Keywords

Over the past two decades, female drug users have moved from their “mad, sad or bad” marginal status, as addicts and substance abusers, out of control and/or needing control, to being mainstream consumers in society. (Measham 2002, p. 344)

In 2015, when I was a recently admitted doctoral student in ethnology at Lund University, Sweden, reading these words in English criminologist Fiona Measham’s article “Doing gender – doing drugs” was puzzling. Thirteen years after they were written, I could not think of any instance of having heard or read in any public, Swedish context of women who use drugs who were not mad, sad or bad, or all of these at once. Neither had Katy, who is interviewed in this book, who says about cannabis:

[…] we’d all been taught how those things worked: a gateway to harder drugs and once you start, well, you’ll end up on the streets. Or admitted to a psych ward.Footnote 1

While the normalisation of illegal drug use can be questioned (Duff 2020), the predictions that Katy describes are not necessarily accurate. Drugs are used by otherwise mainstream consumers as well as by non-mainstream consumers, and most of this use can be described as recreational (Schlag 2020). Cannabis legislation is “softening” around the world and research on psychedelics and other drugs previously understood as club drugs is thriving, which has positioned them in a different light (Heal et al. 2023). At the same time, drugs in the form of medicines are prescribed in continuously increasing quantities (OECD iLibrary 2021). The problems that can be related to drugs, in terms of madness, sadness and badness, are thus only one aspect of the role that they play in the world, including contemporary Sweden. Still, there is very little Swedish research on the everyday use of drugs. Who are the women who take the risk of dealing with stigmatised, mind-altering substances in a country that is striving to become drug-free (Regeringens skrivelse 2015/16:86)?

Measham finishes her article on the socio-cultural context of gender and drug use with the following words:

Moving beyond the oppression/victimization–liberation/emancipation polarization, we can see that the multifaceted nature of […] drugs cultures reflects the complexities of […] accomplished femininities for female drug users: as “club babes”, mothers, professionals, “good girls,” “badass” street-wise women, and so forth. Thus for women, “doing gender” through “doing drugs” allows the possibility of both constructing and challenging traditional and nontraditional notions of femininity. (ibid., pp. 363–364)

How Measham exemplifies the complexity of femininity in multifaceted “drugs cultures” as represented by “‘club babes’, mothers, professionals, ‘good girls’, ‘badass’ street-wise women, and so forth” runs counter to stereotypes of drug-using women as miserable and crazy. Instead, it makes up a varying and unpredictable collection of everyday women “doing gender” through the ever-more-common act of using drugs. If approached with such openness to the possibilities of interpretation, as Measham’s account shows, women who use drugs can be more than objects of research, they can also provide a window into contemporary living conditions and an understanding of the interplay between gender and mind-altering practices. In this book, twelve Swedish women’s accounts of their drug use in everyday life—from parties to the city streets, at work and in the home—are investigated and given the spotlight. Their use of drugs is explored from an intersectional,Footnote 2 ethnological and queer phenomenological perspective, with particular attention being paid to gender and class. The meaning of contemporary drug use has a history that has shaped how drug use is understood in relation to different bodies and different societal positions. This book pays attention to that background (Part I) as well as to the current experiences of the interviewed women (Part II).

The discipline of ethnology studies the human as a cultural being, with a specific interest in local, meaning-making practices and how cultural meanings change over time. As will be explored in more detail in the next chapter, both drug use and the idea of the user of drugs have undergone fascinating changes in meaning over the last 75 years in Sweden (Tham 2021). Up until the mid-twentieth century, a person who used drugs was mainly understood as a low-key morphinist, representative of the middle class and probably a doctor. Any problems in dealing with the drugs were considered to be individual (Edman and Olsson 2014; Björkman 2002). In conjunction with the popularity and spread of amphetamine use in Sweden during the 1950s and 1960s, the image of the person who uses drugs transformed into that of a troublesome, criminal and/or bohemian amphetamine user. Rather quickly, this abuser of drugs, the knarkare,Footnote 3 developed into representing a major threat to society. They were a representative of a social problem that did not differentiate between what and how various illicit drugs were used, and was subject to the criminal law on drugs that was enacted in 1968 (Edman and Olsson 2014; Linton 2015). To counter the threat to society, Sweden employed strict policies and laws against drugs, and formulated a vision of a drug-free society, which is still an official political goal (Regeringens skrivelse 2015/16:86). Sweden is one of the few countries in the world in which the law criminalises the use of illicit drugs, and after prison sentences were included in the scale of possible sentences in 1993, the police were empowered to investigate bodily fluids based on the suspicion that drugs have been used. This is a practice that leads to several thousands of samples being tested every year, up to half of which show negative results (young people more commonly test negative than older people), and the practice has been criticised as intrusive (BRÅ 2018; Gynnå Oguz 2017).

Despite the relatively low numbers of people who are recognised as people who use drugs in Sweden, the idea of the knarkare has had a noticeable cultural and political impact on Swedish society (Linton 2015). This invites studies of meaning-making in relation to the person who uses drugs as a cultural being, from both an emic and an etic perspective. This is true for drugs and the people who use drugs in general, but the complexity of femininity highlighted by Measham, where oppression, victimisation, liberation and emancipation are all relevant topics in relation to the meaning of women’s drug use, means that women who use drugs are in specifically interesting positions from a feminist point of view. The connotations of drug use connecting it to revolt, immorality, criminality, promiscuity and carelessness contrast with the classic feminine ideals of compliance, morality, obedience to the law, prudence and care just as much as they contrast with oppression and victimisation. On the other hand, addiction, understood as to be a slave to one’s habits, and the vulnerable female positions that addiction to drugs connotes is the opposite of what feminism strives for. Considering this tension, why are people who use drugs not central figures in ethnological studies, and why are women who use drugs not central to feminist studies (Travis 2019; Chang 2020)?

One reason why people who use drugs can be missed by research that is focused on the human as a cultural being is the dehumanisation to which restrictive and stigmatising laws lead. Opioid replacement treatments, for example, have been strongly opposed, despite the knowledge that untreated opioid addiction often leads to death (Kakko 2017; Johnson 2005). The political struggles regarding syringe exchanges have been bitter and prolonged (e.g. Antoniusson et al. 2005) and, until a change in the law in 2017, they were very restrictive (Karlsson et al. 2020). Overdose prevention through Naloxone is another life-saving measure that has met with resistance (Eklund 2017). In short, it has been particularly dangerous to use drugs in Sweden because there has been no consensus that people who use them should be kept alive.

A number of researchers have criticised the reluctance to implement life-saving and harm-reducing measures (e.g. Heilig 2017; Richert 2017; Kakko 2011; Johnson 2005), and the high rates of casualties related to drug use have been used as an argument to revise policies (Ekendahl 2009). This has eventually led to an increasing focus on harm reduction, but at the same time political proposals continue in the direction of increases in penalties (Regeringens proposition 2022/23:53) and, according to historian Johan Edman (2021), not much has changed politically in the last 50 years.

This book has been written to counter the view of the woman who uses drugs as dehumanised by her drug use. It is a study of Swedish women who use drugs, considered as cultural beings, based on the notion that “women who use drugs are people”, as an anonymous narcofeministFootnote 4 activist puts it in an interview published in the Sociological Review (Bessonova et al. 2023, p. 755). This means a focus on how drugs and people who use drugs are entangled with social and intersectional factors such as class, gender and race. As we shall see, it is these factors, rather than the substances’ pharmacological properties, that make the difference between a “knarkare” [Swedish, derogatory term for people who use drugs] and a “party girl”, and are decisive in whether a drug will have the ability to add to artistic reputation or devalue human dignity.

