I am not proposing a correct way to define drug-
user subjectivity; I do hope, however, to propose that there are alternative, empirically-based
and pragmatic ways to strategically address the treated subject.

Resisting and rejecting change

While client change was a central concept in accounts of service provision, other accounts
rejected or subverted the need for it. These accounts were provided by workers who did not
work with people specifically using methamphetamine but at general AOD services. This
section features practices that enact unchanging clients, how these relate to the absolutes by
which we understand drug use and the specific ‘set[s] of tensions’ (Mol & Law, 2004, p. 58)
that may arise. Generally, treated bodies were enacted as unchanging for three reasons. First,
clients were not considered capable of change (and harm reduction and/or treatment services
therefore provided ‘respite’). Second, change was considered an almost unpredictable
outcome and not specifically the result of client capacity. Third, clients were viewed as part
of a wider social and economic environment, where elements of this environment were
considered as requiring change rather than the individual client. The discussion that follows
considers these three ways of mobilising change.

Unchangeable bodies
Several accounts enacted an unchangeable drug-using body. In some cases this was done
through the practice of ‘respite’. This practice does not require change; rather a person is
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cared for and kept comfortable for a period of time. The practice of respite was evident in
service provision accounts from inpatient withdrawal services and primary health care
facilities. Yvette, for instance, a worker at an inpatient withdrawal unit, stated that she
thought the goal of abstinence was, for many clients, unrealistic. She thought that there were
‘honest’ clients who admitted from the outset that they were accessing the service as a kind of
respite. Yvette said of these clients:
They’ll say ‘Oh I’ve just come in for a break’, you know, and it’s just a way of harm
minimisation, call it what you like, but you know, the ones that are honest.
With this statement, Yvette legitimised the goal of taking a break from drug use (rather than
wanting to cease drug use altogether) through labelling it ‘harm minimisation’ and by
suggesting that in many cases abstinence is unrealistic.

Yvette’s account enacted an unchanging treated body through acknowledging the enormity of
change required if a client were to become abstinent. She stated:
[The] reality is, I think it’s hard to give it all up at once. You get people who come in,
and they want to get off cigarettes and everything, they’re just not realistic at all. I
mean, four litres of wine a day, they want to come off that, they want to come off
cigarettes and they want to also come off maybe valium they’re prescribed, just do it
all at once. In one week you can only do so much.
Here, Yvette explains the unchangeable body through describing the sheer amount of
substances and practices to be given up if clients were to become abstinent at the cessation of
treatment. She is also cognisant of the limitations of her practice and what is possible in the
space of just one week. Thus, while accepting that her practice is in many cases respite,
Yvette enacts this as a legitimate harm reduction measure. Moreover, while her clients
emerge from practice as unchangeable, they do so because of their relationship to multiple
substances, and as a limitation of practice rather than due to personal failings.

Katrina, a nurse employed at the same inpatient withdrawal unit as Yvette, also noted the
limitations of what was possible in practice in terms of change, but talked about this in
broader terms than people’s substance use. She explained that clients accessing the service
come with:
a whole gamut of different sorts of situations….It can be overwhelming just one of
them, although they have six or seven different things.
Like Yvette, Katrina said that clients might expect outcomes beyond what was possible

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through attending an impatient withdrawal unit:

It’s sort of looking at trying to bring it into perspective of what’s do-able and the
timelines, because everyone sometimes might want to do everything all at once, and
that's part of their chaos; that they can’t do anything, yet they want to do everything
all at once.
Her practice focused on addressing what was possible given the service constraints of the
withdrawal unit:
So it’s trying to sort of bring back the timelines into what's achievable over a short
sort of period of time, and have some sort of sense of what supports are available, but
sort of looking at, let’s just do this in increments. And even sort of starting with just
getting up in the morning and having a sense of, you know, breakfast, lunch and
dinner, socialising with other people, having a routine of the groups and attending that
and being on time, and just that sort of sense.
Katrina’s focus on the possible is pragmatic, yet also enacts a childlike client; one that is
‘chaotic’ and ‘can’t do anything’ and needs to learn the most basic skills such as when to
wake and eat. This is, however, the nature of practice within many inpatient withdrawal units.
These are services where time and space are highly regulated phenomena. Katrina views this
as a necessary response to the ‘chaos’ of people’s lives and of people themselves. Yet the
need for time and space to be tightly ordered is also conducive to maintaining control of a
group of individuals unknown to each other, within a confined space, and often experiencing
physical, social and emotional discomfort. Nonetheless, while Katrina understands aspects of
her clients as chaotic, her practice of addressing what might appear as insurmountable issues
incrementally suggests a commitment to address and respond to some of the issues faced by
her clients such as homelessness, employment and family and legal issues.

Client accounts from the inpatient withdrawal service at which Yvette and Katrina worked
supported their assertion that some people entered the service with very high expectations of
change. William, for instance, a 42 year old unemployed truck driver (introduced earlier), had
been using cannabis, methamphetamine and alcohol daily. As he stated:

I’m trying to kick everything, like yeah, the drink, the smoke, the ice, yeah, speed.
I’m trying to do it all at once so because I see, if I’m on one, I’ll be on the other. It’s
just sort of a habit to me. So yeah, I’m here, trying to give it a shot, to give everything
up.

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William knew this would not be easy:

The next day — that will really start to test me I think, with the withdrawals, so — but
at the moment, I don’t feel too bad — a little bit anxious, yeah, of what’s going to
happen, but I’m feeling positive.

William had used a combination of drugs daily for around 25 years. He had taken drugs while
working, as well as at home, where he had set up an area in his outside shed exclusively for
smoking ice and cannabis. These practices of drug use, where drug consumption was part of
both his work and home life, a daily activity and one given a specific space in his home,
would presumably be difficult to disengage from. It therefore seems unlikely that, despite
wanting to be abstinent, William would achieve this goal as a result of a seven-day stay at an
inpatient withdrawal service.

Other clients of the service expressed the treatment outcome they wanted in broader terms
than drug use. Kate, aged 39 (introduced earlier), said of her stay at the inpatient withdrawal
service:
It’s the start to a new life. I get clean, I can think clearly, I focus more and I know
what I want in life.
Here Kate assumes she will be ‘clean’ (or abstinent) and begin ‘a new life’ upon leaving the
service. She also stated that she would know what she wants once she is abstinent, drawing
upon an addicted/non-addicted binary to understand her clean body as one that can ‘think
clearly’, ‘focus’ and ‘want’ the right things. Peter, aged 35 years, similarly felt that the
inpatient withdrawal service would result in life changes for him. After treatment he aimed to
get custody of his son, repair his relationship with his partner and stop smoking
methamphetamine and cannabis. When asked about his goals for treatment, he said:
To work on getting my boy back, to work with DHS, 20 to get married and having
another little baby and yeah just be a happy family and do the things that like what
you or, you and your partner, all go shopping, go for tea, or you know what I mean,
like 'sorry we can’t go out for tea tonight because I just spent me money on pot'.
Like Kate, Peter believed he would cease using drugs after leaving the service and, as a
result, his life would change: he would have access to ‘normal’ activities such as marriage,
shopping and eating out.

