“Addiction Doesn’t Discriminate”: Colorblind Racism in American Rehab

Abstract

Drawing on ethnography and interviews with recovering men in the Twin Cities, Minnesota, this study explores how two dominant models of American rehab are racialized — coerced treatment theorizing addiction as criminal personality—and a more medicalized, voluntaristic model rooted in the brain disease paradigm. At the “carceral rehab” of “Arcadia House,” staff assumed its majority court-mandated, poor men of color would arrive resistant to reforming their “lifestyle addictions,” justifying treatment backed by (re)incarceration. In contrast, “Healing Bridges” offered its gentler, “medical-restorative rehab” to mostly white, middle-class patients who escaped incarceration despite substantial participation in drug-related crime. While both programs mobilized the colorblind logic that “addiction doesn’t discriminate,” local disparities routed recovering men into vastly different treatments, disproportionately criminalizing the addictions of the Black poor. In a racialized binary operating across the field, Arcadia’s clients of color were viewed as sicker and more out of control than Bridges’ white patients. While Arcadia’s clients required coercive state management, Bridges’ patients were understood as already possessing the capacity for self-management—reinforcing staff’s mission to empower the non-addict within. Distinctions between coerced and voluntary treatment were naturalized and mapped onto recovering men, reproducing race at the most intimate levels of self-making.

Feminized need and racialized danger: Punitive therapeutics and historical addict tropes in a Midwestern drug court

“…As such, white men embody the purest case of the contemporary "hijacked brain" trope. (Our own case presents a striking and almost exclusive differentiation between the neurochemical medicalization of white men (Whetstone, 2021) and the psychological medicalization of white women (Hill and Crawford, 1990). )…”

“…Yet white men remain more redeemable, positioned on the edge of the "criminal addict" construct, where they can either benefit from or lose white privilege (see, for example, Kerrison, 2015;Tiger, 2013). In integrated programs, they tend to be treated as prize pupils, "older brothers" who can teach their more culturally deficient brothers of color (Whetstone, 2021).…”

White as milk: Biocentric bias in the framing of lactose intolerance and lactase persistence

“…Contributing to literature on the medicalisation of eating‐ and food‐related conditions, the case of lactose intolerance and lactase persistence highlights how biocentric biases are reified through medical and health discourse and communicated to the public. Sociological studies have demonstrated how colour‐blindness of medical discourse can obfuscate racism (Netherland & Hansen, 2017; Pryma, 2017; Whetstone, 2021). In particular, research that investigates eating and food‐related conditions often focus on the reproduction of race and class inequalities through diagnosis and treatment, finding that marginalised populations with the fewest choices are disproportionately impacted (Daniel, 2016; Papas et al., 2016; Walker et al., 2010) and blamed for their health outcomes (Firth, 2012; Saguy & Gruys, 2010).…”

Recovering Whiteness in Medical‐Restorative Rehab

“…In contrast, Clive, a 58‐year‐old working‐class patient and one of the few Black men in the program, was routinely criminalized by staff and peers who made stigmatizing jokes about his “crackhead mentality,” asked him to tell “gang stories” (he was not in a gang) and set him up as a cautionary tale of the depths of unchecked addiction. Despite the real moments of catharsis that some reported, the rapid flip back into moralistic shaming for the program's token patients of color demonstrates how the humanizing tone of MRR was ultimately predicated on fictions of white innocence (Whetstone 2021).…”

“…While robust literatures suggest how race might shape “addict habitus” and treatment options, rehab is also a “racialized organization,” itself reproducing raced masculinities through intimate acts of self‐making (Whetstone 2021). Whiteness and white supremacy are embodied, actively performed, and reproduced through structures of the self (Du Bois 1995; Hooks 1997; Lipsitz 2006; Roediger 1998) and “white racial frames” encompassing images, stereotypes, emotions, and interpretations (Feagin 2020).…”