Society for Medical Anthropology
Oral Presentation Session
As replacements for illegal heroin and prescription opioids, opioid substitution treatment (OST) medications (e.g. methadone or buprenorphine) are believed to eliminate withdrawal symptoms and are assumed to reduce cravings for heroin and other opioids. In the language of OST clinics, the medications make persons who are addicted to opioids “healthy.” Driven by a discourse of harm reduction and the growing need to reduce overdoses worldwide, anthropologists have accepted and promoted this view. Yet, OST patients tell a more nuanced story. They challenge the promises of becoming healthy, but they also raise questions that reinvigorate anthropological inquiry on this subject: What is health and what constitutes a medication’s effect? Is the absence of withdrawals a positive effect of a medication? Are cravings gone once the patient is “properly medicated”? What do we mean by “substitution”?