                                                            
20
 DHS is the Department of Human Services (Victoria) — the state government department that Peter was
dealing with regarding child custody.   

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It is easy to understand why these client goals seem unrealistic, or even disingenuous.
William had a long history of drug use and it seemed unlikely this would cease after spending
seven days in an inpatient withdrawal unit. Kate and Peter were both recipients of
government pensions and had limited education and no formal qualifications. Kate lived in a
housing estate and Peter was facing a jail sentence. None of these individuals had access to
significant social and material resources. Changing their lives significantly would require
more than a short stay in a withdrawal unit. Yet, while goals of abstinence and a start to a
new life could be interpreted as platitudes or as wildly unrealistic, these goals also suggest a
desire for a better life, one free from the social and economic instability that these individuals
experienced.

The incongruence between the possibilities of treatment and the expectations and desires of
clients illustrates a shifting set of tensions. Many people enter treatment with the expectation
of change; however, the change they desire is far greater than merely modifying their drug
use. Given the circumstances of many clients that access publicly funded treatment, how are
workers to be mindful of the difficulty of disentangling their clients from networks of poverty
and social isolation, without succumbing to paralysis in the face of what might appear to be
unchangeable? The hazards of this are evident in Robert’s account. As Robert (a mental
health worker at a primary health care service) said of his work:
Some people that we see at our service are like bottomless pits, they need so much
support and so much help and we can only do so much. But even if I was to spend, or
anyone was to spend, 10 hours a day with them, seven days a week, they still would
only get so far.
Here, some clients’ needs are enacted as so great that the process of change is impossible, as
no worker could provide the level of service Robert asserted is required to ‘only get so far’.
Through this statement Robert describes the many problems that his clients face and,
correspondingly, the high level of support they need. But in doing so, he risks evoking
unchangeable clients as immutable objects of hopelessness, as ‘bottomless pits’.

A political effect of enacting drug-using bodies as unchangeable is that efforts at intervention

to enable change are negated. If these bodies are incapable of change then there is no
obligation to address the social and economic marginalisation they may experience; they are
inherently ‘drug’ bodies and beyond assistance. This suggests that while it is important to
recognise the limitations of harm reduction and/or treatment practice, it is also important to

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bear in mind that these practices can play a role in addressing the broader circumstances of
clients. Harm reduction and drug treatment practices involved helping clients to find housing,
deal with family issues such as child custody and so on. As such, practices that are cognisant
of the social and economic status of clients, and that attempt to address incrementally some of
the issues faced by clients (drug use or otherwise), seem pragmatic and useful; an attempt to
improve the client’s lived experience within the limitations of what is possible.

Change by chance
While change was enacted in accounts as linked to individual agency, there were also
accounts in which change was considered almost arbitrary, or at least as a process that was
separate to practice, and perhaps even to the capacity of the individual. Katrina, a worker at
an inpatient withdrawal service, was explicit about the sometimes arbitrary nature of change,
and also saw change in a broader sense than as only relating to the actions of individuals.
When asked why some people might succeed in stopping their drug use, she stated:
There's a variety of things. It might be chance, it might be being in the right place at
the right time, hearing whatever’s said, and then actually listening to what is being
said in a different way. You know, it might be someone sort of just having faith in
them, having some sort of hope in their own ability to make changes. I think there's a
whole gamut of different sorts of things, but it’s looking at what’s important, you
know, that person’s beliefs and values and um, seeing what’s important to them,
rather than what you think’s important, and trying to change them for the sake of
changing. I don’t know, just seeing what sort of benefit people get out of their
dependency, and looking at why they’re wanting to make changes, and if there is
ambivalence.
Here, Katrina moves between offering an agentive account of change (referring to people’s
ability to make changes) and suggesting change might occur by ‘chance’ or by ‘being in the
right place at the right time’. Katrina notes that some people might not need to be changed as
they get benefits from their ‘dependency’. She warns against change ‘for the sake of
changing’ and (similar to her colleague, Yvette) legitimises the practice of respite for those
who do not seek change. She also refers to a ‘whole gamut of different sorts of things’ that
might contribute to change; this evokes a reality where clients are engaged in multiple
encounters and assemblages related to drug use. Considered this way, service encounters such
as treatment are part of myriad assemblages, and may contribute to mitigation of drug-related
harm and drug use, dependent on the other encounters in which people are engaged.

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Katrina’s account of practice subverts neo-liberal interpretations of change. In her account

change is not expressly the result of individual agency, or a corollary of practice; it may be
arbitrary. However, this is different from Robert’s enactment of some clients as
unchangeable, thereby negating the role of harm reduction and treatment services. Katrina’s
account of service encounters, clients and change is not diminishing of the role of treatment.
First, she sees change as possible (although at times incremental). Second, she enacts service
encounters as one kind of encounter among many that clients will have. This does not negate
or dismiss the possible positive effects of these encounters, but does recognise that other
assemblages and encounters in which clients are engaged will mitigate the service encounter.
Thus, treatment has purpose, but it is always part of a broader lived experience. Whether an
individual has housing, whether they have employment or parental obligations — all the
other assemblages and identities in their lives — contribute to the enactment of the treatment
encounter.

Structural change
Another way in which change was enacted in accounts of service provision was in relation to
broader social and environmental considerations. Liam, a manager at an outreach service,
gave an account of service provision that resisted change as related to the capacity of the
individual client. His account was not reliant on the centrality of the client to treatment, and
instead focused on the lived experience of clients and their social and economic disadvantage.
He stated that at his service:
We work very strongly from a sense of social justice and sort of saying the world is
not an equal place, and that this particular group of young people who we target are
often quite marginalised, disadvantaged and not connected with the community. And
so again, we work very much in the framework of a social model of health and so all
our work is sort of around those risk factors around poor health.
Liam expressly stated that a person did not have to want to change in order to be treated
through his service:
Given that our focus is on health and well-being, it’s not like you’re going to have to
want to change…like you’re going to have to stop using.
The object of treatment or intervention, then, was the client’s health and well-being, and this
was not only linked to their drug use. In Liam’s account, clients were not required to change
because their poor health and need for support was assumed to be the result of inequality and

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disadvantage, rather than their individual limitations. It was not the individual that needed to
change in order for their circumstances to improve, but wider considerations such as their
access to economic and social stability. Thus, Liam employed the concept of change in his
practice, but in a broader sense than individual change. As he explained:
I have a very strong belief that we don’t have a fair or equal society and I have a very
strong belief that we should try to basically… there’s a whole lot of social
determinants that go into people’s health…especially because I don’t see biological
factors why everyone has to have differences, we can change this stuff.
Here, clients are embodied within and through their environments. Moreover, these
environments are considered to be productive of the harmful living circumstances of clients
and, in this way, Liam’s account resists the centrality of client change to practice and to the
problem of drug use.