1 Representations

When it comes to women who use drugs in Sweden, two distinguishable, polarised representations emerge, both in the media and in research. These end up being positioned to either side of the large majority of people who use drugs, who constitute an invisible grey zone in the space between (Rödner et al. 2007, p. 47). One representation is of celebrated artists, who actually do sometimes describe their use openly, without necessarily being marked as predominantly mad, sad or bad, but rather as extraordinary. Authors Agnes von Krusenstjerna (1894–1940) and Birgitta Stenberg (1932–2014) and contemporary pop star Tove Lo are examples of openness about drug use in this group. Their drug use is known, but they describe it, and it is described by others, as an interesting feature of otherwise elevated and respected lives. Agnes von Krusenstjerna is described in the historian of ideas Karin Johannisson’s book The Wounded Diva (2015)Footnote 5 as consistently using morphine and other drugs in large quantities. “She sniffs ether, injects morphine, pumps in sleeping pills and tranquilizers. She is an upper-class woman in decline” writes Johannisson (ibid., p. 216). For page after page, she describes how von Krusenstjerna craves and acquires different types of drugs, especially morphine. Yet the detailed narrative is about her eventful life, her health and her prose. The use of drugs remains a side issue, both in Johannisson’s book and in the general knowledge about von Krusenstjerna. As for Tove Lo, her most famous song is called Stay High (2014). It is a remix of the song Habits (2013), and is about how Lo has to stay constantly high, i.e. under the influence of drugs, to cope with being abandoned. In an interview, she said: “In Sweden, when you sing about drugs and numbing the pain, many people take offense and think it’s irresponsible. But I’m not going to take that responsibility. I sing about my life, it’s as simple as that” (Fahl 2014, n.p.). Tove Lo’s life is thus affected by drugs, and this is a starting point she does not seek to hide. Major successes, both in Sweden and abroad, continue to mark the path of her career.

For people in this group, drugs seem to function as integral parts of an experimental and luxurious lifestyle. Use may be perceived as “irresponsible” and the women may end up “in decline”, but the choice to consume drugs does not take over their identities. Rather, it contributes to a class-anchored, individual complexity (cf. Skeggs 2004, pp. 56f.).

The second portrayal, about which there is much more research but which more rarely appears in the media other than as a stereotype, is the drug-abusingFootnote 6 woman (cf. Lander 2003). She is vulnerable, often a prostitute, often homeless and almost always mentally unstable. She is identified as a person at the bottom of society (cf. Campbell 2000, pp. 198f.; Mattsson 2005, pp. 78ff.). Swedish ethnographic studies have been conducted by ethnologist Annette Rosengren (2003) and criminologist Ingrid Lander (2003), both of whom placed great emphasis on depicting the women as individuals far beyond their identities as drug abusers. But in the absence of research that makes drug use visible in different social strata, these works still contribute to the image of women who use drugs as being at the bottom, or in Lander’s words: women who have been dealt “the worst cards” (2003, pp. 31, 38 and 48; cf. Campbell 2000; Rosenbaum 1997).

In a study from 2005, sociologist Tina Mattsson has shown that the women she studied who were taken into care because of drug use were considered to have lost their femininity, perhaps even never having had it. The institution did not offer any activities other than (once in a while) the development of femininity, such as aerobics and beauty treatments, which she describes as being based on a middle-class ideal (pp. 185ff.). All the interviewees in the studies referred to above are described as drug users, but the type of use referred to is frequent and problematic use, i.e. use that is commonly described as drug addiction. But drug use occurs in all social classes (CAN 2021; BRÅ 2018; Wierup and de la Reguera 2010) and does not necessarily lead to addiction (Heilig 2015, pp. 29ff.; Richert 2014, pp. 33ff.). My view is therefore that the use of drugs in Sweden, that is, the use of usually very small and hidden quantities of substances that circulate at all levels of society, must be studied with a broad and mobile searchlight (Daun 2003; cf. the concept of “situated knowledge” explained below under “A power-sensitive approach”, Haraway 1988) that is able to disregard the polarised stereotypes. Some bodies risk being constructed as linked to drugs through class-related conditions and cultural perceptions, while drugs themselves are located in many other places. What is the relationship between gender, class and drug use from different social positions?

There is a mystique around drugs that leads to the subject becoming loaded with connotations of danger, immorality and depravity. A person who uses drugs is by definition not only human. It is someone who has ingested psychoactiveFootnote 7 substances that affect their thoughts, feelings, actions and decisions. Yet such substances are acceptable ingredients in completely normative contexts. Prescription medication treatments, medical care in hospitals, birthdays and wedding parties are examples of circumstances where substances such as amphetamines, opioids or alcohol can be used without being perceived as problematic. Thus, the concepts of drugs and drug use cannot be equated with the use of specific substances, but are given meaning through the cultural significance of how certain substances are used in certain contexts, relying on myths of “good and bad drugs” (Boyd 2004, p. 8).

These differences in meaning become even more evident from a class perspective. Substances, as well as the bodies that have ingested them, take on different meanings depending on whether they are consumed in low- or high-class situations—and this applies to drugs of all kinds (Olsson 1994; Björkman 2002; Bancroft 2009; Berridge 2013, p. 79; Edman 2019; Farber 2022). Class differences are particularly pronounced when it comes to women’s use of such substances (Berridge 2013; Boyd 2004; Sigfridsson 2005; Wiklund and Damberg 2015). The concept of the whore as an image of the fallen woman is always close at hand when danger, immorality and depravity are linked to women (Frykman 1977; Johannisson 1995; Lennartsson 2019), but the differences between how two women’s drug-affected bodies are perceived in a social context can be diametrically opposed, as I have illustrated above.

Part of the mystery of drugs is that one of the most obvious reasons for their use—pleasureFootnote 8—is rarely discussed but is readily portrayed in films, books, song lyrics and magazines. This creates a discrepancy with information and news reports that focus on problems. In research that has focused on the lives of women who use drugs, the analysis usually returns to the original reason for why they started using drugs, which can be that they refused to accept a restrictive female role, and that drug use was a conscious choice, despite its accompanying difficulties (Lander 2003; Laanemets 2002, pp. 250ff.; Friedman and Alicea 1995; Du Rose 2017). One possible reading of these women’s drug use can thus be one of agency exercised through a pleasure-filled revolt against oppressive expectations of the performance of femininity. It is thus a kind of class and gender rebellion. How drug-using women in different societal positions orientate in relation to cultural perceptions, drugs as objects and stigma is an area of research that offers insights into gender and class orders, as well as a deeper understanding of the role of drugs in society.

2 Drugs in Everyday Life

Representations of women who use drugs, as expressed, for example, in the media, research, popular culture and national politics, seem to be directed towards two extremes, as I have described above. There are stories about the vulnerable woman at the bottom of the heap, or the eccentric star. Nevertheless, the statistics reveal something else: the vast majority of women who use drugs cannot be placed at either of these extremes. Instead, most are positioned along the spectrum in between (UNODC 2015; Statens Folkhälsoinstitut 2010, p. 75). In other words, drug use takes place in the middle of Swedish society, as well as on the margins. This book examines how women incorporate drug use into their everyday lives. How does drug use coexist with studies, professional life, children, partners and friendships? What significance do gender and class have for how drugs are used, problematised or legitimised? What drug use is possible and what does it do to women’s life content, choices and conditions? To answer these questions, I focus on time, space and movement, with the intention of analysing how the acquisition, use and concealment of drugs become practices that have significance for the women in terms of gender and class.

