At the Expense of a Life: Race, Class, and the Meaning of Buprenorphine in Pharmaceuticalized “Care”

Alexandrea E. Hatcher, Sonia Mendoza, Helena Hansen

    Research output: Contribution to journalArticle

    Abstract

    Background/Objective: Office-based buprenorphine maintenance has been legalized and promoted as a treatment approach that not only expands access to care, but also reduces the stigma of addiction treatment by placing it in a mainstream clinical setting. At the same time, there are differences in buprenorphine treatment utilization by race, ethnicity, and socioeconomic status. Methods: This article draws on qualitative data from interviews with 77 diverse patients receiving buprenorphine in a primary care clinic and two outpatient substance dependence clinics to examine differences in patients' experiences of stigma in relation their need for psychosocial supports and services. Results: Management of stigma and perception of social needs varied significantly by ethnicity, race and SES, with white educated patients best able to capitalize on the medical focus and confidentiality of office-based buprenorphine, given that they have other sources of support outside of the clinic, and Black or Latino/a low income patients experiencing office-based buprenorphine treatment as isolating. Conclusion: Drawing on Agamben's theory of “bare life,” and on the theory of intersectionality, the article argues that without attention to the multiple oppressions and survival needs of addiction patients who are further stigmatized by race and class, buprenorphine treatment can become a form of clinical abandonment.

    Original languageEnglish (US)
    Pages (from-to)301-310
    Number of pages10
    JournalSubstance Use and Misuse
    Volume53
    Issue number2
    DOIs
    StatePublished - Jan 28 2018

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    Keywords

    • Medication assisted treatment
    • addiction
    • intersectionality
    • multiple oppressions
    • race
    • socioeconomic status
    • stigma
    • structural violence

    ASJC Scopus subject areas

    • Health(social science)
    • Medicine (miscellaneous)
    • Public Health, Environmental and Occupational Health
    • Psychiatry and Mental health

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