In enacting change in a broad sense, however, tensions arise between practice and policy and
funding bodies, as these produce the concept of change in a narrow sense. As Liam stated:
Our work has to be accounted for by significant treatment goals. So we’ve got targets.
That in itself is a bit of a flawed system. We have to do a certain amount of work with
people and because it is very hard to be tangible around that kind of work, what we
have to do is we have to sort of say, we have to actually sort of meet a certain amount
of episodes of care. It means that we have to get a significant treatment goal. Those
significant treatment goals are actually fairly wishy-washy and that suits us because it
means — the last thing we want to suggest is that we’re not accountable, we’re happy
for our work to be scrutinised, absolutely we just don’t always agree on what
measures should be — I would argue that for a 17, 18-year-old that given things like
the social model of health for instance, that simply looking at someone’s end product
of drug use, whether it reduces or not, is not necessarily the only factor.
This statement demonstrates how treatment practice is shaped by the assemblages of
government. The targets and goals produced through these assemblages ensure that individual
change is central to the provision of service to people who use drugs. Liam characterised the
actual targets that must be met as ‘wishy-washy’ but suggested that this is helpful in making
his actual practice fit with the prescribed episodes of care model. However, he also suggests
that the way in which treatment is funded and assessed others pressing issues that people

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using drugs often face — such as a lack of housing and financial insecurity — through the
need to meet targets and goals.

While client change was enacted in many service provider accounts as central to harm
reduction and/or treatment practice, this concept was resisted or subverted in other accounts.
These interventions led to their own particular set of tensions. In accounts where change was
not required, there was the risk that clients were materialised as unchangeable, and
responsibility for the social and economic marginalisation they experience was alleviated for
treatment providers. Change was also subverted, enacted as arbitrary and as part of a ‘whole
gamut’ of different things. This is potentially confronting in that it could be interpreted as
negating treatment practice. Yet, it also creates an opportunity for the practitioner to be
mindful of the many encounters in which their clients are engaged, and that these all play a
role in their drug use experiences. Lastly, for practitioners attempting to enact change as a
broader phenomenon, tensions arise between practice and the ways in which the assemblages
of funding and policy shape harm reduction and/or treatment practice.

Conclusion
In this chapter I have analysed accounts of methamphetamine-related service provision in
order to illuminate the ways dominant understandings of this drug and its consumers shape
practice. My analysis addressed the ontological contingency of treated bodies, showing how
dominant figures such as the neo-liberal subject and the absolutes of drug use are embraced
and resisted in their constitution. While attending to the specificity of methamphetamine
through exploring accounts of practice at a stimulant-only service, I have also necessarily
looked at service provision in AOD more broadly, as most AOD services are accessed by
people using a range of drugs. Nonetheless, accounts, whether methamphetamine-specific or
not, reveal the ways in which the treatment practices made available to methamphetamine
and other drug users are shaped by the broader conditions of possibility, and are inherently
political.

I addressed accounts of service provision through tracing the ways in which change is
conceptualised in accounts, and how this might result in various sets of tension. While
accounts produce conventional understandings of change, such as locating the capacity for
change within the individual, accounts also resisted and complicated this conceptualisation of
change. These accounts posit that change may occur, change may be unrelated to treatment
practices, and change should be considered in a broader sense rather than at individual level.

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Tensions arose when service practices that assumed a neo-liberal subject ignored the
networks and assemblages through which individuals embodied themselves. For those people
enmeshed within networks delineated by their lack of material, economic and social
resources, this was problematic as their circumstances were then considered the result of
choices or priorities. Conversely, those people with access to the resources needed to emulate
the neo-liberal citizen found it difficult to reconcile the way they embodied themselves with
the figure of the drug-using subject. While there were efforts to address this discrepancy, it
raises the question as to why anyone accessing drug services should have to identify with this
particular compulsive and addicted subject.

Less conventional understandings of change also introduced tensions. The practice of respite
was considered a legitimate response to drug use. Enacting clients as bodies in need of respite
takes into account their marginalisation and lack of significant social and economic
resources. Yet, while it is important to acknowledge the social and economic marginalisation
of clients, this should not lead to them being materialised as unchangeable, as immutable
bodies. This might lead to inaction in terms of addressing this significant level of
marginalisation. For some service providers addressing the significant challenges clients
faced in finding housing, employment and so on were best addressed incrementally,
acknowledging that the support required was beyond what the service could offer. Some
service providers sought to enact change in a broader sense in their practice, by
acknowledging that environmental aspects may produce the health, social and financial
problems experienced by their clients, however, tensions arose when this practice was
required to fit the assemblages of policy and funding. Finally, there were service providers
who, in order to understand change in the lives of clients, conceived of service encounters as
simply one of many encounters that will produce and/or mitigate a person’s drug use.

These accounts also show the specificity of methamphetamine-related treatment practice. The
stimulant-only service effectively offered CBT, with some adjunct services. This was unique
to this service. These practices enacted a hyper-knowledgeable, self-controlled and reflective
client, similar to the treatment literature reviewed in Chapter 5. And yet clients of this service
had additional mental health problems (including psychosis) and used a drug inscribed with
destructive and addictive properties. This finding suggests the contingency of knowledge
around drug use — that we can understand some ‘destructive’ drugs as treatable through
modes emphasising an active subject (methamphetamine) and others as not (heroin). It also
shows the performativity of practice, and how different treatment assemblages capacitate

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individuals in different ways. Most importantly, it shows how access to resources such as
education, income, housing and so on enable people to make choices about their drug use,
suggesting the ongoing need to remain cognisant of the many elements that enhance a
person’s capacity for change.

In the conclusion that follows, I bring together the themes of the previous chapters — the
constitution of the substance ‘methamphetamine’, the extreme absolutes of methamphetamine
use as they are produced and reproduced through policy, treatment and media texts, and the
ways in which these are embraced, resisted or subverted in accounts of methamphetamine use
and service provision — in order to make some final comments with respect to the
ontological politics of methamphetamine.

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Chapter 8: Conclusion
Methamphetamine is a drug that continues to receive significant scientific, policy, treatment
and media attention. In this thesis I provide an analysis of this attention informed by two
related research questions. First, how are methamphetamine and methamphetamine
consumers constituted in scientific, policy, treatment and media discourse? Second, how do
consumers and service providers draw upon, reject and subvert authoritative discourse
through consumption and harm reduction/treatment practices? To address these research
questions I investigated the material—semiotic relations of methamphetamine. I traced the
enactments of methamphetamine and methamphetamine-using subjects in scientific, policy,
treatment and media discourse, showing their political effects and specificity. I then
examined accounts of methamphetamine consumption and service provision, describing how
individuals draw upon these enactments, embracing, resisting or subverting them, in order to
constitute themselves — and the object ‘methamphetamine’ — in multiple ways. My key
concern in this exercise was to make visible the ontological politics of methamphetamine,
illuminating the open and contested nature of realities. In doing so, I sought to disrupt the
dominant ways in which we know methamphetamine and methamphetamine users.
Moreover, I have shown that the very limited ways of constituting methamphetamine and
methamphetamine users result in the further pathologisation and marginalisation of people
who use this drug.