Contradictions and taboos surround drug use, especially women’s use of drugs. Why does Swedish society seem to be simultaneously obsessed with and dismissive of psychoactive substances and the bodies that ingest them (cf. Edman 2019)? Some use is visible everywhere, while other use, even of substances associated with less serious risks or illness, is associated with stigma and/or high penalties. In this way, drugs act as tools that create order, but it is a strange and disorderly order. The rules are different in different countries, but in Sweden, where attitudes towards illegal drugs are generally harsh, heavy drinking at certain places and times is an expected and encouraged feature of the street scene. The unrestrained intoxication of some bodies is thus given space in public places, while other bodies can only become intoxicated illegally in secret, and the slightest sign of improper influence is monitored. The subject is surrounded by complex cultural attitudes and boundaries that still surprise me after eight years of research, linked to dirt and cleanliness, order and disorder, sickness and health, morality and immorality.

Identifying as a woman is a starting point that is already closer to the negative category of the dichotomies listed above. Women’s constant exposure to being associated with immorality, dirt and disease is linked to the risk of coming too close to the whore stigma (Lennartsson 2019). Feminist scholarship has delved into the mechanisms that place women in classed, confined spaces, where careless movements always threaten to lead to moral condemnation (Johannisson 2015; Skeggs 1998; Irigaray 1985). Idealised femininity is therefore about a constant striving towards order, purity, morality and cleanliness. How women approach—and do—illegal drug use are therefore questions that serve as gateways (cf. e.g. Löfgren and Ehn 2010, p. 78) to broader feminist questions about agency, desire, health and physicality.

Statistics show that the use of illegal drugs is increasing. The Central Association for Alcohol and Drug Information (CAN 2019, p. 5) states that, despite difficulties in producing reliable figures, the available data for the period 2014–2019 indicates that problematic drug use in Sweden is at historically high levels. Resold medicines are one of the groups of preparations that have increased the most, according to seizure statistics (ibid., p. 12) and are now the most commonly used drug group (ibid., p. 18) and the second most commonly seized, after cannabis. This makes discussions about what drugs are, and possible approaches to them, urgent. I have asked myself what feminist approaches to drugs can be and how alcohol, illegal drugs and narcotics relate to issues such as liberation, pleasure, risk, neoliberal society, violence and norms. In every possible answer, there are contradictions, which are not diminished by the wide variety of effects that different drugs can have. On the one hand, there are risks; on the other hand, there are opportunities. These thoughts have led to this study.

With this book, I want to contribute to a political and scientific awareness of the drugs that are all around us and within us, what we do with them and what they do to us, by looking at how the women in Sweden who participate in this study relate to their use of drugs.

3 The Women Participants

The studyFootnote 9 is based on interviews with twelve women. They are all Swedish citizens, but four of them were born in other countries, three of whom came to Sweden as small children, while the fourth arrived as a young person. Two had been living abroad for some years at the time of the interviews. All of them can be perceived as white Swedes, and I believe—but did not ask—that all of them would describe themselves as such in situations where such identification is requested (although in a couple of cases the nationality of the country of birth might also be mentioned). These twelve women were the first to answer my call, and the selection does not mean to imply that all women are white. Instead, they speak from specific positions organised by race. Whiteness is a privilege based on a racialisation “invented” by science, which on the one hand constructs a notion that it is actually about the characteristics of individuals and groups, and on the other hand makes spaces comfortable and obvious for white people but uncomfortable and inaccessible for others (Ahmed 2007). Whiteness, feminist scholar Sara Ahmed writes, can be partly understood as an inherited, implicit knowledge of where things are and how they can be used (ibid., p. 155). The movements of the body are thus structured by race. Furthermore, whiteness is “a category of experience that disappears as a category through experience, and […] this disappearance makes whiteness ‘worldly’” (ibid., p. 150).Footnote 10 Although this book focuses on gender and class, the women’s performance of whiteness and conditions of whiteness shaped their experiences of drug use, both in Sweden and abroad, profoundly. However, one or more of the women could perhaps perceive themselves as “not quite white”,Footnote 11 that is, not fully experiencing themselves as completely white and/or always being accepted as white. Race is an incredibly strong, structuralising factor in terms of how handling drugs is perceived and met (Farber 2022), and, as a consequence, the interviewees were usually using drugs under very different conditions than if they had been perceived as non-white women.

So, what is a woman? In my study, gender is understood as a set of social constructions situated in context (West and Zimmerman 1987), both subjectively and by the environment, working in dialogue. Since a person’s categorisation as a woman also includes the environment’s interpretations and reactions, people who enact femininity have experiences that can be similar to those of other women and differ from those of other gender categories. The reason why I chose to target people who identified as women was partly because, as I have described earlier, I have a feminist interest in how women’s drug use might contest or align with classic ideals of femininity. But I was also interested in norm-breaking through drug use from positions that already do not conform to the expected male user of drugs (Campbell and Ettorre 2011). Therefore, I regretted not having been more clearly open in the invitation to the study, as any gender-queer person would have made relevant and valuable contributions. Non-binary gender identifications are invisible in the statistics and in most of the drug research that I have used, both quantitative and qualitative, and the contributions of such individuals would have contested the invisibility-making that is inherent in relying on invisibility-making statistics (cf. Buxton et al. 2020). However, despite an invitation directed at women, luckily it did not only attract women who follow straight lines of womanhood. At least four of the interviewees identify as lesbian or queer, one of whom has undergone gender-affirming treatment.Footnote 12

3.1 The interviewees

Here, the participants are briefly presented, each with a fictitious name, approximate age, occupation and current consumption habits in terms of drugs, medicines and alcohol, according to their own statements.

  • Agnes, aged 25, psychologist: Uses amphetamines and the amphetamine-like drug mephedrone (4-methylmethcathinone) as well as MDMA/ecstasy at parties. Smokes cannabis. Self-reportedly drinks a lot of alcohol.

  • Nanne, aged 65, retired, former journalist. Uses cannabis oil, so-called CBD oil. Receives opioid drugs on prescription for her pain conditions. Often drinks wine.

  • Boel, in her 30s, works as a public-relations officer. Prefers to use hallucinogenic drugs such as LSD and MDMA. Also uses cocaine, amphetamines and poppers when the opportunity arises. Micro-doses MDMA during stressful periods at work. Claims to drink a lot of alcohol and to be a “funny alcoholic”.

  • Katy, in her 40s, consultant in an architectural office. Uses cocaine on select occasions. Smokes cannabis. Drinks alcohol sparingly.

  • Madelene, aged 35, senior software analyst at an IT company. Uses a variety of prescription drugs, mainly Xanax, Oxynorm and Klonopin, for anxiety and pleasure. Injects heroin a couple of times a month. Does not drink alcohol.

  • Dora, aged 25, is a student. Smokes cannabis a few times a year. Drinks alcohol almost daily but not very much at a time when there is no party.

  • Carolina, aged 35, musician. Used amphetamines daily for eight years but has stopped and only uses Clomipramine for depression and OCD. Does not drink alcohol.

  • Thea, aged 35, visual artist. Uses mainly hallucinogens such as psilocybin mushrooms and LSD, but on occasion also amphetamines, MDMA, cocaine and cannabis. Has undergone an extended period of illness that has caused a lot of physical pain and felt that she was in too poor a condition to use a lot of drugs or alcohol during the interview period, but does so on occasion. Occasionally uses opioid painkillers, both illegally purchased and prescribed.

  • Pernilla, in her 40s, works for a book publisher. Prefers to use cocaine, but due to its high price in Sweden cannot do so very often. Sometimes uses amphetamines at parties. Smokes marijuana (cannabis). Likes to drink alcohol.

  • Angela, aged 45, paints, receives sickness benefit. Uses the drugs Elvanse for depression and as part of treatment for ADHD, Lyrica for anxiety, and amphetamines and MDMA at parties. States that she drinks quite a lot of wine at times.

  • Hanna, aged 50, receives financial assistance, shoplifts food and clothes, sells sex from time to time. Injects heroin daily. Uses drugs such as benzodiazepines when they come her way. Basically does not drink alcohol.

