Self-detoxification, embodiment and masculinity: a qualitative analysis of dependent heroin users’ experiences of coming off drugs in prison

Abstract

Not all heroin users that enter the prison estate continue to use heroin or access opiate maintenance or detoxification treatment programmes. Some prisoners decide to self-detoxify. The literature on self-detoxification is thin and focuses on the decisions and practices of self-detoxification in community settings. Less attention has been given to the role of the body and the lived experience of selfdetoxification in prison settings. The aim of this paper therefore is to examine the process of selfdetoxification in prison, with a particular focus on the role of the body, embodiment and prisoner social relations. This paper draws on Drew Leder's (1990) absent body theoretical framework and the literature on prison masculinity to analyse qualitative interviews with recently released prisoners. It shows how the decision to self-detoxify can be understood as part of the masculine performance of keeping a low profile. Keeping a low profile helped the participants minimise the risks of victimisation. The self-detoxification techniques the participants used were underpinned by an awareness of the body as poisoned by heroin, suffering because of its presence, rather than its absence. This study has implications for prisoners' access to opiate maintenance and detoxification treatment programmes and harm reduction services upon release.

How do patients feel during the first 72 h after initiating long‐acting injectable buprenorphine? An embodied qualitative analysis

“…Subsequently, Duff [42] drew attention to how drug use is experienced as an embodied activity, subject to its own unique rituals and customs and governed by myriad local cultures and contextual norms [42][43][44][45]. Since then, other authors have deployed an embodied lens to study substance use [40,[46][47][48][49], selfdetoxification [50], treatment [51][52][53] and recovery [54][55][56][57][58]. Furthermore, it has been argued that those providing addiction services need to understand, and take seriously, the complex bodily experiences of people receiving opioid pharmacotherapy if we are to increase treatment effectiveness, address rising opioid use and reduce overdose deaths [53].…”

“…Within more conceptual literature, various authors have considered the embodied experiences of detoxification [50,54] and being in treatment and/or recovery [52][53][54][55]57]; yet, this literature has also not described the visceral, perceptual and emotional benefits of 'initiating' treatment for opioid use disorder. One possible explanation for this omission is that these very early treatment gains are a distinctive feature of LAIB.…”