This research was theoretically driven by the work of Gilles Deleuze and Michel Foucault,
and STS scholars Bruno Latour, John Law and Annemarie Mol. These scholars provide
concepts that illuminate the contingency of realities — revealing how these are shaped
through localised networks of practice, as well as hegemonic ideals. Employing these
concepts, I have foregrounded the performativity of methamphetamine-related practice. I
showed how localised methamphetamine-related practices are produced by, and are
productive of, the subjects, objects and spaces of drug consumption and drug service
provision. Further, I have argued that while the assemblages of drug consumption and service
provision enact a multiplicity of phenomena, these have common features due to the
overarching discourses and practices that constitute a Euro-American ‘reality’ (Law, 2004;
Mol, 1999). These common features include the valorisation of choice and autonomy, and
fear and disgust of the addicted subject.

Drawing on the work of post-structuralism and STS entailed a methodological approach that
could address a multiple and inherently political reality. Thus, in order to carry out my

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research, I employed a method assemblage approach. This methodological arrangement

addresses an ‘interactive, remade, indefinite and multiple’ world (Law, 2004, p. 122). It is an
approach that assumes that research practice performs ‘truths and non-truths, realities and
non-realities, presences and absences’ (Law, 2004, p. 143). In this sense, method assemblage
is unavoidably political. It obliges the researcher to be cognisant and reflective of practice,
being aware of the objects, subjects, practices and spaces that are constituted through method.
It is also a commitment to enacting realities that are less oppressive — ‘to make some
realities realer, others less so’ (Law, 2004, p. 67).

As detailed earlier in this thesis, a range of scholarly work uses post-structuralism and STS to
address drug consumption, harm reduction and treatment. I have taken up some of the
insights generated from this work to interrogate methamphetamine consumption and related
service provision. This is an area worthy of critical attention. As I have shown in this thesis
dominant discourses constitute methamphetamine users as specifically violent and psychotic
and methamphetamine as a uniquely toxic drug. Government and policymakers continue to
problematise this drug, while the media enacts users as grotesque figures. These discourses
hence problematise methamphetamine and further pathologise and marginalise users of this
drug. My research builds upon the existing literature to disrupt these extremely pejorative
enactments, making visible more nuanced and complex but less oppressive realities. This is
significant as more complex readings of drug use enable us to understand it as a practice
undertaken for reasons other than compulsion — such as pleasure, desire, functionality,
control and wakefulness. It allows us to consider this practice as one of many an individual
may undertake, and one that is not inherently harmful. Moreover, it requires us to conceive of
the outcomes of drug use (harmful or otherwise) as constituted by myriad aspects, not simply
the purported pharmaceutical properties of a drug and actions of the drug user.

In addition to providing a complex account of methamphetamine use and service provision,

my research augments critical accounts of drug use more broadly, as it foregrounds the
ontological possibilities of drug use and harm reduction/treatment assemblages. This means
that I show how the many forces, spaces, objects and subjects of drug use come together to
constitute methamphetamine and methamphetamine users. This empirically driven way of
attending to methamphetamine moves beyond accounts of drug use which conceive of drugs
and drug users as pre-existing phenomena (with reified properties), interacting within pre-
existing contexts. Instead, I show the dynamic nature of the connections and relationships
people can form and how these capacitate individuals as well as shape the materiality of

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methamphetamine itself. This attends to the political nature of all things — never assuming
any substance or identity is a true representation of reality. It thus opens up a wider range of
possibilities for understanding drug use and drug users, beyond that of traumatised, violent
and psychotic individuals interacting with toxic substances. Further, considering all elements
of drug use as enmeshed within and produced through assemblages provides an empirically
robust method of tracing ‘an array of agents active in any instance of AOD use’ (Duff, 2012,
p. 155). This contributes to an alternative body of knowledge that addresses
methamphetamine consumption in ways that are not driven by the need to intervene on
pathologised and/or deviant subjects.

In this conclusion, I draw together the themes explored in this thesis, considering the
boundaries that I have enacted — that is, what has been made present in the course of this
research.

Methamphetamine as a matter of fact

I have shown how the substance ‘methamphetamine’ — particularly in the form of ice — is
reified in dominant discourses in Australia as a uniquely addictive and destructive drug. One
of the purposes of my research has been to disrupt such claims. In order to illuminate the
ontological contingency of methamphetamine, I examined its constitution in the field of
science. While an existing body of literature critiques the construction of methamphetamine
‘panics’ (see Chapter 2), this work assumes methamphetamine is an ontologically stable
substance. The ‘panic’ argument is that the pre-existing object ‘methamphetamine’ has been
misrepresented by fields of knowledge such as the media and policy, and a problem — or
panic — is constructed in these particular domains. It is, however, assumed that domains
such as science, public health and biomedicine are true representations of reality —
incontestable fields of knowledge — and these domains are used to assert the real scale of the
methamphetamine problem.

My research differs from these accounts by addressing methamphetamine as a multiple

substance with contestable material properties. It is thus made and re-made through practice
— including scientific practice. I argue that science (like any other body of knowledge) is a
form of craftwork, and trace the ways in which methamphetamine is enacted in scientific
texts. I find that these texts are not descriptions of the pre-existing substance
‘methamphetamine’ but, through literary inscription, enact this substance as specifically
potent and its users as uniquely violent and psychotic ( see Chapters 4 and 5). I posit that

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scientific practices and devices can only ever inscribe illicit drugs in particular ways as they
are embedded in existing hinterlands such as biomedicine and addiction studies. Within the
these hinterlands, established inscription devices, such as the SDS, can be referenced and
adapted in order to ‘make’ methamphetamine a drug of addiction. Previously inscribed
substances with purportedly similar characteristics, such as amphetamine and cocaine, are
also embedded in these hinterlands. This provides an evidence base from which to draw upon
to inscribe methamphetamine.

In undertaking this exercise, my aim was not to debunk facts and to assert what
methamphetamine actually is but to argue that the reification of methamphetamine is a result
of particular practices, inscription devices and political choices. While not wishing to deny
that people using methamphetamine can experience physical and mental health problems, it is
worth questioning the relentless publication of research that inscribes people who use
methamphetamine as highly pathologised individuals and the political effects of these
activities. How do these ‘facts’ about methamphetamine-using individuals affect their lives?
Do they make a positive difference, or do they contribute to broader discourses that
problematise and further marginalise this group? Can the lived experience of people using
methamphetamine be researched without relying on diagnoses that further pathologise and
marginalise this group?

