Socio-spatial stigmatization and the contested space of addiction treatment: Remapping strategies of opposition to the disorder of drugs

Abstract

In recent years, the Not-In-My-Back-Yard (NIMBY) phenomenon has become increasingly prevalent with regard to harm reduction sites, addiction treatment facilities and their clients. Drawing from a case study of community conflict generated by the relocation of a methadone clinic into a rapidly gentrifying neighbourhood in downtown Toronto, Canada, this article offers a unique analysis of oppositional strategies regarding the perceived (socio-spatial) ‘disorder of drugs’. Based on interviews with local residents and business owners this article suggests the existence of three interrelated oppositional strategies, shifting from a recourse to urban planning policy, to a critique of methadone maintenance treatment (MMT) practice, to explicit forms of socio-spatial stigmatization that posited the body of the (methadone) ‘addict’ as abject agent of infection and the clinic as a site of contagion. Exploring the dialectical, socio-spatial interplay between the body of the addict and the social body of the city, this article demonstrates the unique aspects of opposition to the physically, ideologically and discursively contested space of addiction treatment. Representations of the methadone clinic, its clients and the larger space of the neighbourhood, this paper suggests, served to situate addiction as a ‘pathology (out) of place’ and recast the city itself as a site of safe/supervised consumption.

‘Not just Methadone Tracy’: transformations in service-user identity following the introduction of hepatitis C treatment into Australian opiate substitution settings

“…On one hand, the clinical, social and public health benefits of OST are well documented [7,8]; OST continues to provide a pragmatic and sometimes compassionate response to opiate dependence under the existing sociopolitical and legal conditions of the liberal West. On the other hand, much of the critical literature argues for the active role OST settings play in the (re)production and perpetuation of socially stigmatized identities and attendant social disadvantage and exclusion [9][10][11][12]. Hence, the discredited identity of 'the drug user' is reproduced and reinforced by the very treatment programme purportedly aiding its relinquishment.…”

Drug Addiction Stigma in the Context of Methadone Maintenance Therapy: An Investigation into Understudied Sources of Stigma

“…Therefore, in the current work we employ qualitative methods to characterize drug addiction stigma from multiple sources experienced by people with a history of drug addiction. We focus on the experiences of methadone maintenance therapy (MMT) patients because stigma associated with MMT is particularly strong (Des Jarlais et al 1995; Smith 2010; Tempalski et al 2007) and stigma has been identified as a barrier to MMT retention and success (Anstice et al 2009; Brener & von Hippel 2008; Brener et al 2007; 2010; von Hippel et al 2008). …”

Beyond NIMBYism: Understanding community antipathy toward needle distribution services

“…I meeting are familiar from the existing literature on NIMBYism and services for people who use drugs. As just one example, Smith (2010), describing opposition to a methadone clinic in Toronto, Canada, documents similar concerns being expressed about services being ‘dumped’ in neighbourhoods (p. 862), the physical disorder of garbage, vomiting, and defecation (pp. 863–864), the intimidating nature of service users (p. 864), and attacks on the validity of the methods being used by the service (p. 863).…”

“…In addition, other scholars have argued that ‘policy narratives’ and the ways in which they frame social problems and their solutions can affect the acceptability of needle exchange and related services (Fitzgerald, 2013; Shaw, 2006; Tempalski, 2007). Finally, others locate NIMBY resistance to services as an attempt by communities to avoid being ‘stained’ by an association with a stigmatized population or activity (Law & Takahashi, 2000; Smith, 2010; Strike, Myers, & Millson, 2004; Takahashi, 1997, 1998; Takahashi & Dear, 1997). …”