The practice of substituting one drug for another has arguably become a taken-for-granted feature of contemporary responses to heroin dependency in Britain. Substitute prescribing has, however, recently come under attack from various commentators both inside and outside of the drug treatment system. The general tone of the argument is that problem drug users who are dependent upon heroin are entering the drug treatment system and are simply being “parked on methadone.” In order to shed new light on this particular drug treatment intervention, this article will use the genealogical method to map out the historical conditions from which it became rational and necessary for medical experts to govern the heroin-dependent body through the practice of substitute prescribing. The principal thesis of this article is that substitute prescribing can be understood as an outcome of a convergence between the discursive fields of poisoning and addiction during the latter half of the 19th Century. This way of thinking and acting upon the heroin-dependent body as a poisoned object has had a lasting and significant impact upon the way we think about and respond to heroin withdrawal through the practice of substitute prescribing.

This article offers a critical contribution to the debate on a problematic ‘type’ of injecting drug use referred to as needle fixation. At the heart of this debate, is a questioning of the existence, prevalence and usefulness of the needle fixation concept for academics and drug treatment practitioners working with injecting drug users. The aim of this article is to extend and develop this discussion by examining the historical conditions of the needle fixation discourse. Drawing upon Michel Foucault’s concept of governmentality, it uses primary and secondary sources from the 19th century to the present to trace the historical trajectory of the problematic relationship between the injecting drug user, the syringe and truth. By reconceptualizing needle fixation as a technology of government, this article will argue that needle fixation can be seen to be incompatible with contemporary rationalities found in treatment policy and practice, suggesting that we have moved beyond needle fixation as a way of governing injecting drug use and into the domain of risk management. Beyond revealing this tension, the article highlights new lines that are currently being drawn between the injecting drug user, the syringe and truth from the field of neuroscience and the risk-management potential of psychopharmacology.

Heroin withdrawal is perhaps one of the most taken-for-granted components of the addiction framework. Heroin users as well as researchers, policy makers, and practitioners have become dependent on it for thinking about and acting upon the process of heroin leaving the body. It is thought to be among the most challenging aspects of the recovery journey and has been linked to a range of public health, legal, and social problems. The taken-for-granted nature of heroin withdrawal has arguably limited its scrutiny in sociological and historical analyses. This article offers an alternative and critical perspective that draws attention to the heterogeneity of historical events and strategies that have left their mark on the withdrawing body of the heroin user. It maps changes in the discourse from the 18th century to the present and closes with developments in the neuroscience of addiction, which have relocated withdrawal from the body to the neurocircuitry of the brain and reframed it as a negative emotional state. This new language suggests the future of the discourse of withdrawal might be relatively short. The analysis moves beyond existing understandings of withdrawal as the simple absence of drugs from the body.

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.

Purpose The purpose of this paper is to assess the impact of the recommendation to replace identity-first language with person-first language on people who self-identify as recovering addicts as part of a recovery programme. Narcotics Anonymous (NA) will be used to illustrate the contextualised nature of the recovering addict identity. Design/methodology/approach To demonstrate the value of the recovering addict identity and social relations in NA, this paper draws on Axel Honneth’s theory of mutual recognition and self-formation. Findings Person-first language overlooks the significance of identity-first language to people in 12-step recovery. This oversight is linked to the logic of stigma reduction which excludes all identity-first language by association rather than assessing the impact of such terms on a case-by-case basis. Honneth’s theory is used to show how the recovering addict identity facilitates self-confidence and self-esteem through relations of mutual recognition in NA. Research limitations/implications The argument excludes people who identify as recovering addicts, but do not attend 12-step groups. Further research would be needed to understand how the recommendation to use person-first language instead of identity-first language impacts upon other recovery communities and pathways. Practical implications The recommendation to replace identity-first language with person-first language might result in 12-step fellowships becoming marginalised within the broader academic and policy and practice arena. Language preferences can become a contentious issue when 12-step groups and their members enter the wider recovery arena where their preferred terminology is viewed as stigmatising and dehumanising. Originality/value To the best of the author’s knowledge, this is the first article to propose an alternative theoretical framework to stigma reduction for judging morally appropriate language in the alcohol and drugs field.