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Culture, Medicine, and Psychiatry

, Volume 36, Issue 1, pp 26–50 | Cite as

The Psychotropic Self/Imaginary: Subjectivity and Psychopharmaceutical Use Among Heroin Users with Co-Occurring Mental Illness

  • Allison V. SchlosserEmail author
  • Lee D. Hoffer
Original Paper

Abstract

Many people diagnosed with mental illnesses struggle with illicit drug addiction. These individuals are often treated with psychiatric medications, yet little is known about how they experience this treatment. Research on the subjective experience of psychiatric medication use highlights the complex, contradictory, and ambiguous feelings often associated with this treatment. However, for those with mental illness and addiction, this experience is complicated by the need to manage both psychiatric medication and illicit drug use. Using ethnographic data from a study of heroin use in Northeast Ohio, we explore this experience by expanding the pharmaceutical self/imaginary (Jenkins, Pharmaceutical Self: The Global Shaping of Experience in an Age of Psychopharmacology, School for Advanced Research Press, Santa Fe, NM, 2010b) to include psychopharmaceuticals and illicit drugs, what we call the psychotropic self/imaginary. Through this lens we explore the ways participants interpret and manage their psychotropic drug use in relation to sociocultural, institutional, and political–economic contexts. This analysis reveals how participants seek desired effects of legally prescribed and illicit drugs to treat mental illness, manage heroin addiction, and maintain a perceived “normal” self. Participants manage their drug use using active strategies, such as selective use of psychiatric medications, in the context of structural constraints, such as restricted access to mental health care, and cultural contexts that blur distinctions between “good” medicines and “bad” drugs.

Keywords

Addiction Mental illness Illegal drugs Subjectivity Psychiatric medication 

Notes

Acknowledgments

This research was supported by a grant from the National Science Foundation [NSF BCS-0724320] awarded to Lee D. Hoffer (Principal Investigator). Members of the Case Western Reserve University Social Dynamics Research Team contributed to data collection. An earlier version of this paper was presented as part of the session The Anthropology of Psychopharmaceuticals: Cultural and Pharmacological Efficacies in Context at the Society for Psychological Anthropology 2011 Biennial Meeting in Santa Monica, CA. We thank Janis Jenkins, who served as discussant for the session, for helpful comments. We also thank an anonymous reviewer for emphasizing the need to critique the structure of biopsychiatric treatment. Finally, our greatest thanks to study participants for sharing their lives and experiences.

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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of AnthropologyCase Western Reserve UniversityClevelandUSA

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