In responding to these questions I followed Latour’s (2004) suggestion that, rather than
hastily inscribing materiality through the creation of ‘facts’, we should consider phenomena
as ‘matters of concern’. This does not mean rejecting scientific knowledge but
acknowledging its limitations and political effects, and expanding upon it through a renewed
form of empiricism. Drawing on Latour’s argument, my research acknowledges the
multiplicity of the substance methamphetamine: that it can be a drug of harm, but also a drug
of pleasure; that it can be associated with violence but also with work, sport or ‘normality’.
Researching methamphetamine as a matter of concern and empirical focus required opening
up the study of drug use to consider the assemblages of objects, subjects and spaces that
come together to enact drug use, making visible specific networks and assemblages of drug
use and drug harm reduction/treatment. I now discuss my analysis of the ‘absolutes’ of
methamphetamine use and then present some concluding remarks about how these absolutes
shape the assemblages of methamphetamine use.

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Methamphetamine‐using subjects: ‘Hyper’ absolutes

In this thesis I have argued that policy, treatment and media texts constitute
methamphetamine users in binaries. As illustrated in Chapter 5, this reflects the work of other
scholars who have exposed the binaries that enact drug use in modern Western thought such
as voluntarity/compulsivity, controlled/chaotic and addict/abstinence. Building on the work
of these scholars I have exposed the specificity of methamphetamine, arguing that
methamphetamine-using subjects are enacted in ‘hyper’ absolutes. Further, I have extended
the concept of absolutes, describing their ontological implications — how they shape
methamphetamine-related practices. In this section I discuss some of the key points I raised
in my analysis of methamphetamine-using ‘bodies’.

My analysis of authoritative texts argued that a hyper-knowledgeable, choice-making,

methamphetamine-using subject is constituted through harm reduction practices and highly
active treatment practices such as CBT and self-help. These practices are shaped by neo-
liberal health care systems, where citizens are obliged to access and use information in the
interests of their own health. However, they are also shaped by the way methamphetamine
has been inscribed as psycho-socially addictive rather than physically addictive, unlike the
inscription of heroin. The psycho-social nature of methamphetamine addiction has led to
methamphetamine-using subjects being obliged to work upon themselves in order to address
their behaviour and related psychological disorders such as depression and anxiety. As such,
methamphetamine treatment practices are very different from the dominant treatment practice
for heroin — OST — which does not oblige individuals to acknowledge or address their
psychological state, but are required instead to attend a dispensing point each day to consume
a drug under supervision. These two treatment subjects are binary opposites: the
methamphetamine-treated subject is active and reflective while the heroin-treated subject is
supervised and drugged. And yet, in spite of the enactment of methamphetamine addiction as
a psycho-social phenomenon, there remains a desire to discover an appropriate
pharmaceutical to treat methamphetamine use. Perhaps a discovery in this area would allow
us to shape methamphetamine treatment practices in a more familiar way, by foregrounding
the physicality of addiction (Keane, 2012). By revealing the various ways we understand
addiction, I have not argued for the merits of different types of treatment. Rather, I have
shown how treatment practices are political, shaped and constituted by a range of phenomena
— including broader understandings of the self and available pharmacology — and how
these practices, in turn, enact particular types of treated bodies.

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Another aspect of the knowledgeable and controlled methamphetamine-using subject that I

have sought to highlight in my research is that it is a paradoxical figure. Although this subject
is highly agentive, the inscribed properties of methamphetamine (potent and addictive),
require that methamphetamine-using subjects are always at risk of addiction and chaos.
Making present this paradox led to the more familiar manifestation of the addicted and
chaotic methamphetamine-using subject. In the case of methamphetamine, this subject
features prominently in the media, but is also visible as a non-compliant, anxious, psychotic
and violent figure in policy and treatment texts. Like the hyper-controlled methamphetamine-
using body, this subject is also extreme. Methamphetamine-using bodies (particularly ice-
using bodies) are constituted as more ‘hardcore’ and more prone to violence and psychosis
than other drug-using bodies (see Chapter 5). I therefore argue that we understand
methamphetamine-using bodies as both uniquely controlled and functional, and as uniquely
without control and chaotic. This reveals the contradictions inherent in the practices that
surround methamphetamine consumption and service provision and the limited understanding
provided by the absolutes of drug use. The very different treatment practices and expectations
of users of heroin, another ‘destructive’ drug, further demonstrate the contingency of
knowledge around drug use.

Interrogating the binary spheres of methamphetamine-using subjects made visible the

political effects of understanding methamphetamine use in this way. Most significantly,
binaries such as voluntarity/compulsivity locate agency within the individual, thus
responsibilising drug-using subjects (Rose, 1999). The practices and assumptions that enact
knowledgeable and reflective subjects — such as CBT and self-help — ‘other’ the
assemblages of drug use and the circumstances of people who use drugs that, in turn, shape
their capacity to ‘choose’ or to change their drug use. The assumption is that individuals
make unhindered choices and are thus responsible for the outcomes of these choices. This is
problematic, particularly for those individuals enmeshed within assemblages characterised by
social and economic deprivation who, because of these specific assemblages, are less able to
‘choose’ employment, safe housing, higher education and so on. Thus, a political implication
of responsibilising drug-using subjects is that those without access and linkages to resources
that enable them to make health-orientated choices are held to be responsible for their status.

By showing the limitations and political effects of the binaries that underpin drug use, I have
argued this is a problematic and inadequate way to frame drug use. In response to these

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limited understandings of drug use, I have made visible the ways in which the assemblages of
drug use capacitate individuals, enacting multiple subjectivities and objects — including
methamphetamine. In the following section I sum up my arguments concerning the
assemblages of methamphetamine consumption and treatment.

Drug consumption assemblages

One key challenge in researching methamphetamine use was how to describe practice in
ways that could do justice to shifting and multiple versions of reality. This required a
methodological commitment to look beyond the individual drug user to the material—
semiotic networks in which they were enmeshed — using ‘assemblage thinking’ (Duff, 2014,
p. 633). As I noted in Chapter 2, scholars in this area have previously used this way of
thinking to good effect. However, my research represents a novel application of this concept
as I apply it to disrupt the absolutes of methamphetamine use. That is, I use assemblage
thinking to show how attributes such as ‘controlled’ and ‘uncontrolled’ are produced through
the connections and relationships individuals form within discrete assemblages. I thus argue
these assemblages have ontological implications — ‘making’ controlled individuals, rather
than this being an inherent personal quality. This is an exercise not previously undertaken in
the literature. It is, however, a significant analysis as it spotlights the political effects of the
way methamphetamine users are currently constituted, showing that they are specifically
constituted as hyper-controlled and, at the same time, hyper-chaotic. Moreover, by focusing
on assemblages my research contributes to a body of work that is able to challenge common
assumptions about drugs and drug users — that drugs are inherently toxic, and that drug users
are compulsive and chaotic beings. One of the ways I do this is to argue that drug
assemblages capacitate bodies in particular ways. Thus the binaries of drug use practice (such
as controlled drug use or chaotic drug use) are not the result of personal failings or strengths
but are produced through the various material—semiotic networks individuals are enmeshed
within.