  • Filippa, aged 25, psychology student. Uses cannabis and psilocybin mushrooms. Likes to drink alcohol.

Filippa subsequently asked to be further anonymised, which means that I only use statements from her when the interview responses are in line with those of others. Sentences such as “several interviewees believe that …” may thus be partly based on Filippa’s interview answers, but otherwise her statements have been omitted. We agreed on this because she was worried about being revealed in some way, for example through a personal way of expressing herself.

Other interviewees’ information that is not relevant to the study has in some cases been changed to reinforce anonymity, which has been specifically important to consider in this study, where the interviewees have a lot to lose if their participation were to be revealed, such as jobs, reputations, children and so on (Waters 2015).

4 A Power-Sensitive Approach

Asking about everyday experiences and starting from there, in line with Sara Ahmed’s queer phenomenology, with a focus on direction, emotions and objects but without ignoring political and social conditions, is not only useful as a theoretical perspective (to which I will return below) but also as a method. I see this method as close to what Donna Haraway (1988) describes as the pursuit of “situated knowledge”, which is based on a multi-positioned, power-sensitive conversation with the environment. Skeggs writes about the importance of the research perspective with reference to Haraway’s concept:

knowledge is always a matter of positioning. It is the space from which we speak, the political, disciplinary and social inheritances that we travel through, which leave traces and marks upon us, enabling us to see some things and be blind to others. This is, of course, tautological, because it is our social positioning and categorisation (of which class is one) that enables our only ever partial perception. (Skeggs 2004, p. 45)

Having a place, the academy, from which we can speak is, on the one hand, a privilege that allows some perspectives to be heard and seen far more than others. On the other hand, as I read Skeggs and Haraway, positioning implies a feminist responsibility to widen the field of vision by not failing to point out what we see, even if few others seem to see the same thing. Haraway writes:

Rational knowledge is a process of ongoing critical interpretation among “fields” of interpreters and decoders. Rational knowledge is a power sensitive conversation. (1988, p. 590)

For the science produced to be rational, Haraway argues that many perspectives are needed. In the case of drug-use issues, representation is currently virtually impossible, especially in Sweden, where being under the influence of drugs is a punishable offence. Illegality, stigma and perceptions of unreliability mean that people who use drugs are rarely heard. Elizabeth Ettorre writes:

Even within the women’s movement, women’s drug use was considered as emblematic failure of gendered performativity […] Drug-using women were seen as “failures” as women. As Campbell […] has argued, drug using women are not epistemologically credible; they continue to be constructed as willfully wayward women who are morally corrupt and “deviant” in socially unacceptable ways. (2015, p. 795)

Women who use drugs are thus impossible subjects, both as people who use drugs and as women. Despite the fact that women who use drugs are not perceived as exempt from men’s violence, sexism or harassment, Ettorre argues that even feminist movements are exclusionary. In Sweden, where drug-related mortality is described as more than four times the European average (EMCDDA 2021, p. 8), but where gender-equality issues are prioritised, it may seem strange that the voices of women who use drugs are not heard. However, the laws targeting personal use effectively place the drug-affected voice outside the public debate. This project has been about collecting material from such positions and building the text in dialogue with previous and contemporary research, as well as with the interviewees.

5 The Interviews

In order to reach people who use drugs who were not to be found in institutions, I sent an invitation mail to people I knew, encouraging them to pass it forwards to potential participants. I also spread the word at conferences and talks. After receiving expressions of interest in participating from the women presented above, I conducted semi-structured in-depth interviews with each of them, in locations chosen by them, preferably at home or in a café. In some cases, subsequent email, messenger and WhatsApp communication has also become part of the material. Six of the women also participated in go-along interviews, in places that they considered to be important to them in relation to their use of drugs.

During the collection of my interview material, the balance of power created by the topic between researchers and people who use drugs has been a relevant issue. I have tried to address it primarily through a straightforward and respectful approach and by acting and asking questions in a way that, as far as possible, does not resemble the language of an authority (Nairn et al. 2005). Ethnologist Signe Bremer describes interview material as collected versions of a social reality, a product of an interpersonal encounter (2011a, p. 196). This highlights the researcher’s own role in the interview situation and makes visible that other researchers would have collected at least partially different material from the same interview situation. This returns us to Skeggs’ words that knowledge is always a question of positioning and that this position allows us to see some things but leaves us blind to others (2004, p. 45). But it also applies to the interviewee him/herself and the specific perspective that he or she contributes.

Traditional methodological texts that specifically deal with interviewing people who use drugs commonly describe encounters with excluded people, where the power relationship between interviewer and interviewee becomes conspicuous. Anthropologist Trond Grønnestad and researcher in social work Philip Lalander write for example:

When a person who is labelled as outsider, for example a narcotic user, meets people who are “normal”, he or she may try to hide the stigma in order to “pass” as a normal person. The objective is then to avoid being labelled and seen as inferior in the encounter and in the gaze of the other. If that is difficult, if the stigma is easily discovered, for example, through a worn appearance, an individual may experience the encounter as uncomfortable, an occasion of inferiority (Garfinkel 1967).Footnote 13 (Grønnestad and Lalander 2015, p. 168)

Most of the interviewees whom I met are in completely different positions from the “outsiders” described above. Several are clearly proud of their careers and life choices and highlighted these, with or without the intention of overshadowing their stigmatising drug use. As a result, I could sometimes feel that I was “studying upwards” (Nader 1972), while the interviewees, like the “outsiders” described in the quote, often related to notions of normality as the antithesis of drug use in different ways. This can be described as a third presence, or sometimes rather a “questioning ghost” (Pripp 2011, p. 69), who is silently questioning the interviewees based on expected negative perceptions. In situations where I felt that such a questioning ghost began to take over, or in some other way the interview took a turn away from the purpose of the study, I turned to the interview guide and changed the topic to something that I hoped would be inspiring rather than threatening.

The go-along interviews were conducted by me taking walks together with the women to places that, for various reasons, they associated with drug use. The point of the method is to evoke associations, memories and feelings and thus generate an in-depth narrative that is difficult to access in a traditional interview situation (Kusenbach 2003). Sociologist Margarethe Kusenbach describes the go-along method as a phenomenologically based method that aims to bring together the different strengths of the observation and interview methods. This, she argues, makes the go-along method better suited to capturing two key aspects of lived experience: its constitutive role and the transcendent significance of the physical environment (ibid., p. 458). She argues that methods that can take into account movement through the environment are a necessary step in conducting phenomenological ethnography that considers how experiences change in relation to place. They allowed me to follow the interviewees’ directions and to see how they oriented themselves and at the same time reasoned about memories that emerged in relation to the places. Experiences of disorientation often became significant (cf. Ahmed 2006a, pp. 157ff.) during the go-alongs as important and thoroughly described processes. I believe that these experiences would not have been mentioned at all, or would have been talked about in other ways, in a seated interview situation. During the go-alongs, scenarios that were confusing and/or contradictory for the interviewee could be recounted in detail, based on their memories of emotions that arose at the site, and I believe that summary accounts of the same events could have given different impressions (cf. Kusenbach 2003, pp. 472ff.).

6 A Queer Phenomenological Approach to Drug Use

In this book, Sara Ahmed’s queer phenomenology (2006a, 2006b) serves as the main theoretical approach.

Phenomenological perspectives on the body, space and objects, as developed by, for example, the philosophers Martin Heidegger (1962/1927), Simone de Beauvoir (2004/1949), Maurice Merleau-Ponty (1968, 2010) and Sara Ahmed (2006a, 2006b), can be used as valuable ethnological tools to explore ethnographic material as lived, bodily experiences, and for understanding directions and movements of consciousness in space (see, e.g., Hansson 2007; Bremer 2011b; Göransson 2012).

