May 22, 2015

The Clinic and Elsewhere

Addiction, Adolescents, and the Afterlife of Therapy

Todd Meyers

Hosted by Monique Dufour

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Summary

Todd Meyers' The Clinic and Elsewhere: Addiction, Adolescents, and the Afterlife of Therapy (University of Washington Press, 2013) is many things, all of them compelling and fully realized. Most directly, the book is an ethnography of drug dependence and treatment among adolescents in Baltimore between 2005-2008. Meyers traces twelve people through their treatment in the clinic and beyond, into what he calls "the afterlife of therapy." The group of adolescents was diverse--their economic and family circumstances, their demographics, and arc of their narratives from addiction to treatment varied widely. Yet they shared at least one important experience: "each had either been enrolled in a clinical trial or were currently being treated with a relatively new drug for opiate withdrawal and replacement therapy: buprenorphine" (4). In this way, the book is also the story of a pharmaceutical making its way and its mark in the worlds of therapeutics, law, public opinion and, especially, in the lives of its users. Meyers shows how the lives and experiences of these adolescents (as well as others in their lives) were often shaped and constrained by their roles as subjects in pharmaceutical trials evaluating the effectiveness of buprenorphine. Moreover, Meyers looks beyond the questions and answers asked and answered under the constraints of randomized controlled trials. Rather, as he puts it, "my ethnographic gaze is fixed upon the intersection of clinical medicine and social life, at the place where medical and pharmacological subjects are constituted under the sign of therapeutics" (17). As a result, The Clinic as Elsewhere locates palpable places where medicine and the social intersect in the material world and lived experience; as readers, we see the relationship between the medical and the social as much as understand it as a conceptual given. Ultimately, Meyers shows how therapeutics is not only a form of intervention, but a "sign": under which people are constituted as subjects, and with which people "assign value, meaning, and worth assign value to pharmaceutical intervention" (116).