Employing assemblage thinking entailed moving beyond broad, structuralist concepts such as
class as explanatory tools. At the same time, it was necessary to spotlight the power
arrangements of assemblages in order to demonstrate the ways in which power shapes and
constrains the lives of individuals, and to show the links between agency and power, and
access to economic and social resources. Methamphetamine-using participants were not a
homogenous group with respect to their access to these resources. Some were unemployed,
and as a result had very low incomes. Some participants had well-paying professional jobs.

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Some participants were homeless while others were home owners. Some participants had
very strong connections to their families, with a sense of obligation towards them, whereas
others were estranged from their families. By describing the drug-using assemblages people
were enmeshed within, I sought to illustrate how these connections and relationships are
productive of the ways people constituted themselves and their drug use. I argued that the
assemblages of methamphetamine consumption showed that the connections and
relationships individuals formed were productive of specific capacities. For instance,
individuals who embodied themselves as highly knowledgeable about methamphetamine and
brain chemistry had ready access to education and tools such as computers. Individuals who
felt powerless over methamphetamine or ‘taken over’ by this drug were enmeshed within
networks characterised by a lack of access to significant social and economic resources, and
thus were typically constrained in the choices they could make.

While I sought to interrogate the absolutes of methamphetamine-using subjects, revealing

their slippages, inconsistencies and limitations, it was apparent that participants drew upon
these binaries and other dominant ideas of drug use in order understand themselves and their
methamphetamine consumption. All of the people interviewed for my research constituted
themselves as addicted or as having an ‘addictive personality’, thus embodying themselves as
compulsive drug users. The prominence of addiction in accounts reflects the authoritative
status of the concept in Western liberal societies: ‘addiction’ is used to describe any allegedly
compulsive practice and any practice can be labelled compulsive. If addiction to anything is
possible, the word’s negative connotations are diminished; however, when applied to drugs
— particularly ice and heroin — the term ‘addict’ evokes a very specific, out-of-control,
immoral, hopeless and repugnant subject.

In this research, I have outlined the ways in which individuals draw upon dominant
discourses to constitute agency and drug use. However, I also argue that participants
subverted and resisted these discourses in methamphetamine consumption and service
provision practice. For instance, people using methamphetamine compulsively also engaged
in consumption practices that were highly agentive. Thus, while embodying themselves as
addicts, they could still display the attributes of a highly in-control individual. This suggests
that powerful discourses limit and shape the ways we can produce drug use in Western liberal
societies, and people using drugs necessarily constitute their practice as addictive. At the
same time, their lived experiences complicate the idea of addiction and of agency and drug

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use. Further, participants drew upon, but also subverted and resisted, dominant
understandings of concepts such as trauma and psychosis. Ice was taken to self-medicate but
also to empower the traumatised body. Psychosis was terrifying, but also controlled. In
making present some of these complications, I wish to suggest the existence of other
narratives that might better describe drug use, narratives in which the figure of the addict
does not dominate, but instead give attention to the many forces that contribute to drug use
and its myriad forms.

Harm reduction/treatment assemblages and change

In addition to exploring methamphetamine consumption, I examined the absolutes of drug
use through harm reduction and/or treatment practices. As I have noted previously,
methamphetamine service provision has received little theoretical attention. Through my
analysis of this area, I provide new insight into the specificity of treatment for
methamphetamine use. I also contribute to the literature more broadly as I describe the
ontological implications of treatment and harm reduction practice. Building upon insights
offered by scholars such as Moore and Fraser (2006) concerning the drug-using subject, I
have illuminated the ways in which practices of service provision capacitate subjects in
different ways.

I analysed a range of accounts of harm reduction and/or treatment practices, showing how
these practices oblige bodies to constitute themselves in specific ways and exploring some of
the political effects of these embodiments. I noted the specificity of methamphetamine
specialist treatment — a set of treatment practices that embodied individuals as highly
knowledgeable and ‘active’. I also foregrounded the concepts of change in these accounts,
using the different ways in which practitioners deployed this concept in order to further
examine the binaries that underpin drug use. Conventional understandings of change
articulated by practitioners were made present, as were accounts that subverted and/or
resisted the concept of change. It was also evident that the political effects of these
conceptualisations of change were dependent upon the resources to which individuals in
treatment had access and could connect. For instance, some people accessing treatment
embraced the idea of change as resulting from individual capacity and saw themselves as
active in their treatment — and thus were able to instigate change. In turn, the assemblages
and provider practices that enabled them to embody themselves in this way implied that
change is inherent in the individual, and as something that could come from the techniques
taught as part of treatment practice.

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However, while it was possible and desirable for some individuals to embrace change and to
embody themselves as active treated subjects, for others this proved more problematic.
Change was also required of individuals who were enmeshed within assemblages
characterised by a lack of economic and social resources. In doing so these assemblages were
othered, and if people did not change they were seen as not prioritising correctly or as
unwilling to change. Thus, enacting people who use drugs as inherently capable of change
can obscure their lived experience — one that might be characterised by very limited access
to social and material resources, thereby limiting their capacity to change. I also noted that
assemblage thinking enables moving beyond the ‘change-ready’ subject; that is, subjects
could be considered in terms of their immediate connections and relationships to social and
material resources, and their capacity to change seen as being produced through these
connections, rather than through inherent individual attributes.

Another significant way of thinking about change made visible by this research — and one
that challenges more conventional understandings of the change concept — is where change
is conceptualised as unnecessary or as unpredictable. These practices constituted clients in
different ways and with different outcomes. First, they could enact clients as beyond change,
immutable and non-agentive, with the political effect of negating the need for intervention,
assistance or support to people who use drugs. However, these practices might also enact
clients as in need of respite — requiring that service providers were first and foremost
pragmatic, addressing clients’ immediate needs without the expectation of change. Harm
reduction and/or treatment practices also constituted clients as changeable, but with change
emerging not solely as the result of service encounters. Such practice recognised that the
service encounter could be one of many encounters that might mitigate or change drug use.
Finally, I also revealed how change was conceptualised in a very broad way, without the onus
being on the client to change. This was the expectation that clients’ lives would improve with
social and environmental change, but these practices were constrained by the assemblages of
policy and funding in which certain institutional and bureaucratic requirements valorised
individual change.

Summary
In illuminating the ontological politics of methamphetamine and the contested nature of
realities, my research was guided by two main research questions. First, I traced the dominant
enactments of methamphetamine and methamphetamine-using bodies in authoritative fields
such as science, policy, treatment and media. In these fields, methamphetamine is enacted as

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a uniquely potent and addictive drug, and methamphetamine-using bodies are materialised in
hyper-absolutes. On the one hand they are highly knowledgeable, controlled, choice-making
subjects; on the other, they are psychotic, chaotic and violent — ‘worse’ than heroin users.
Second, drawing on accounts of consumption and service provision, I illustrated multiple
enactments of methamphetamine and methamphetamine-using bodies; this allowed me to
illuminate the ways that consumers and harm reduction/treatment practitioners draw upon,
subvert and resist hegemonic enactments of methamphetamine and methamphetamine users.
It showed the multiplicity and messiness of methamphetamine and its related practices; that
this drug can be enacted in many ways — as a drug to handle trauma, as a pick-me-up before
work, as one of a series of substances taken on a bender. Moreover, like all individuals,
people using methamphetamine are constituted through the desiring forces, connections and
relationships to which they have access and which, in turn, form them. These forces,
connections and relationships shape drug practices — whether controlled, chaotic or
functional — and also shape the available choices. Thus, individuals who use
methamphetamine embody themselves through their local assemblages of use, but also draw
upon broader understandings of drug use.