Phenomenology emphasizes the importance of lived experience, the intentionality of consciousness, the significance of nearness or what is ready to hand, and the role of repeated and habitual actions in shaping bodies and worlds. (Ahmed 2006b, p. 544)

What is close and what movements are repeated, writes Ahmed, is significant for how bodies and worlds take shape. Furthermore, consciousness is always assumed to be directed towards objects and is therefore always worldly, situated and embodied (ibid.). Phenomenology thus focuses on how bodies and objects (all kinds of objects, including drugs) are positioned in the world, and how bodies and objects take up that position together, how they approach, and distance themselves from, each other. How then do bodies, objects and places in proximity to each other take shape when drugs are one of the objects?

Heidegger describes how, when used, objects can disappear from the consciousness and become extensions of the body (1962/1927). Frykman exemplifies such a change in the relationship between body, mind and object as the difference between thinking about an object and thinking with the object (2006). He uses the example of a car. When a driver makes their way along a road with a country house in sight, past other road users and with rowdy children in the back seat, the car is an object through which the driver experiences the world, rather than something they think about in terms of what it represents (ibid., pp. 66ff.). In the context of drug use, this phenomenological starting point is complicated. Drugs come much closer to bodies than a car can. They are objects in the world that can be moved and thought about, but their purpose for the person who uses them is to be introduced into the body and dissolved in bodily fluids, which leads to bodily changes (cf. Hansson 2007). The drug thus temporarily becomes the body in a physical sense. The unification between the body and the drug in turn affects the direction of the consciousness. Once the drug has been ingested, the person who used it must think with the drug, even while thinking about the drug, until its effects have ceased. The living body is thus altered in a distinctive way that distinguishes the use of drugs and medicines from most other uses of objects.

Moreover, since the 1960s, the type of object that drugs constitute has been associated with strong cultural charges of danger and threat (Edman 2019). Drugs can therefore induce experiences of disorientation both through their pharmacological properties when used and as stigmatised and criminalised objects that are consequently socially risky to approach at all. To analyse the use of such a type of object, phenomenology must focus on these disorienting experiences, their meanings and also on the conditions surrounding drug use as an act. Ahmed writes that phenomenology has to be queer in order to understand how disorientation can be a meaningful starting point. Rather than quickly moving on from disoriented queer moments—which can be experienced as unpleasant and as preventing the possibility of action (2006a, pp. 66, 159)—she writes that a queer phenomenology can orient itself differently in relation to them. She argues:

A queer phenomenology might find what is queer within phenomenology and use that queerness to make some rather different points. Phenomenology, after all, is full of queer moments, moments of disorientation. (2006b, p. 544)

Considered as significant focal points, Ahmed thus means that theoretical disorientations can open up other insights than oriented starting points, when things are in their expected places, so to speak. But experiences of disorientation can also be about the researcher’s bodily starting point. Ahmed gives the example of the female philosopher, who deviates from the male norm.

bodies can take up spaces that do not extend their shape, which can in turn work to “reorientate” bodies and space. […] there are women philosophers, and […] they still cause trouble as “bodies out of place” in the “home” of philosophy […] So what happens when the woman philosopher takes up her pen? What happens when the study is not reproduced as a masculine domain by the collective repetition of such moments of deviation? (2006a, p. 61)

As a woman, turning towards philosophy and taking up a pen to write is to orientate oneself in an unexpected way and can lead to experiences of disorientation. But in order to do what was intended, to write, Ahmed argues, is to tread a new path that becomes more accessible as spaces, objects and bodies take shape from each other. New paths are trodden by the female philosopher who insists on writing, which, Ahmed points out, can involve a different, feminist approach to where the attention should be directed (ibid., pp. 61ff.). In this way, queer phenomenology becomes a political phenomenology, in line with, for example, critical cultural theory, feminist theory and postcolonial theory, all of which are interested in exploring the creation and maintenance of power.

Unlike Ahmed’s primary work, this book is based on fieldwork and the contributions of interviewees. The queer phenomenology developed by Ahmed therefore takes on additional dimensions. Following in Ahmed’s footsteps and thinking in line with her theory turns me into the female researcher who picks up a pen and seeks to orient herself, not primarily as a philosopher but as a feminist and ethnologist in a field researched predominantly by male drug researchers and ethnologists who rarely research drugs. Thus, what is noticed is not always the same as what has been noticed before. To a certain extent, this path has been trodden by other feminists, but to the extent that it has been followed by ethnologists, it is different ways of thinking than those common in drug research that have inspired them. The quest for reorientation has therefore often been overriding. But what is noticed is based on fieldwork, i.e. what the interviewees, the women who use drugs, have noticed. The queer phenomenology is therefore partly performed by them—for example, they remain in the memory of the disoriented moments together with me and formulate the material I have to work with. This creates a link between the field and the desk, to which I want to draw attention, particularly because the reproduction of deviance in research on women who use drugs is a problem that researchers have struggled to resolve (Campbell 2000). There are interesting similarities between philosophers, other researchers and people who use drugs. Drugs are not alone in their ability to alter consciousness and intentions. Disorientation and orientation as analytical concepts serve as a bridge between the orientation of the interviewees (after all, what is participation in an interview about drug use, other than an attempt to concretise disorientation, orientation, intentional directions and the conditions for them?) and my own efforts to orient myself analytically through the material in the form of text production.

The influence of drugs has inevitable links with disorientation, through drug effects and illegality, which in turn implies drug-related orientations—the striving for or the obviousness of feeling oriented. Paying attention to experiences of orientation and disorientation in studies of direction, movement and their conditions in relation to the environment can shed light on power relations and opportunities for action.

Such attention is directed towards what the interviewees have noticed, as well as what the researcher sees and how directions are taken from there. People who use drugs turn to drugs just as philosophers turn to their desks to become philosophers (Ahmed 2006a, pp. 52, 55). It is through drug use that the women become people who use drugs, and this, perhaps with even greater intensity than women writing philosophy, can produce experiences of being “out of place”, since drug use, unlike philosophy, is prohibited by law. (These are relationships that have changed over time, but in opposite directions. Philosophical institutions in Sweden were opened to women in 1873 and the penal code for drugs was established, as previously stated, in 1968.) Thus, perhaps what happens during thinking and under the influence of drugs is not as different as it might first appear? Both states refer to different forms of mind alteration—consciousness can change and disorientation can occur—from which new orientations take place. People who use drugs may feel that the world is against them. It can also be an uncomfortable experience to write about a taboo subject, allowing research and empirical material to lead the way, when this is not in line with heavily morally charged cultural beliefs. I have often been angry, scared and lost (cf. Ettorre 2017). Ahmed writes:

disorientation happens when the ground no longer supports an action. We lose ground, we lose our sense of how we stand; we might even lose our standing. (2006a, p. 170)

To make things queer is to disrupt the order of things, Ahmed writes (ibid., p. 161), and it entails a deviation that is not always comfortable, but can be a prerequisite for seeing new patterns (ibid., p. 171). A central idea throughout this book is therefore to keep this relationship in mind. Orientation takes place from the point where consciousness of the body is located, and directions are determined from there (2006b, p. 544). This is an ever-changing process, whether the mind/body is influenced by philosophy (and other research), drugs or something else, and new directions take shape in the constant pursuit of orientation through temporary, prolonged, uncertain, shifting states of disorientation. What I perceive as the queer in queer phenomenology, with parallels to the risks faced by both researchers and people who use drugs, is a view of disorientation, including the feelings to which it can give rise—of uncertainty, anxiety and many more—as a starting point for possibilities of renewal that may not cease to be uncomfortable. Interviewing people who use drugs is thus a queer encounter between different processes of orientation, disorientation and reorientation, and between subjects who sometimes claim “I can”, even though the starting point does not seem to be in line with the environment (2006a, p. 159).

