Two tiers of biomedicalization: METHADONE buprenorphine and the racial politics of addiction treatment

Helena Hansen, Samuel K. Roberts

    Research output: Chapter in Book/Report/Conference proceedingChapter

    Abstract

    Purpose - To compare the histories of two opioid medications that are pharmacologically similar but subject to contrasting regulations in their use in treatment of opiate dependence in the United States - methadone and buprenorphine - in order to analyze the role of racial imagery and racial politics in the legalization and clinical promotion of their use. Methodology/approach - Historical methods of archival analysis of published articles and unpublished governmental records were used in researching methadone. Ethnographic methods of participant observation and semistructured interviews were used in researching buprenorphine. Findings - Contrasting uses of racial imagery played a major role in shaping the current regulatory differences between the two treatments. The association of methadone with black and Latino heroin users has contributed to its increased federal regulation while the association of buprenorphine with white middle class prescription opioid users enabled its use in deregulated private physicians' offices. Originality/value of paper - Advocates of biomedicalization of behaviors and conditions thought of as social or moral such as addiction argue that biomedicalization reduces the stigma of the condition and imply that in turn it also reduces the racial inequalities associated with the condition. This study of the biomedicalization of treatment for opioid dependence indicates that the very process of biomedicalization depended on heightened racial imagery associated with each treatment and ultimately intensified rather than reduced the stigma of addiction for black and Latino low-income patients.

    Original languageEnglish (US)
    Title of host publicationCritical Perspectives on Addiction
    Pages79-102
    Number of pages24
    Volume14
    DOIs
    StatePublished - 2012

    Publication series

    NameAdvances in Medical Sociology
    Volume14
    ISSN (Print)1057-6290

    Fingerprint

    Buprenorphine
    Politics
    addiction
    Imagery (Psychotherapy)
    Methadone
    medication
    Opioid Analgesics
    regulation
    legalization
    politics
    participant observation
    Hispanic Americans
    middle class
    low income
    promotion
    physician
    Opioid-Related Disorders
    Physicians' Offices
    Heroin
    methodology

    Keywords

    • Biomedicalization
    • Buprenorphine treatment
    • Medicalization
    • Methadone maintenance
    • Opiate addiction
    • Race

    ASJC Scopus subject areas

    • Health(social science)
    • Public Health, Environmental and Occupational Health

    Cite this

    Hansen, H., & Roberts, S. K. (2012). Two tiers of biomedicalization: METHADONE buprenorphine and the racial politics of addiction treatment. In Critical Perspectives on Addiction (Vol. 14, pp. 79-102). (Advances in Medical Sociology; Vol. 14). https://doi.org/10.1108/S1057-6290(2012)0000014008

    Two tiers of biomedicalization : METHADONE buprenorphine and the racial politics of addiction treatment. / Hansen, Helena; Roberts, Samuel K.

    Critical Perspectives on Addiction. Vol. 14 2012. p. 79-102 (Advances in Medical Sociology; Vol. 14).

    Research output: Chapter in Book/Report/Conference proceedingChapter

    Hansen, H & Roberts, SK 2012, Two tiers of biomedicalization: METHADONE buprenorphine and the racial politics of addiction treatment. in Critical Perspectives on Addiction. vol. 14, Advances in Medical Sociology, vol. 14, pp. 79-102. https://doi.org/10.1108/S1057-6290(2012)0000014008
    Hansen H, Roberts SK. Two tiers of biomedicalization: METHADONE buprenorphine and the racial politics of addiction treatment. In Critical Perspectives on Addiction. Vol. 14. 2012. p. 79-102. (Advances in Medical Sociology). https://doi.org/10.1108/S1057-6290(2012)0000014008
    Hansen, Helena ; Roberts, Samuel K. / Two tiers of biomedicalization : METHADONE buprenorphine and the racial politics of addiction treatment. Critical Perspectives on Addiction. Vol. 14 2012. pp. 79-102 (Advances in Medical Sociology).
    @inbook{9453af4e2c6b4fc0a7008d2864d5191c,
    title = "Two tiers of biomedicalization: METHADONE buprenorphine and the racial politics of addiction treatment",
    abstract = "Purpose - To compare the histories of two opioid medications that are pharmacologically similar but subject to contrasting regulations in their use in treatment of opiate dependence in the United States - methadone and buprenorphine - in order to analyze the role of racial imagery and racial politics in the legalization and clinical promotion of their use. Methodology/approach - Historical methods of archival analysis of published articles and unpublished governmental records were used in researching methadone. Ethnographic methods of participant observation and semistructured interviews were used in researching buprenorphine. Findings - Contrasting uses of racial imagery played a major role in shaping the current regulatory differences between the two treatments. The association of methadone with black and Latino heroin users has contributed to its increased federal regulation while the association of buprenorphine with white middle class prescription opioid users enabled its use in deregulated private physicians' offices. Originality/value of paper - Advocates of biomedicalization of behaviors and conditions thought of as social or moral such as addiction argue that biomedicalization reduces the stigma of the condition and imply that in turn it also reduces the racial inequalities associated with the condition. This study of the biomedicalization of treatment for opioid dependence indicates that the very process of biomedicalization depended on heightened racial imagery associated with each treatment and ultimately intensified rather than reduced the stigma of addiction for black and Latino low-income patients.",
    keywords = "Biomedicalization, Buprenorphine treatment, Medicalization, Methadone maintenance, Opiate addiction, Race",
    author = "Helena Hansen and Roberts, {Samuel K.}",
    year = "2012",
    doi = "10.1108/S1057-6290(2012)0000014008",
    language = "English (US)",
    isbn = "9781780529301",
    volume = "14",
    series = "Advances in Medical Sociology",
    pages = "79--102",
    booktitle = "Critical Perspectives on Addiction",

