Doctoral Dissertation Research: An Ethnography of Opioid Addiction Treatment Trajectories and Experiences

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The research supported by this award brings anthropological attention to an issue that has long been dominated by public health researchers: understanding how healthcare and criminal justice systems shape the well-being of low-income substance users. Opioid addiction has become a global problem, having reached epidemic proportions in many countries. Governments have responded with myriad policies and programs to reduce the impact of opioid use, on society and on the lives of low-income populations. Unfortunately, sometimes the result is policies that are inconsistent in their messaging and contradictory in their effects. For example, low-income opioid users may continue to face harsh criminal laws even as their access to free and subsidized social services and treatment increases. Therefore, it is important to understand how low-income opioid users experience and negotiate these contradictions in order to further national efforts to craft innovative and effective policies to address this growing social issue. The research will be conducted by Brown University anthropology doctoral student, Parsa Bastani, with the oversight of Dr. Katherine A. Mason. The researcher will use Iran as a case study. Iran is an appropriate site to examine how contradictory policies are experienced because the country has laws that subject illicit substance users to both state-mandated care and surveillance, control, and punishment. This laws have included subjecting anyone who even appears to be an illicit drug user in public spaces to criminal prosecution, even if not in possession of drugs at the time of arrest. Recently, the government amended the laws to mandate that police-apprehended substance users undergo mandatory detoxification while detained in specialized carceral centers followed by aftercare in reintegration-oriented harm reduction and rehabilitation facilities. The researcher will undertake twelve months of ethnographic research to investigate how low-income opioid users experience and respond to being simultaneously criminalized and cared for by the state. He will collect data through semi-structured interviews, participant-observation, and document analysis, to examine: 1) Experiences of criminalization: how do low-income substance users encounter and navigate the criminal justice system? 2) Experiences of care: what impact does care infrastructure have on low-income substance users' experiences with social marginalization? 3) Experiences of addiction: What are low income substance users' moral dispositions toward their drug usage? What do they make of competing moral discourses about addiction? Findings from this research will contribute to understanding the actual effects of laws about illegal opioid use and the factors that enable and hinder the reintegration of highly stigmatized populations into society. The research also will contribute to building more robust social scientific understanding of how marginalized social actors negotiate conflicting social institutions and moral discourses.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.