Socio-spatial stigmatization and the contested space of addiction treatment: Remapping strategies of opposition to the disorder of drugs

doi:10.1016/j.socscimed.2009.10.033

Social Science & Medicine

Volume 70, Issue 6, March 2010, Pages 859-866

https://doi.org/10.1016/j.socscimed.2009.10.033 Get rights and content

Abstract

In recent years, the Not-In-My-Back-Yard (NIMBY) phenomenon has become increasingly prevalent with regard to harm reduction sites, addiction treatment facilities and their clients. Drawing from a case study of community conflict generated by the relocation of a methadone clinic into a rapidly gentrifying neighbourhood in downtown Toronto, Canada, this article offers a unique analysis of oppositional strategies regarding the perceived (socio-spatial) ‘disorder of drugs’. Based on interviews with local residents and business owners this article suggests the existence of three interrelated oppositional strategies, shifting from a recourse to urban planning policy, to a critique of methadone maintenance treatment (MMT) practice, to explicit forms of socio-spatial stigmatization that posited the body of the (methadone) ‘addict’ as abject agent of infection and the clinic as a site of contagion. Exploring the dialectical, socio-spatial interplay between the body of the addict and the social body of the city, this article demonstrates the unique aspects of opposition to the physically, ideologically and discursively contested space of addiction treatment. Representations of the methadone clinic, its clients and the larger space of the neighbourhood, this paper suggests, served to situate addiction as a ‘pathology (out) of place’ and recast the city itself as a site of safe/supervised consumption.

Section snippets

Introduction: Corktown and the contested space of addiction treatment

Following deindustrialization, the landscape of east central downtown Toronto witnessed significant disinvestment and residential desertion, leading to the area being considered a ‘void’ or ‘wasteland’ throughout the second half of the twentieth century (Wintrob, 2006). Owing to its low residential density and relative distance from the central business district, this area became the site of a high concentration of social services, including homeless shelters and drug treatment facilities,

Literature review: NIMBYism, socio-spatial stigmatization and the place of drugs in the city

Sibley (1995) and others have argued that a critical consideration of abjection is central to understanding processes of socio-spatial exclusion (for examples related to drug users and other abject urban outcasts, see Bergschmidt, 2004, Butler, 1990, Fitzgerald and Threadgold, 2004, Sommers, 1998). The desire to exclude the abject, which commonly manifests in the enforcement of socio-spatial borders—distinctions, both in built form and social practice between “clean and dirty, ordered and

Methodology: from junky to NARC and back again

Based on six months of ethnographic fieldwork during the height of the conflict surrounding the Corktown methadone clinic (June–November 2006), this article draws from qualitative interviews with local opponents, public documents produced by the Corktown Residents' and Business Association (CRBA) and other mediated forms of community self-representation. While other areas of the larger project from which this work was drawn are devoted to examining the voices of addiction treatment clients,

Research findings: remapping strategies of opposition to the disorder of drugs

Through intra-urban boosterism strategies that shifted seamlessly between discourses of place promotion and spatial purification, Corktown was distinguished as a space of rapid socio-spatial transformation, a symbolically purified space tainted by the arrival of the methadone clinic (Short, 1999). Driven by the CRBA, community opponents employed three interrelated strategies against the methadone clinic, each based on emphasizing a different relational configuration between the body of the

Conclusion: MMT, ‘social productivity’ and the disorder of drugs

Inverting normative capitalist notions of ‘consumption’ and ‘control’, the disorder of drugs signals a pathology (out) of place, beneath which lies a critique constructed on conceptions of ‘social productivity’. Resonating closely with Takahashi's (1997) description of socio-spatial stigmatization based on the perception of non-productivity, Derrida's (2003) discussion of the discursive logic of prohibitionism points back to processes of production and consumption. Here, while

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Citation Excerpt :
Of note, her positionality as not only a PWUD, but as a woman who uses drugs, appeared to increase her sense of (physical) vulnerability (Kulesza et al., 2016; Measham, 2002). This drug-use-as-survival mechanism was provoked in large part by endemic social stratifications and socio-spatial policing systems (C. B. Smith, 2010), dynamics which are discussed more in-depth in the proceeding section. Social policy, or lack thereof, in relation to drug use, was frequently couched as fueling stigma processes and stunting socio-geographic mobility.
Research suggests that the built environment is associated with drug use. However, there is limited scholarship focusing on specific features of the built environment that influence drug use behaviors, experiences, and patterns and how risk factors for drug use are placed in distinctive urban and rural settings. Applying Neely and Samura's conceptual theory that describes space as contested, fluid and historical, interactional and relational, and defined by inequality and difference, we assessed data from semi-structured qualitative interviews conducted between 2019 and 2020 with consumers at syringe exchange programs (SEPs) in an urban location (New York City) and a rural location (southern Illinois). We aimed to contextualize how drug use manifests in each space. In total, 65 individuals, including 59 people who use drugs (PWUD) and six professionals who worked with PWUD, were interviewed. Findings illustrate that, in both the urban and rural setting, the built environment regulates the drug use milieu by mediating social reproduction, namely the degree of agency PWUD exert to acquire and use drugs where they desire. Processes of “stigma zoning,” defined as socio-spatial policing of boundaries of behavior deemed undesirable or deviant, impacted PWUD's socio-geographic mobility, social conditions, and resource access, and modulated PWUD's broader capacity and self-efficacy. Similar patterns of drug use, according to social and economic inequities chiefly related to housing instability, were further observed in both settings.

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Socio-spatial stigmatization and the contested space of addiction treatment: Remapping strategies of opposition to the disorder of drugs

Abstract

Section snippets

Introduction: Corktown and the contested space of addiction treatment

Literature review: NIMBYism, socio-spatial stigmatization and the place of drugs in the city

Methodology: from junky to NARC and back again

Research findings: remapping strategies of opposition to the disorder of drugs

Conclusion: MMT, ‘social productivity’ and the disorder of drugs

Drug and Alcohol Dependence

International Journal of Drug Policy

Geoforum

International Journal of Drug Policy

International Journal of Drug Policy

Social Science & Medicine

Community and nostalgia in urban revitalisation: a critique of urban village and creative class strategies as remedies for social ‘problems’

Australian Geographer

Abjection and miserable forms

Whose side are we on?

Social Problems

Pleasure, power and dangerous substances: applying foucault to the study of ‘heroin dependence’ in Germany

Anthropology and Medicine

The gentrification of gentrification and other strategies of Toronto's creative class

Fuse Magazine

Gender trouble: Feminism and the subversion of identity

Methadone maintenance treatment: A community planning guide

Culture plan for the creative city

Resistance to a residential AIDS home: an empirical test of NIMBY

Journal of Homosexuality

Community impact statement

In place/out of place: Geography, ideology, transgression

Understanding and overcoming the NIMBY syndrome

Journal of the American Planning Association

Landscapes of despair: From deinstitutionalization to homelessness

The rhetoric of drugs

Heroin addiction: a metabolic disease

Archives of Internal Medicine

MDs profit from methadone scheme; OPP health fraud squad raided addiction clinic offices; owners are going to court to get search warrant quashed

Toronto Star

Purity and danger: An analysis of concepts of pollution and taboo