There have been numerous attempts to provide a comprehensive account of the relationships between drugs, bodies, culture, economy and the everyday. Popular books such as Griffith Edwards’ Matters of Substance (2005) and Jim Orford’s Excessive Appetites (2001) emerged from psychological medicine and have focused on rationality and evidence. Mariana Valverde’s Diseases of the Will (1998) demonstrated that the larger systems of knowledge through which we understand drug use, such as those from psychology and medicine, achieve their effects through historically contingent processes and sometimes through the simple ‘piling up of rationalities’. The dominance of moral discourse in the late nineteenth century was overtaken by pharmaceutical science in the mid-1900s, then by the social sciences in the 1970s, then by psychology, neuroscience and most recently through the ubiquitous ‘bio-psycho-social’ model of drug use. This final, all-encompassing system of knowledge about drug use has attempted to be all things to all people, to account for many of the complexities of drug use through its inclusive framework. Valverde’s metaphor of the ‘piling up of rationalities’ sums up the bio-psycho-social approach to understanding drug use and also highlights its pitfalls.
Unable to display preview. Download preview PDF.