Addiction Trajectories ed. by Eugene Raikhel and William Garriott (review)

Accomplishment of a book’s stated goals becomes especially difficult when different authors have written the book’s component chapters. Addiction Trajectories largely succeeds in keeping its overall thrust together throughout the introduction, ten chapters, and afterword contained between its covers. Eugene Raikhel and William Garriott, the two editors, conceived of an apt image in furtherance of the volume’s intentions—the trajectory. It has often been the wont of anthropologists who study drug users to focus on the life histories of the participants in their research, and the single most evocative metaphor for drug users’ histories of drug use is some sort of curvilinear tracing of drug use, remission, recidivism, nadir, or “hitting bottom,” and resurgence, among other features.

The book’s introduction for its concept of the trajectory familiarizes the reader with its key aspects, emphasizing movement, therapy, and experience. Each of the chapters addresses parts of the human trajectory of addiction, from hopelessness engendered by the nexus between personal tragedy and recidivism, as in Angela Garcia’s narrative about Alma, to the “pharmaceutical optimism” (p. 238) described in Nancy Campbell’s chapter on neuroimaging and popular perception. Some of the most edifying perspectives in any of the book’s chapters appear in Natasha Dow Schüll’s analysis of machine-based gambling in Nevada. The duality of meditation and medication, serving as both a treatment and as a trigger for going into “the zone” in which addicted gamblers go out of control, provides a cautionary tale for those who would intervene among machine gamblers. Molly, one of Schüll’s study participants, contributes a cognitive map of her day that succinctly points out the key features of daily routine that present risk of recidivism. This kind of concrete illustration of the addict’s human circumstances shows the reader just how risk laden the addict’s personal environment may be.

Todd Meyers’s chapter on adolescent addicts in Baltimore succeeds somewhat less than other chapters, although to his credit, he points out that addicts in circumstances of pharmaceutic treatment occupy a kind of liminal space that neither they nor the public media completely comprehend. Helena Hansen’s chapter deals with buprenorphine treatment and likens the role of Pentecostal Christianity in the recruitment and ongoing participation of recovering addicts into roles of religious leadership to the adoption of buprenorphine therapy. Two communities, one in Puerto Rico and the other in New York, exemplify these processes.

Narcology, as presented by Anne Lovell, comes under comparative scrutiny, but it needs more material like the chapter’s striking final pages that describe the contrasts between Marseillaise and Russian clientele of French treatment centers. E. Summerson Carr’s chapter on denial and self-talk as therapeutic tools adroitly brings the reader into the philosophy and goals of psychotherapy as they are practiced in drug treatment centers, raising important questions about the nature of denial, and the potential of encouraging positive self-talk to achieve the goals of drug treatment.

Eugene Raikhel’s discussion of deceptive placebo use in the Russian tradition of kimzashchita constitutes some of the most lucid and revelatory narratives on the practice of narcology ever seen in the literature. His likening of the disulfiram deception to the creation of a “prosthesis for the will” (p. 190) in a system that does not require treatment patients to take responsibility for their self-destructive actions is inspired. Based on West Virginia’s methamphetamine using population and their institutional criminalization by local constabulary and other authorities, Garriott brings the reader into a difficult community-wide dilemma and the inhabitants’ adaptation to it. The chapter’s final quotes of key informants, who make assertions that the addict population is impossible to control, add a tone of pessimism that seems appropriate for most of the rest of the book.

In her final chapter on the disciplinary stakes in current approaches to addiction and the “war on drugs,” A. Jamie Saris invokes the issue...