7 Power Relations

Ahmed’s works often focuses on gender, sexuality and race. They have a clear political orientation and these focus areas make it clear why uncomfortable feelings of not belonging are important starting points in Ahmed’s analyses. When she writes “queer”, the analytical examples are often about non-heterosexual relationships. Drug use has some similarities with sexuality, as both often involve curiosity, pleasure-seeking and desire that directs bodies, making them follow “desire lines” (2006a, p. 19), and can lead to social consequences, such as categorisation and identification. Both sexuality and drug use can also manifest as love relationships (Shulgin and Shulgin 2019; Svensson 1996; Lander 2003, p. 180). But is it really okay to transfer theory designed to illuminate racist, misogynist and heteronormative structures to analyse something that may seem as banal and temporary as the use of drugs?

As previous research has shown, drug use does not have to be banal or temporary, but can have a crucial impact on how people are valued, and their ability to move around in the world (e.g. Boyd 2004; Campbell and Ettorre 2011; Du Rose 2015). But even the most banal drug use occurs, as we will see in the empirical chapters, in relation to risks of changes in value. Such changes do not occur in a vacuum but are in turn linked to other power relations, as queer phenomenology makes visible. But I have also wondered whether there is a risk of undermining the concept of queer when it is used in research that does not focus on sexuality.

Ahmed uses the word queer both in the sense of the expression of something strange or deviant and in the sense of non-straight sexuality or non-heterosexual (2006b, p. 565). She writes that she thinks it is important to emphasise both of these meanings so that the concept retains its full breadth with a common historical origin, without the meanings being reducible to each other. She writes:

This means recalling what makes specific sexualities describable as queer in the first place: that is, that they are seen as odd, bent, twisted. The root of the word queer is from the Greek for cross, oblique, adverse. The word might allow us to ‘twist’ between sexual and social registers, without flattening them or reducing them to a single line. Although we risk losing the specificity of queer as a commitment to a life of sexual deviation, we would also sustain the significance of deviation in what makes queer lives queer. (ibid., p. 565)

The significance of the odd, bent and twisted, rooted in spatial meanings such as cross and adverse, allows the concept of queer to twist, according to Ahmed. It does not need to be straightened out but can retain both its sexual and its social dimensions, which she points out is fundamental to why queer lives are queer. At the same time, she sees a risk that such use could cause the concept to lose its sexual meaning. The direction of desire, in the case of drug use a direction towards psychoactive substances, could be interpreted as interesting for a semi-queer phenomenology. The use is not necessarily either queer (deviant) or queer (sexuality). Can an activity such as drug use be analysed within this tradition of ideas without detaching it from its association with sexually deviant lives?

It can also be argued that sexuality is based on a technical-biological bodily starting point, which is highlighted particularly clearly by postmodern transsexuality. The philosopher Paul B. Preciado, who himself uses testosterone, describes the use of pharmacological preparations as an integral, non-natural part of being human in the postmodern world (2013, p. 35). The picture he paints when describing the extent of the global industries behind technological inventions intended to change the body and consciousness, such as medicines, prostheses, sex aids and drugs, depicts the human living in that world as a cyborg. This is in reference to Donna Haraway’s concept of the human being as a fusion of body and technology (Haraway 1991). Preciado argues that Judith Butler’s analysis of gender as performative acts that produce the subjects they claim to describe has now been pushed even further into the body. Nowadays, he argues, even organs, cells, bodily fluids, chromosomes and genes are about performative production (2013, p. 110). If we are all cyborgs living as techno-biological beings, such subjectivity is not queer per se, but Preciado argues that the strategic use of technological possibilities can implode the dichotomous divisions between men and women, hetero- and homosexuality and so on. On the other hand, technological solutions can also be used to reinforce these very dichotomies. Whether psychoactive drugs queer sexuality therefore becomes a subjective, or at least contextual, issue, which is also related to class and opportunities for performativity (cf. Skeggs 2004, p. 67). However, in this book, the concept of queer is primarily used to analyse dichotomies and norms that are bent, crossed and resisted, and it is not my intention to hollow out the important meaning of non-straight sexualities as queer, but rather to elaborate on the potentials of queerness.

8 The Concepts of Lines and Orientation

The concept of lines is important in this book. It is used in a way that emphasises its starting point, the body: where the body is located and the perspectives that are made possible from there. I perceive experiences of being oriented and from there pointing out a direction, being in line with a direction or, conversely, not being in line and experiencing disorientation, as complex and sometimes contradictory, everyday and constantly changing experiences. Ahmed makes normative lines visible as “straight lines”. This has a double meaning: both as “thick” and persistent lines that have been followed by many and as straight lines not designed for queer people (2006b, pp. 554ff.). She argues that following “straight lines” can be rewarding (2006a, p. 179; 2010, p. 115). At the same time, people can avoid following normative lines, for example by fighting against racism or living their life as a queer person. Both normative and non-normative lines can thus provide experiences of being oriented and, depending on the context, the line can be about either following or staking out. The use of drugs can in itself be a deviation from a thick, straight and normative line. However, using them can also be about following such a line, for example when controlled drugs are prescribed. According to phenomenology, orienting oneself in a certain direction and moving in that direction is an intentional act. But intentions change along the path, and the use of drugs can change intentions in an instant, and it is therefore specifically interesting to theorise phenomenologically. How are lines affected by the use of drugs?

Ahmed describes the intention to direct oneself and approach something as being linked to desires and to points along the lines that are being followed. For example, getting married and having children are points along a normative line (2010, p. 91). Lines therefore take the form of conceptions of long lines, such as a “straight line”, an expected line where the goal is happiness and many points are visible from afar. But lines can also be deviant, winding, uncertain, diffuse or interrupted. In empirical material, a winding line can look short, like a sudden detour without any thought for the future, towards something that has appeared in the field of vision—for example a decision to try heroin—as an effect of being oriented in that direction (2006a, pp. 15, 27). Such a line can turn out to run parallel with longer lines, maybe a childhood decision to try all drugs and become someone who did. However, from the point of trying, the line can also develop in new directions. The visual field changes as the body moves, from a certain point the world unfolds in a different way than it did before that point had been reached (ibid., pp. 28ff.). From the body’s here and now, further orientation takes place, and this is always shaped by factors such as gender and class. Ahmed writes:

Orientations are about how we begin, how we proceed from here. […] The starting point for orientation is the point from which the world unfolds: the here of the body and the where of its dwelling. (2006b, p. 545)

This is a central starting point for this book’s focus on the use of drugs. Orientation is based on a situated body and drug use changes the vantage point, the body’s experience of how the world develops. This can be significant both for further orientation and for how lines are followed and what appears in the field of vision. But the body’s starting point is also situated. Where it lives or is usually located, its historical and current social and material contexts shape how the lines are drawn.

9 Respectability and Value

Phenomenology’s starting point in the body is complemented by queer phenomenology’s focus on the power relations and material conditions that surround that body. The perspective is thus broadened by being queered. As it has been necessary to understand how ethnographic material can be analysed in relation to class, the queer phenomenology in this book is further broadened and queered by many other theoretical inputs, the most significant being sociologist Beverley Skeggs’ (1998, 2004) theory of class.

