Introduction. 'Addiction' is an ambiguous concept. Its meaning, and how it is used in drug policy and treatment, depends on how it is conceptualised.While the 'disease' model of addiction is prevalent in Australia, differing, sometimes contradictory, interpretations of this model are mobilised. Methods. Drawing on 20 semi-structured interviews conducted with professionals working in the area of drug use in Victoria, Australia, this paper develops a typology delineating different approaches to addiction. Results. Five domains of meaning related to addiction were identified in the data. These were: (i) the sign of craving; (ii) susceptibility; (iii) social and psychological issues producing addiction; (iv) self-concept; and (v) social functions of addiction. These domains are further divided into two subtypes based on how the participants understood the role of a key notion in addiction: volition, that is, whether or not an 'addict' has control over drug use and other aspects of life.
Discussion. By systematically mapping different conceptualisations of addiction, this typology identifies the ambiguities and contradictions in the models currently in use, especially with respect to the notion of volition.While a homogeneous approach to these issues is neither practical nor desirable, there is a need to consider the implications of this lack of coherence.Conclusions. Service providers, medical practitioners and policy makers need to reflect on their assumptions, and consider the implications of their different approaches for clients, some of whom encounter more than one approach when undergoing treatment for drug use. [Karasaki M, Fraser S, Moore D, Dietze P. The place of volition in addiction: Differing approaches and their implications for policy and service provision. Drug Alcohol Rev 2013;32:195-204]
The private space of the home is an important site of health care in most industrialised countries, and rehabilitation following intensive in-hospital treatment largely takes place in domestic settings. Home in this context is implicitly understood by individuals affected by illness (people with illness, family members, friends, carers), health care providers, and policy makers as an a priori entity that naturally provides continuity and stability. This takes for granted that family carers will maintain both therapeutic activities and the sense of 'being at home' -and all of the accompanying emotional dimensions -within the home environment. Drawing on ethnographic research with relatively young spousal carers in Victoria, Australia, we explore how the reconstruction of home as a site for post-stroke recovery changed the experiences and meanings given to the idea of home. Home as a therapeutic place depended on constant orchestrating work that reconfigured the physical, symbolic, and practical elements of home. This was not a straightforward or singular process, as tensions arose in trying to integrate the new, post-stroke therapeutic landscape and pre-stroke conceptualisations and lived realities of home life.
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