The collective body: Legacies of monastic discipline in the post-Soviet prison

Azbel, Lyuba; Morse, Evan Winter; Rhodes, Tim

doi:10.1177/1362480620930677

Cited by 10 publications

(14 citation statements)

References 33 publications

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“…Similar dynamics of governance (Azbel et al, 2019;Slade & Azbel, 2020) exist throughout post-Soviet space, and therefore we suggest that the ontology of methadone be carefully examined throughout the region. When methadone is made as a tool of social governance, it has become undesirable for prisoners who maintain allegiance to the agents of informal governance, and indeed an enemy to the often venerated-but contested-informal modes of governance.…”

Section: Discussionmentioning

confidence: 70%

Addiction Treatment as Prison Governance: A Critical Discourse Analysis of Methadone Delivery in Kyrgyz Prisons

Azbel

Bromberg

Dvoryak

et al. 2021

Contemporary Drug Problems

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Methadone treatment is prescribed by evidence-based medicine as the most effective tool for the treatment of opioid addiction. Its implementation into high-need prison settings worldwide has been met with challenges, particularly in Eastern Europe and Central Asia where the opioid epidemic continues to expand. To address these impasses to intervention translation, we turn to post-structural approaches to policy analysis. These approaches open space for (re)thinking the ways that translated interventions emerge locally, by treating policy texts as social practices that make interventions in specific, sometimes unexpected, ways. We leverage Carol Bacchi’s post-structuralist analytic framework to interrogate how the object of methadone is constituted in Kyrgyz prisons through an analysis of the national legislative document, the “Government Program,” which provides the legislative basis for opioid addiction treatment administration in the Kyrgyz Republic. Rather than the medicalized methadone for the treatment of opioid use disorder, contained in the distinct objectivization of methadone emerging from this policy text, is the previously unexamined assumption that methadone is a particular type of governance. We describe a methadone object tied up with the shifting social structures that govern Kyrgyz prisons, divided between formal (state-run) and informal (prisoner-run) governance. In Kyrgyz prisons, where opioid policy discourse produces a divide between formal and informal governance, methadone emerges as a tool of the formal prison administration to regain control of the prisons from the practices of prisoner subculture. Although this study takes the Kyrgyz case as an example, the enactment of methadone as formal governance is likely to resonate throughout Eastern Europe and Central Asia, where there is a strong legacy of self-governing prisons. We conclude with a call for global health policymakers to consider how opioid addiction treatment is constituted within local governing relations, in ways that may depart sharply from the evidence base.

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Section: Discussionmentioning

confidence: 70%

Addiction Treatment as Prison Governance: A Critical Discourse Analysis of Methadone Delivery in Kyrgyz Prisons

Azbel

Bromberg

Dvoryak

et al. 2021

Contemporary Drug Problems

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“…At the same time, it is obvious that this enforced carceral collectivism that results from the communal and poor conditions of the enclosed environment produces the practice of sharing, including needles and syringes as an inevitable part of such shared living. In one of the studies of post-Soviet Kyrgyz prisons [ 75 , 76 ], by referring to post-Soviet collective identities as the opposite of the individualism of the West, the authors suggest “that a healthy body is produced through a healing process that rests on submission to the collective, with a constant threat of exile. In such settings, health care interventions aimed at the individual are unlikely to succeed without consideration of collective healing practices” [ 76 ].…”

Section: Discussionmentioning

confidence: 99%

“…In one of the studies of post-Soviet Kyrgyz prisons [ 75 , 76 ], by referring to post-Soviet collective identities as the opposite of the individualism of the West, the authors suggest “that a healthy body is produced through a healing process that rests on submission to the collective, with a constant threat of exile. In such settings, health care interventions aimed at the individual are unlikely to succeed without consideration of collective healing practices” [ 76 ]. It could be suggested, that the mentioned observation should be considered in regard to any intervention in the process of integration into the post-Soviet prison system.…”

Section: Discussionmentioning

confidence: 99%

More evidence or stronger political will: exploring the feasibility of needle and syringe programs in Ukrainian prisons