Skeggs has conducted a number of ethnographic studies with a primary focus on class. She describes class categorisations as the middle class’s effort to construct itself as the moral, modern, knowledgeable, clean and reliable social group. But, for these values to mean anything, a counterpart is needed, a class whose members are defined from the perspective of the middle class as failing on every point (cf. 2004, p. 6). She writes:

What we read as objective class divisions are produced and maintained by the middle-class in the minutiae of everyday practice, as judgements of culture are put into effect. Any judgement of the working-class as negative (waste, excess, vulgar, unmodern, authentic, etc.) is an attempt by the middle-class to accrue value. This is what the representations of the working-class should be seen to be about; they have absolutely nothing to do with the working-class themselves, but are about the middle-class creating value for themselves in a myriad of ways, through distance, denigration and disgust as well as appropriation and affect of attribution. (2004, p. 118)

Skeggs’ definition can thus be interpreted as meaning that the descriptor “working class” is rather about the constant work to constitute the middle class, without any payment. On the contrary, the working class is put into positions from which it is difficult to accumulate capital. Being in a vulnerable social position is a concrete, lived experience with very tangible consequences (Skeggs 2011, p. 503), but the concept of class is not inherent in either people or things. It is intended to raise the analysis of lived experiences to an abstract level, where questions can be asked about how class constructions operate.

Skeggs describes class as closely linked to respectability and thus morality. A person who lacks respectability has low social value and weak legitimacy (1998, p. 3), which can be transferred to the meaning of low class. Instead, she shows that having respectability and morality is an inherent part of how the middle class has been constructed historically. She writes:

Respectability embodies moral authority: those who are respectable have it, those who are not do not. But only some groups were considered to be capable of being moral, others were seen to be in need of control. (1998, p. 3)

According to Skeggs, this relationship has continued unabated and permeates society at all levels. She states that, among other things, this means that the middle class is attributed individuality, a unique way of being, unlike the working class. Managing individuality through choice, Skeggs argues, is a coercive, capitalist norm for the middle class that aims to increase the value of the self (2004, p. 140). These choices are thus made from a class position with access to cultural, moral capital. She writes:

Using culture as a resource is one of the ways morality is coded into social relations and institutionalized through property relations, most obviously institutionalized through law. Morality is always present in the ‘social contract’, through the ways we know and relate to others in civil society. (ibid., p. 174)

However, expressing the complex self requires access to exciting cultural expressions which, paradoxically, are often appropriated from the working-class community (ibid., p. 105). What is taken and managed, however, is not the same as that which was held, and the change is determined by the relationship (ibid., p. 12). Applying such an analysis—in which moral authority is attributed to some groups in society while others lack it—to the subject of this book means that the act of drug use per se is loosened from moral judgements. It indicates a fluid valuation of drugs if the morality of an action is determined by the class-based morality of the actor. The drug then takes on different meanings depending on who is handling it. Several drug researchers have pointed this out with regard to opium, amphetamines and tobacco, for example, all of which have made downward class journeys to the same extent as they have become popular with the working class (Berg 2016; Edman and Olsson 2014; Berridge 2013). At the same time, socially vulnerable people who use drugs, as described above, have just as rapidly been formulated as constituting a societal problem, even as being “public enemy number one” (see, e.g., Nelson 2021). A number of researchers (see Chapter 2) have argued that ideological positions—which have been aimed, not at helping people who use drugs but at disciplining them, although often lacking the resources to do so (Lander 2003, pp. 259f., 301)—have caused a large number of unnecessary deaths. How do people become so worthless?

Conceptions of certain social groups as threats to the nation have a long history. Post-colonial scholar Anne McClintock links the emergence of the class concept to imperialist and racist ideas (see also Johannisson 1995, p. 81) about “degenerate classes”:

The degenerate classes, defined as departures from the normal human type, were as necessary to the self-definition of the middle class as the idea of degeneration was to the idea of progress, for the distance along the path of progress traveled by some portions of humanity could be measured only by the distance others lagged behind. […] Normality thus emerged as a product of deviance, and the baroque invention of clusters of degenerate types highlighted the boundaries of the normal. (McClintock 1995, p. 46)

Thus, according to McClintock, degeneracy, a term used to define those classes considered non-normal, was necessary for notions of social progress. This brought together notions that gave rise to middle-class racial categorisations and their view of the non-respectable working class (which differed from the respectable working class, who could and would work, see ibid., footnote 56, p. 401) into a common image of “dangerous classes”. Such notions, Skeggs argues, take on a tautological character, placing people in positions that in turn affect their access to cultural and economic resources (1998, p. 5). The notion of the working class as a mass of non-individuals who are pathologised and alienated, she argues, is still very much at work in both academic and popular representations (1998, p. 3, see also 2004, pp. 173ff.). Skeggs gives the example of descriptions of “welfare mothers” or “crack babies” in the USA and shows how these are based on historical thought constructions that give the concepts their meaning (1998, p. 3). She writes that the damage and wounds inflicted upon those who are not recognised as human beings are not recognised either (2004, p. 184).

The picture of successful women’s individualised use of drugs, in contrast to their use by vulnerable, anonymous people, which I drew at the beginning, can be interpreted from a historical perspective as rendering the drug use of the working class dangerous and pathological but expected, as the group is already considered degenerate. The use of drugs by successful women becomes part of their complex individual selves. But isn’t drug use generally pathologised, albeit in different ways for different social groups? In her book The Dark ContinentFootnote 14 (1995), the historian of ideas Karin Johannisson describes how women from both the upper and lower classes were considered malfunctioning in the nineteenth century. The upper-class woman, she writes, was weak, fragile and sickly, while the lower-class woman was strong, dangerous and contagious (ibid., p. 14). However, the weak body was not a defect but a mark of nobility. It was highly valued as imbued with soul, while strong and capable bodies were good only for work (ibid., p. 81). She writes:

Through a kind of collective projection, the underclass took on the physicality – dirt, smell, sound, and sexuality – that the bourgeoisie had sorted out from its own culture through long processes of disciplining. The underclass became the carrier of the forbidden impulses. It was identified with the lower and more primitive, a residual product of past stages of development: it drank, slurped and copulated unconcerned with the progress of civilization. (Johannisson, 1995, p. 81)

The dirty, impulse-driven physicality of the lower class, even though—or indeed because—it was strong and fit for work, thus became a sign of degeneration, which was contrasted with a weak, civilised body. However, the view of the upper-class woman’s morbidity changed and in the twentieth century began to be regarded as a problem (ibid., p. 92). Weak women could not give birth to strong children. The view of middle-class women’s health swung instead towards notions of moral responsibility to take care of oneself. This has similarities with how the modern individual in the consumer society is expected to invest in her own health (cf. Lupton, 2012, chapter 2, pp. 13ff.), and who makes herself valuable by making choices through consumption (Skeggs 2004, pp. 56ff.). These choices, which are required and made, demonstrate morality, but now they also need to show individuality, which according to Skeggs is achieved through performative reflexivity. She describes the contradiction between demands for a sense of moral duty and hedonistic consumption that renders individuality an ethical problem, inherent in the premises of capitalism, which is overcome by the ability to demand recognition of one’s pain (2004, p. 184). How the actual performance of individuality is achieved thus constitutes both morality and other components of a valuable self (ibid., pp. 56ff., see also pp. 119ff.).

Whether performative individuality is performed at all, and how it is valued, is related to the resources available. Skeggs uses French sociologist Pierre Bourdieu’s conceptual apparatus to theorise middle-class capital. Four forms of class-defining capital serve as the basis for his concept of class: economic capital (which is about money), cultural capital (which includes institutionalised capital such as education, objectified capital in the form of cultural affiliations, and embodied capital such as habitusFootnote 15), social capital (that is, a person’s social network) and symbolic capital (Bourdieu 2010). In simple terms, his class theory means that the first three forms of capital are anchored in concrete assets. However, none of these assets functions as a status-enhancing class definition in all contexts. They must be recognised by the environment as class markers in order to become symbolic. On the basis of this type of capital, valuable selves can thus be expressed. But one problem is that, according to Bourdieu’s theory, being working class is defined as lack, and it becomes difficult to analyse values that do not fit into middle-class capital metaphors.

