"I Was Not Sick and I Didn't Need to Recover": Methadone Maintenance Treatment (MMT) as a Refuge from Criminalization
"I Was Not Sick and I Didn't Need to Recover": Methadone Maintenance Treatment (MMT) as a Refuge from Criminalization
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DOI：
10.1080/10826084.2017.1310247
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发表时间：
2018-01-01
影响因子：
2
通讯作者：
Frank, David
中科院分区：
文献类型：
--
作者：
Frank, David
背景：美国美沙酮维持治疗（MMT）一直在向概念化的方案作为康复为基础的治疗转变。虽然恢复被一些人视为恢复MMT作为基于医学的成瘾治疗的合法地位的一种手段，但它可能并不代表经验，也不满足吸毒者（PWUD）的需求，其中许多人将该计划用作减少与刑事定罪相关的伤害的实用手段。目的：检查MMT的替代结构，以产生更丰富，更情境化的程序和PWUD使用其服务的原因。方法：本文采用半结构式访谈23人的MMT（无论是目前或过去两年）。结果如下：大多数与会者将其对MMT的使用与禁止/刑事定罪的结构法律背景联系起来，而不是通过对恢复模式的叙述。回应表明，恢复模式的功能部分模糊了刑事定罪的作用，在伤害PWUD的经验，有利于基于个人病理模型。结论/重要性：与恢复模式相反，MMT不能脱离刑事定罪和禁毒战争的结构性背景来理解，这将非法使用毒品塑造为一种困难和危险的活动，因此将MMT定位为减轻或逃避这些伤害的一种方式。
Background: Methadone Maintenance Treatment (MMT) in the United States (U.S.) has been undergoing a shift towards conceptualizing the program as recovery-based treatment. Although recovery is seen by some as a means to restore MMT to its rightful position as a medically-based treatment for addiction, it may not represent the experiences, or meet the needs of people who use drugs (PWUD), many of whom who use the program as a pragmatic means of reducing harms associated with criminalization. Objectives: To examine alternative constructions of MMT in order to produce a richer, more contextualized picture of the program and the reasons PWUD employ its services. Methods: This paper uses semi-structured interviews with 23 people on MMT (either currently or within the previous two years). Results: Most participants linked their use of MMT to the structural-legal context of prohibition/criminalization rather than through the narrative of the recovery model. Responses suggested the recovery model functions in part to obscure the role of criminalization in the harms PWUD experience in favor of a model based on individual pathology. Conclusions/Importance: In contrast to the recovery model, MMT cannot be understood outside of the structural context of criminalization and the War on Drugs which shape illegal drug use as a difficult and dangerous activity, and consequently position MMT as a way to moderate or escape from those harms.