“We’re supposed to be a family here”: An ethnography of preserving, achieving, and performing normality within methamphetamine recovery

Abstract

The perception of being abnormal, and a visceral desire to ‘feel normal again’, is a common feature of the literature on drug use and recovery. Normality is constructed, however, in response to context-dependent values and priorities, thereby legitimating certain behaviours as normative and therefore the assumed goal of people in recovery. In this paper we draw on an ethnographic study with twelve people attempting to reduce harmful methamphetamine use to explore how they engaged with ‘normality’. Semi-structured interviews and ethnographic observations were conducted across a range of settings related to participants’ recovery, including private residences, withdrawal services, doctor’s offices, counselling rooms, and court houses. We used a relational lens to conduct thematic analysis on interview transcripts and fieldnotes collected over six months, following the steps of Iterative Categorisation. Our analysis explores the central organising theme of normality as something that can be ‘preserved’, ‘achieved’, or ‘performed’ by people using methamphetamine. Findings are understood through the original concept of ‘ambient paternalism’, where neoliberal norms and values shape recovery trajectories even outside of engagement with services. Exhibiting normality enabled participants to work against the stigmatisation and moralisation of methamphetamine use by demonstrating their socio-political acceptability. Methamphetamine use could also be strategically used to enable participants to keep up with neoliberal normative standards of independent self-management. Increasing awareness of these complex repertoires of normality, and a more critical understanding of how this ideal is constructed and can impact service interactions, can support a less homogenising or coercive approach towards treatment and policy for people in methamphetamine recovery.

Situating Stigma: An Ethnographic Exploration of How Stigma Arises in Interactions at Different Stages of People’s Drug Use Journeys

“…However, residents find that they are necessarily constricted by the institutional setting within which identity negotiation takes place [22]. Moreover, some individuals may have simply been regurgitating the goals of a 'normal life', which were implicit in many programmes [16]. Those at DN distance themselves from the stigma of drug use by separating their former and current 'selves', and highlighting how drug use conflicts with who they are now.…”

“…Distancing, as a stigma management strategy, does not only occur in relation to others, rather it is also possible to distance from one's former 'drug-using' self, something which is particularly evident amongst those engaging with drug use services [14,15]. These individuals often embrace the disease model of drug use and the ensuing necessity for treatment, which suggests that identity construction reflects specific ideals that are rooted in policy, such as the need for self-regulation [15,16].…”

“…In some cases, PWUD actively invoke prosocial roles-roles which are widely considered positive-in the face of stigmatising drug user identities, such as 'junkie' or 'addict' [2]. Prosocial roles may relate to positive past identities, such as past employment or achievements [21], or future goals and the roles they entail, including employment, money, possessions, and romantic partners [1], in other words, the ingredients of a 'normal' life [16]. However, this strategy is not without its problems.…”

‘Making Ground’: An Ethnography of ‘Living With’ Harmful Methamphetamine Use and the Plurality of Recovery

“…This analysis of normative public health is therefore situated within broader critiques of neoliberalism and its construction of the ideal modern individual as rational, independent, and temperate (Wrenn & Waller, 2017), to which compulsive drug use will always be antithetical. This marks a shift away from Foucault’s (2004) identification of how disciplinary norms of health have been laboriously inculcated from above, towards a neoliberal environment where individuals accept the need for health and healthy behaviour due to the ambient norms of health within the culture and administrations of society (Brookfield et al, 2021). Interpreting participant’s statements in this context highlights the more subtle way in which drug use can still be constructed as ‘deviance’ (Becker, 1963; Netherland, 2012), and confined to the binary framework of health/pathology.…”

“…Responses to drug use are increasingly focused on supporting PWUD to undergo ‘recovery’, despite many people experiencing significant drug use related issues not identifying with this framing (Kelly, Abry, Milligan, Bergman, & Hoeppner, 2018). Recovery is often based around accessing treatment services and undergoing personal development, with the goal of long term abstinence, and increased capacity to function within contemporary neoliberal society (Brookfield, Fitzgerald, Selvey, & Maher, 2021; Brookfield et al, 2019; Kaskutas et al, 2014; McIntosh & McKeganey, 2000). This formulation is written into policy and treatment protocols (Fomiatti, 2020) and enacted by PWUD, clinicians, and other representatives of recovery services (Schlosser, 2018).…”