Some time after Skeggs’ book Becoming Respectable: Constructions of Class and Gender (1998) was published, she realised that respectability was really about value (2012, p. 69). What the women in her study were constantly fighting for was to establish and maintain their value, she writes. But Bourdieu’s capital metaphors are not sufficient to theorise the value of the working class, i.e. a social group constituted as scarcity (Skeggs 2011, pp. 501ff.). His metaphors are about values that are regarded as valuable according to the capitalist logic of the middle class, i.e. as market values. Instead, Skeggs argues that we need an analysis that allows us to see personal values, which the bourgeois gaze does not perceive (2011, p. 496), such as integrity, care and love (ibid., p. 504). In this book, I have thus strived to move beyond the capital metaphors. However, to do so in an academic text from an academic position integrated into the perspectives that underlie the entire academic conceptual apparatus is difficult, but aided by the use of a power-sensitive approach, aiming to view the world as it unfolds from the bodily positions of the interviewees. However, the analysis reveals spaces for value beyond the metaphors of capital, rather than a new conceptual apparatus for value. A new language for these spaces is needed.

10 Disposition

I want to emphasise that drug use linked to gender and class could be researched in countless ways. This is true of all research subjects, but in this book, which sheds light on the subject from many angles, it is important to emphasise that the study is not an attempt to get a grip on drug use as a whole. The themes that have emerged are about interesting issues that came to light from a queer phenomenological perspective that makes class and gender visible.

Drugs are a topic that evokes strong emotions. Talking about drugs makes people stop in their tracks and raise their eyebrows. At the same time, it is a subject about which few people have in-depth knowledge. This combination of strong emotions and vague understandings of the subject makes it important to ask some basic questions before turning to the interview material in the book. These questions are: What exactly is a drug? How do drugs relate to medicines? How did they come onto the market, where are they now and how are they used in Sweden? What does the research on drugs look like, and how did the drug use that was criminalised become illegal? These are all questions that need to be answered to some extent in order to contextualise the interview material and position the study.

11 Part I

The first part of the book, after this introduction, therefore consists of a background chapter: Drugs, Alcohol and Medicine in Sweden. Here, I examine how drugs have become meaningful and what this has to do with class and gender. Under the heading Drug Laws and Drug Culture, I show how drugs first came into use in the Western world, how they spread and how different substances and preparations came to be regarded from a legal and moral perspective. Why is alcohol not obviously perceived as a drug and what role do class and gender play in the laws and moral positions related to intoxication? In the third section, Drugs and Women, I examine the legal market for controlled medicines and its connection to women. Why do women use more medicines but fewer illicit drugs than men? This has to do with how women’s drug use has been constructed historically, and how the effects of different substances can be related to gender and class.

In 1968, the Narcotics Penalty Act came into force, and from then onwards, certain drugs became more strictly regulated. The fourth section, Sweden’s Drug Problem from the 1960s Onwards, examines how this happened and explains how illness and social deviation have been two influential perspectives on how drug use is viewed, with roots extending far back in history. This is reflected in the remarkable gap between drug policy and drug research in Sweden since the 1980s, when repressive policies have been fiercely debated. The last section, Qualitative Research on People Who Use Drugs, looks into studies based on fieldwork and interviews with people who use drugs, especially women. The majority of such studies, and drug research in general, focus on socially marginalised people who use drugs. In this book, I argue that such a focus helps to shape the understanding of drugs and drug use in Sweden. When coupled only with marginalised people who use drugs, moral condemnation of drugs and drug use that builds on that research will be directed towards a specific group of people, rather than the substances and their use.

12 Part II

The second part of the book begins where the interviewees began their use of drugs. The First Visits explores how the women encountered drugs for the first time. The interviewees describe their use in spatial terms and I elaborate on the metaphor of a gateway into drugs, and the Swedish metaphor of a knarkträsk—a drug swamp—signifying problem-use contexts, as cultural reference points. I then look at where they went from their first encounters with drugs, and how these movements in space relate to class.

The next chapter, Avoiding the Knarkare, delves into the most threatening images associated with encounters between people and drugs. The Swedish concept of a knarkare—a person who uses drugs—symbolises dirt and danger and is very similar to the most negative images of the working class. But the knarkare has its own symbols, such as the hypodermic syringe that once signified purity, the opposite of dirt. I have examined how the women relate to cultural perceptions of knarkare and how they move close to them or keep their distance while using drugs.

This is followed by the chapter Obtaining Drugs, which also deals with encounters between drugs and people, but this chapter examines how the drugs are acquired in relation to drug markets. The clash between an illegal, masculine-coded and violence-associated market and the ideal drug-induced state, which is described in terms of intimacy and community, is explored. Where does the encounter take place? On what terms? What are the roles of gender and class?

The next chapter, Staying Appropriate, examines how the influence of drugs is lived and embodied, and how the fusion of bodies and drugs creates proximities to and distances from other bodies and objects in time and space. How is an appropriate rhythm of restraint and release through the use of drugs kept up? How are drugs hidden or visible while they are in the body?

In many ways, children were perceived by the women as the symbolic counterpart of drugs, which then also make drug-affected bodies the symbolic counterparts of children. In Behaving with Children, I explore this charged relationship between women who use drugs and children, who are traditionally women’s responsibility to look after. The women describe various strategies to take responsibility, for both symbolic and real-life children.

The chapter Appropriate Drugs deals with the interviewees’ perceptions of the legitimacy of drug use. Here, the initial focus is on legally prescribed drugs. The interviewees’ approach to drugs is analysed in a social context where psychiatric medication is common and often prescribed, but also involves a link to illness and control. The use of illegal drugs can then, in direct contrast to their reputation, represent health and self-control for some of the women, if they have the right resources.

This is followed by the chapter Negotiating Addiction, which examines the meanings of addiction from a phenomenological perspective, using Sara Ahmed’s concept of lines in relation to the makings of class. How can the relationship between fear of addiction and the desire to use certain drugs but not others be understood? The women’s experiences of pleasure as crucial to the development of addiction are explored, as well as the relationship between addiction and middle-class ideals of self-actualisation and development.

The chapter Happy Using Drugs? then addresses the charged and ethically problematic relationship between positive emotions and drug use. Such feelings are important motivations for using drugs, but are experienced and described in constant contrast to the opposite of happiness, misery. Is drug-related happiness false? How do respondents deal with their drug-induced happiness?

The chapter, Is It Ok to Laugh?, focuses on the drug-use-related expression of laughter. The discussion on research ethics linked to the interviewees’ positive feelings evoked by drug use is deepened, with a focus on subsequent laughter and humour as aspects of drug use. The chapter explores the meaning of laughter at drug use from a gender perspective and the specificity in the pattern of the funny stories the women told. These narrations challenge the stereotype of them as mad, sad and bad in positioning them as temporarily mad, but funny and even heroic in their madness.

In the Conclusions, I argue that the findings of variety in how drugs are used, and the women’s thought-provoking motives and considerations regarding drug use, which have been discussed throughout the book, highlight the discrepancy between drug use as a seemingly fixed and delimited problem, and the multitude of meanings and uses that it can actually have. This book calls for an intersectional revision of what drug use is, and how problems regarding drugs should be tackled, that takes social, material and cultural conditions into account. The world is not drug-free, and the changes of perspective in drug use, as well as the risks, depend upon the point in the world where that drug use takes place.

The appendix Drugs and Medicines is a list of the various substances and preparations used by the women participating in the study. It aims to bring these usually hidden objects into the light, thus demystifying them. This is in order to provide greater insight into what the interviewees are talking about. This chapter describes the objects’ appearance, history, described effects and uses.