Introduction

Abstract

Like many other areas of medicine, methadone maintenance treatment (MMT) inspires feelings of intense ambivalence among its consumers. As one of the participants in the study that forms the basis of this book makes clear, methadone is both meat and poison; it is pharmakon in Derrida’s fullest sense in that it combines remedy, toxin and is ‘a means of producing something’.¹ Yet methadone also differs from almost all other areas of medicine in at least one devastatingly important way: it treats a condition widely seen as mainly social in significance. For heroin addiction, accompanied though it is by physical symptoms, and reframed though it has been in recent decades as a medical rather than moral issue, is not considered primarily physical in the sense that diabetes or cancer or heart disease usually are. If it were, it would undoubtedly enjoy more acceptance. Instead, it continues to register in Western discourse firstly as a political, cultural and social problem, a form of ‘deviance’, and, policing aside, methadone is Western liberal society’s main response to it.

Methadone just allows us to be normal, that’s all. It’s no different from a diabetic taking insulin. No different. Best analogy. Or […] a vampire taking his blood every night, or, or a lion getting his meat […] We need it just to stay normal, and that’s it, we’re poisoned, so we need the poison, and that’s all it does, it’s just the same as heroin. Except the only difference is you don’t get a rush […] you’re just normal.

(Cameron, Melbourne, Victoria, client, 42 years old)