    }

    TY - CHAP

    T1 - Two tiers of biomedicalization

    T2 - METHADONE buprenorphine and the racial politics of addiction treatment

    AU - Hansen, Helena

    AU - Roberts, Samuel K.

    PY - 2012

    Y1 - 2012

    N2 - Purpose - To compare the histories of two opioid medications that are pharmacologically similar but subject to contrasting regulations in their use in treatment of opiate dependence in the United States - methadone and buprenorphine - in order to analyze the role of racial imagery and racial politics in the legalization and clinical promotion of their use. Methodology/approach - Historical methods of archival analysis of published articles and unpublished governmental records were used in researching methadone. Ethnographic methods of participant observation and semistructured interviews were used in researching buprenorphine. Findings - Contrasting uses of racial imagery played a major role in shaping the current regulatory differences between the two treatments. The association of methadone with black and Latino heroin users has contributed to its increased federal regulation while the association of buprenorphine with white middle class prescription opioid users enabled its use in deregulated private physicians' offices. Originality/value of paper - Advocates of biomedicalization of behaviors and conditions thought of as social or moral such as addiction argue that biomedicalization reduces the stigma of the condition and imply that in turn it also reduces the racial inequalities associated with the condition. This study of the biomedicalization of treatment for opioid dependence indicates that the very process of biomedicalization depended on heightened racial imagery associated with each treatment and ultimately intensified rather than reduced the stigma of addiction for black and Latino low-income patients.

    AB - Purpose - To compare the histories of two opioid medications that are pharmacologically similar but subject to contrasting regulations in their use in treatment of opiate dependence in the United States - methadone and buprenorphine - in order to analyze the role of racial imagery and racial politics in the legalization and clinical promotion of their use. Methodology/approach - Historical methods of archival analysis of published articles and unpublished governmental records were used in researching methadone. Ethnographic methods of participant observation and semistructured interviews were used in researching buprenorphine. Findings - Contrasting uses of racial imagery played a major role in shaping the current regulatory differences between the two treatments. The association of methadone with black and Latino heroin users has contributed to its increased federal regulation while the association of buprenorphine with white middle class prescription opioid users enabled its use in deregulated private physicians' offices. Originality/value of paper - Advocates of biomedicalization of behaviors and conditions thought of as social or moral such as addiction argue that biomedicalization reduces the stigma of the condition and imply that in turn it also reduces the racial inequalities associated with the condition. This study of the biomedicalization of treatment for opioid dependence indicates that the very process of biomedicalization depended on heightened racial imagery associated with each treatment and ultimately intensified rather than reduced the stigma of addiction for black and Latino low-income patients.

    KW - Biomedicalization

    KW - Buprenorphine treatment

    KW - Medicalization

    KW - Methadone maintenance

    KW - Opiate addiction

    KW - Race

    UR - http://www.scopus.com/inward/record.url?scp=84886444681&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=84886444681&partnerID=8YFLogxK

    U2 - 10.1108/S1057-6290(2012)0000014008

    DO - 10.1108/S1057-6290(2012)0000014008

    M3 - Chapter

    AN - SCOPUS:84886444681

    SN - 9781780529301

    VL - 14

    T3 - Advances in Medical Sociology

    SP - 79

    EP - 102

    BT - Critical Perspectives on Addiction

    ER -