Dmitrieva¹,

Stepanov

Svyrydova³

et al. 2021

Harm Reduct J

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Introduction In 2007, the World Health Organization (WHO) recommended for prison authorities to introduce prison needle and syringe programs (PNSP) if they have any evidence that injecting drug use is taking place in prisons. This article presents descriptive evidence that injecting drug use takes place in Ukrainian prisons, it discusses how (denial of) access to injection equipment is regulated in the current system and what changes should be considered in order to implement PNSP. Background Ukrainian prisons still live by the laws and policies adopted in the Soviet Union. Besides laws and regulations, these legacies are replicated through the organization and infrastructure of the prison’s physical space, and through “carceral collectivism” as a specific form of living and behaving. Inviolability of the prison order over time helps the prison staff to normalize and routinely rationalize punishment enforcement as a power “over” prisoners, but not a power “for” achieving a specific goal. Methods The Participatory Action Research approach was used as a way of involving different actors in the study’s working group and research process. The data were gathered through 160 semi-structured interviews with prison health care workers, guards, people who inject drugs (PWID) who served one or several terms and other informants. Results The “expertise” in drug use among prisoners demonstrated by prison staff tells us two things—they admit that injecting use takes place in prisons, and that the surveillance of prisoner behavior has been carried out constantly since the very beginning as a core function of control. The communal living conditions and prison collectivism may not only produce and reproduce a criminal subculture but, using the same mechanisms, produce and reproduce drug use in prison. The “political will” incorporated into prison laws and policies is essential for the revision of outdated legacies and making PNSP implementation feasible. Conclusion PNSP implementation is not just a question of having evidence of injecting drug use in the hands of prison authorities. For PNSP to be feasible in the prison environment, there is a need for specific changes to transition from one historical period and political leadership to another. And, thus, to make PNSP work requires making power work for change, and not just for reproducing the power itself.

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“…Caste is assigned by compliance with these codes of conduct and organized around contribution of labor to the [obshchak] , or prisoners’ common fund. Participation in the prisoner economy is rewarded with distribution of [razgon], or material rewards including heroin, which is trafficked and controlled by informal prison leadership as described elsewhere [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

“…The parent project was designed to longitudinally and qualitatively assess barriers to MMT uptake during and after incarceration and evaluate the ways in which the prison risk environment influenced perceptions and use of methadone. Findings on HIV risk [ 24 ] suggest that most PWID incarcerated in Kyrgyzstan continue to inject in prison [ 6 ], prisoners are organized into rigid hierarchies that perpetuate inequalities in access to HIV prevention resources [ 23 ], and social factors shape patient engagement with methadone [ 22 ], especially after prison release and during the transition to communities [ 25 ] and among women [ 26 ]. Here, we explore the harmful health effects of Dimedrol injecting in prisons and implications for harm reduction programs.…”

Section: Methodsmentioning

confidence: 99%

A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reduction

et al. 2020

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Background To reduce opioid dependence and HIV transmission, Kyrgyzstan has introduced methadone maintenance therapy and needle/syringe programs into prisons. Illicit injection of diphenhydramine, an antihistamine branded as Dimedrol®, has been anecdotally reported as a potential challenge to harm reduction efforts in prisons but has not been studied systematically. Methods We conducted qualitative interviews in Kyrgyz or Russian with prisoners (n = 49), former prisoners (n = 19), and stakeholders (n = 18), including prison administrators and prisoner advocates near Bishkek, Kyrgyzstan from October 2016 to September 2018. Interviews explored social–contextual factors influencing methadone utilization in prisons. Transcripts were coded by five researchers using content analysis. Dimedrol injection emerged as an important topic, prompting a dedicated analysis. Results After drinking methadone, some people in prison inject crushed Dimedrol tablets, a non-prescription antihistamine that is banned but obtainable in prison, to achieve a state of euphoria. From the perspectives of the study participants, Dimedrol injection was associated with devastating physical and mental health consequences, including psychosis and skin infections. Moreover, the visible wounds of Dimedrol injecting contributed to the perception of methadone as a harmful drug and supporting preference for heroin over methadone. Conclusion Dimedrol injecting is a potentially serious threat to harm reduction and HIV prevention efforts in Kyrgyzstan and elsewhere in the Eastern European and Central Asian region and requires further investigation.

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The collective body: Legacies of monastic discipline in the post-Soviet prison

Cited by 10 publications

References 33 publications

Addiction Treatment as Prison Governance: A Critical Discourse Analysis of Methadone Delivery in Kyrgyz Prisons

Addiction Treatment as Prison Governance: A Critical Discourse Analysis of Methadone Delivery in Kyrgyz Prisons

More evidence or stronger political will: exploring the feasibility of needle and syringe programs in Ukrainian prisons

A qualitative study of diphenhydramine injection in Kyrgyz prisons and implications for harm reduction

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