My aim was to address methamphetamine consumption as a matter of concern. I have argued

that the knowledge around methamphetamine is always contestable and, using empirical
methods, I have analysed this knowledge and illuminated its political effects. By assuming
the materiality of methamphetamine is contingent, I have provided an alternative account to
the very singular and specific way this drug is currently understood in dominant discourse.
By treating the assemblages and networks of methamphetamine consumption and harm
reduction/treatment as units of study, I have moved beyond the interrogation and description
of the methamphetamine-using subject as a way in which to address methamphetamine
consumption. Employing these strategies to address methamphetamine consumption has been
a political commitment to decentre the drug-using subject. It has also been a means to
describe methamphetamine consumption and harm reduction/treatment in complex and
nuanced ways, providing an account that does not contribute to the further pathologisation
and marginalisation of people who use drugs.

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Appendix A: Scientific claims about methamphetamine

Table 1 Methamphetamine claims in Australian scientific literature

Claim Article Author (year)

Meth/amphetamine is a drug of Validation of the amphetamine Topp and Mattick,
dependence dependence syndrome and the SamDQ (1997b)
The applicability of the dependence Topp and Darke
syndrome to amphetamine (1997)
Choosing a cut-off on the Severity of Topp and Mattick,
Dependence Scale (SDS) for amphetamine (1997a)
users
The relationship between crystalline McKetin et al.,
methamphetamine use and dependence (2006a)

Methamphetamine is harmful 'Crystal meth' use among polydrug users Degenhardt and
in Sydney's dance party subculture: Topp, (2003)
Characteristics, use patterns and
associated harms
The emergence of potent forms of Topp et al., (2002)
methamphetamine in Sydney, Australia: A
case study of the IDRS as a strategic early
warning system.
Major physical and psychological harms Darke et al., (2008)
of methamphetamine use
Crystal methamphetamine smoking Kinner and
among regular ecstasy users in Australia: Degenhardt, (2008)
increases in use and associations with
harm.

Crystal methamphetamine 'Crystal meth' use among polydrug users Degenhardt and
(‘ice’) is more harmful than in Sydney's dance party subculture: Topp, (2003)
other forms of Characteristics, use patterns and
methamphetamine associated harms
The emergence of potent forms of Topp et al., (2002)
methamphetamine in Sydney, Australia: A
case study of the IDRS as a strategic early
warning system.
The relationship between crystalline McKetin et al.,
methamphetamine use and dependence (2006a)

Crystal methamphetamine is The relationship between crystalline McKetin et al.,

more likely to cause dependence methamphetamine use and dependence (2006a)
than other forms of
methamphetamine

Crystal methamphetamine is not Crystal methamphetamine smoking Kinner and

more likely to cause dependence among regular ecstasy users in Australia: Degenhardt, (2008)
than other forms of Increases in use and associations with
methamphetamine harm

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Methamphetamine users have The prevalence of psychotic symptoms McKetin et al.,

higher levels of psychotic among methamphetamine users (2006b)
symptoms than the broader
population

Methamphetamine use is Hostility among methamphetamine users McKetin et al.,

associated with, or related to, experiencing psychotic symptoms (2008b)
violence

Methamphetamine can have Cardiotoxicity associated with Kaye and McKetin,

adverse effects on the methamphetamine use and signs of (2005)
cardiovascular system cardiovascular pathology among
methamphetamine users

Methamphetamine associated Impaired physical health among McKetin et al.,

with poor physical health methamphetamine users in comparison (2008a)
with the general population: The role of
methamphetamine dependence and opioid
use
 

   

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Appendix B: Interview guides

Interview Guide: Methamphetamine users not using health and treatment services 
The interview is likely to take about one hour. I’m going to ask you to read the plain language 
statement to give you a little bit more detail about my study aims, intended outcomes, your 
participation and your confidentiality. 
Do you have any questions about the research or any of the issues identified in the plain language 
statement? Do you consent to participate in the study?” [if yes, record oral consent]. 
Quantitative component of the interview: 

Age: 

Gender: 

Australian born: 

Permanent resident: 

Occupation: 

Level of education:      Private/public: 

Detailed drug use history:    
 types of drug used currently 
 frequency of use of each drug (daily, weekly, monthly) 
 method of ingestion 
 age of first use of methamphetamine 
 pattern of methamphetamine use (daily, binge etc) 
 combinations of typically drug used  
 environment drugs used in – street, home or club‐based 
 drugs taken in the last 28 days. 
Detailed health/treatment service history: 
 first treatment episode (type, date of entry and length) 
 most recent treatment episode (type, date of entry and length) 
 most regular form of health/treatment service used  
 treatment service used in the last 6 months. 

Open‐ended section of the interviews: 
1. Can you describe the last time that you took methamphetamine? How did you take it? What other 
drugs did you take? Who were you with? Where did you get it from? Where were you? What did you 
do during and after? 
2. Is this the way that you usually take methamphetamine? If not, under what circumstances you 
would you normally use it? 
3. Do you consider yourself a regular or heavy methamphetamine user? Has using 
methamphetamine made a big difference to your life?  
4. Can you tell me why you enjoy taking methamphetamine? 

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5. Have you experienced any harms or consequences related to your methamphetamine use? 
Describe these. 
6. What are the things that you do to use methamphetamine in safer way – or to reduce your use? 
7. Do you feel that you have your meth use under control? Would it be hard for you to stop taking 
meth? 
8. Thinking about the harms that you have mentioned: 

 what kind of support would be helpful to you? 
 Is there a health or treatment service that provides that kind of support? 
 Which one/s and why  
9. Do you think that you know a lot a methamphetamine and methamphetamine use? Do you need 
to get information about methamphetamine? What sort of information? Where do you get it from? 
Has the information you have been able to get been helpful – why/why not? 
10. Can you tell me the main reason you have not used a health or treatment service in the last 6 
months? Are there any other reasons? 
11. Are there issues that are not related to your drug use that affect you being able to use health 
and treatment services? (eg job, childcare) 
12. Can you describe the circumstances (drug use patterns etc) that might lead up to you needing to 
access health or treatment services? (or describe the lead up to the last time accessed services) 
13. Thinking about the last time you entered a health or treatment service for you 
methamphetamine use, what was the main thing you wanted from the service? Did the service 
provide this? How/how not? 
14. What has been your best experience of health and treatment services (for methamphetamine 
use)? 
15. What has been your worst experience of health and treatment services (for methamphetamine 
use)? 
16. How could health and treatment services change to better respond to methamphetamine use? 
17. Can you tell about the role of health/treatment service workers during treatment? 
18. Are they helpful to you in getting what you need from the health/treatment service? 
19. What qualities do you think are important in the staff that work at health and treatment 
services? 
20. Do you think that methamphetamine is an addictive drug? Why? 
21. Are you addicted to methamphetamine? If so, how do you know? 
22. Where do you see yourself in 5 years from now – will you still be using? 
This interview is about finding out more about methamphetamine users accessing services and how 
service providers view their role in relation to addressing methamphetamine‐related harm. Can you 
think of anything else along these lines that you think we should know? 
Thank you for your time and input. 

