Casting one's mind back to the post-war expansion in sociology, something which continued right up to the late 1980s, sociology had as much to say about non-normative behaviour as did psychology. Moreover, it was not only the case that sociological approaches had something to say, but they were influential both in terms of how people understood the world and of wider social and cultural debates. Since that time, with the advent of new technologies, the collapse of visibly obvious political polarities (the cold war was a wonderful way of viewing the whole of life in Manichean terms), and an increasing acceptance of the “other” or outsider, sociology has become somewhat less conspicuous. The individual is now understood less as the product of a social construct and more as the agglomeration of neuro-chemical, genetic and psychological markers, all tantalisingly close to be mapped out in true genome fashion.
In this new world, to talk of addiction in terms of moral panic or as a by-product of economic status would seem almost whimsical. We are, after all, living in an age of addiction as brain disease, and as a brain disease its range of potential objects or strange attractors is seemingly endless: drugs, drink, sex and food seem almost too prosaic to warrant the technological apparatus we have at our disposal to chart that picturesque firing of the brain so effectively in the mighty MRI and FRMI machines. But machines are, of course, actually very obvious constructs, operating in a socially constructed world that is not simply objective fact, but interpretable fact or at the very least judiciously focused upon fact. Julie Netherland's book is a rather pleasant reminder that the conditions in which we understand addiction and what we understand about addiction arise not from some burrowing down into objectivity but through shining a light on some of the assumptions and biases that populate and create our addictive universe.
Split into four main areas: the (bio)-medicalisation of addiction; race and the shaping of addicts; addiction and social control; and the expansion of addiction and its implications, Netherland's edited volume does a fairly good job of putting sociology, or as one should now perhaps term it “critical perspectives”, back on the agenda when she says “one great strength of sociology is to offer a critical understanding of an otherwise taken-for-granted phenomenon. Addiction with all its ambiguities and complexities demands studies that take into account historical, social, economic, and political context” (p. xvii).
The three chapters in the “Bio-medicalization of Addiction” examine the extent to which addiction can be thought of as a biologically rooted disease as opposed to an individually experienced social construction. Some thought is also given to the role of discussion through an interesting historical analysis of nicotine replacement therapies. The second part of the book deals with “Race and the Shaping of Addicts”. An interesting chapter looks at the racial divide between who gets prescribed methadone and buprenorphine in the USA. Another chapter seeks to analyse the racial content of a US show “Intervention”. Both chapters in essence argue that there is a systematic white bias, one which does not reflect the statistics of addiction, ignoring in particular the Hispanic population. Part three “Punishing the Sick and Saving the Lost: Addiction and Social Control” examines foetal alcohol syndrome as part and parcel of a punishment and control system for pregnant women. This is followed by an ethnography of a Christian-based rehab which is for me one of the most interesting chapters in the book, particularly when related back to the bio-medicalisation thesis. The final part of the book looks at “The Expansion of Addiction and its Implications”. There is a fascinating account of the history of self-help movements for those with weight difficulties, followed by an interesting chapter based on qualitative interviews with individuals who have had bariatric surgery. The final chapter looks at the question of whether excessive playing of video games constitutes addiction through an analysis of individual game players.
There are a number of things worth noting about this book. The first is that, apart from two contributions from Sweden and Australia, it is essentially a US volume. I was unconvinced as to whether the arguments put forward in some chapters, particularly those on race, would have the same findings in the UK. With the analysis of the family intervention programme we simply do not have this as a TV experience. The question as to if you are white you are more likely to be prescribed buprenorphine than methadone has I suspect a lot to do with the US health care funding structure that is quite different from ours.
The book did contain quite a lot of typos or missing words. I counted 20, along with a number of unexplained acronyms. This does detract slightly from the arguments being put forward. Each of the chapters is set out very much like a paper with an abstract at the beginning, outlining, purpose, methodology, findings, social implications, originality and keywords. This made the whole volume read like a collection of papers, and I suspect many chapters would have fitted better into a journal than a book. It is telling that the book does not have an index. I found some of the writing rather poor. This tended to occur when the writers used pseudo-academic language with excessively long sentences. Such criticisms aside, there are some interesting chapters and whilst few readers will buy this at over £50 themselves, it could be a useful reference book.
For me the book, whilst not always being entirely successful, is a reminder of the importance of sociological perspectives and taken for granted assumptions about what is going on when we talk about addictions. For that reason it is a project to be welcomed.