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Interview Guide: Methamphetamine users using health and treatment services 
The interview is likely to take about one hour. I’m going to ask you to read the plain language 
statement to give you a little bit more detail about my study aims, intended outcomes, your 
participation and your confidentiality. 
Do you have any questions about the research or any of the issues identified in the plain language 
statement? Do you consent to participate in the study?” [if yes, record oral consent]. 
Quantitative component of the interview: 

Age: 

Gender: 

Australian born: 

Permanent resident: 

Occupation:          Level of education:    Public/private: 

Detailed drug use history:    
 types of drug used currently 
 frequency of use of each drug (daily, weekly, monthly) 
 method of ingestion 
 age of first use of MA 
 pattern of MA use (daily, binge etc) 
 combinations of typically drug used  
 environment drugs used in – street, home or club‐based 
Detailed health/treatment service history: 
 first treatment episode (type, date of entry and length) 
 most recent treatment episode (type, date of entry and length) 
 most regular form of health/treatment service used  
Open‐ended section: 
1. Can you tell me about coming to this service? What led up to you coming here? What was the 
main thing you wanted from this service? 
2. What happened when you arrived? 
3. What happens now when you come to the service? 
4. What contact do you have with staff? 
5. Can you tell me why coming here is helpful or not helpful? 
6. What qualities do you think are important in the staff that work at health and treatment services? 
What is their role? 
7. Have there ever been reasons that have stopped you from entering treatment or using a health 
service? What were these? 
8. Best and worst health/treatment service experience and why. 

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9. On the whole, do you think that using health/treatment services has been beneficial for you? In 
what way? Why/why not?  
10. How could health and treatment services change to better respond to methamphetamine use? 
11. Can you describe the last time that you took methamphetamine? How did you take it? What 
other drugs did you take? Who were you with? Where did you get it from? Where were you? What 
did you do while you were taking it and after? 
12. Is this the way that you usually take methamphetamine? If not, under what circumstances you 
would you normally use it? 
13. Do you consider yourself a regular or heavy methamphetamine user? Has using 
methamphetamine made a big difference to your life? 
14. What are some of the harms you have experienced that you think are related to your 
methamphetamine use? 
Thinking about the harms that you have mentioned: 

 what kind of support would be helpful to you? 
 Is there a health or treatment service that provides that kind of support? 
 Which one/s and why? 
15. What are the things that you do to use methamphetamine in safer or less harmful way? 
16. Do you think that methamphetamine is an addictive drug? Why? 
17. Are you addicted to meth? How do you know? 
18. Where do you see yourself in 5 years for now – will you still be using?  
This interview is about finding out more about methamphetamine users accessing services and how 
service providers view their role in relation to addressing methamphetamine‐related harm. Can you 
think of anything else along these lines that you think we should know? 
Thank you for your time and input 

239
 
  

Interview Guide: Service providers 
The interview is likely to take about one hour. I’m going to ask you to read the plain language 
statement to give you a little bit more detail about my study aims, intended outcomes, your 
participation and your confidentiality. 
Do you have any questions about the research or any of the issues identified in the plain language 
statement? Do you consent to participate in the study?” [if yes, record oral consent]. 
Quantitative component of the interview: 

Age: 

Gender: 

Occupation: 

Current job title and role 

Detailed employment history (positions held, length of time in each position, approximate dates of 
employment): 
Guidelines for the open‐ended section of the interviews: 

1. What has brought you to this type of work? What are the rewards/drawbacks? 
2. Observations about methamphetamine users accessing the service (eg. Characteristics of users, 
range of drugs and combinations used, frequency and modes of administration, harms experienced, 
treatment outcomes).  
3. Are methamphetamine users different to other clients? Why, why not? 
4. Are there issues specific to methamphetamine use and/or users that make it easier/difficult to 
treat/address? 
5. Is methamphetamine an addictive drug? How do you know? 
6. What are the current barriers to accessing your service that methamphetamine users may 
experience? How has your service attempted to address these barriers? 
7. When a methamphetamine user comes to your service seeking treatment, what do you do? Can 
you give me an example of your last session with a methamphetamine client? Is this a typical 
session? Why/why not? What usually happens? 
8. What do you think is the most effective treatment for methamphetamine use and why? 
9. When clients leave here, what should skills and  
10. Can you tell me the most important qualities in a service provider at your organisation and why 
you think they are important? 
11. What are your personal guiding philosophies/beliefs/models? 
12. What are the models/principles guiding service delivery? 
13. Personal impact of such work and ways of debriefing? 

240
 
  

This interview is about finding out more about methamphetamine users accessing services and how 
service providers view their role in relation to addressing methamphetamine‐related harm. Can you 
think of anything else along these lines that you think we should know? 
Thank you for your time and input. 

   

241
 
  

Vignettes 

Case study 1 
Amy, a 19 year old female, contacts your service. Amy works in a nightclub behind the bar. She 
has been smoking crystal recreationally on her days off for the past two years. In the last three 
months, however, her drug use has increased and she has found herself smoking before she goes 
to work. When she finishes her shift, Amy usually goes out with her workmates and drinks 
alcohol and smokes cannabis. She finds that this helps her get to sleep. Amy thinks that her 
increasing methamphetamine use is causing mood swings and occasional bouts of depression 
where she can’t leave her bedroom. 
You see Amy for an initial consultation and she tells you that she loves using crystal, but is 
worried about the side effects. Also, her boss has had a go at her for having too many sick days 
and she is worried about losing her job. She wants to go back to just using recreationally – how 
can you assist her? 

Case study 2 
Leo is a 16 year old, polydrug user who uses your service regularly. Leo is unemployed, not 
enrolled at school and lives in state residential accommodation or at friends’ houses. He has 
intermittent contact with his mother who is unable to care for him or provide financial support. 
He prefers to use heroin, but also uses methamphetamine (speed or ice/crystal) whenever he 
can. On average, he uses heroin and meth about 4 times a week. Additionally, Leo drinks around 
6 standard drinks daily and smokes at least a gram of cannabis.  
Leo comes to see you. He wants help for his heroin use and asks you if you can get him into a 
detox. He is less concerned about his methamphetamine use, seeing it as a recreational drug and 
one that he can stop taking if he wants to.  fight in the street with an acquaintance over a debt. 
speed use was to blame for a recent episode where he was picked up by police after a physical 
How can you support him? 

  

242