Taking Pleasure in Drugs

The twenty-first century would seem to be a banner era for consumers of drugs. Pharmaceutical advertisements fill televisions, radios, Internet sites, newspapers, and magazines. These ads, the logic goes, empower consumers by alerting them to a wide array of pharmaceutical anodynes: anodynes for illness, to be sure, but also for the conditions that threaten the pleasures of daily living. Drug consumers are no longer the passive supplicants of prior decades, when doctors knew best because pharmaceutical knowledge was the sole domain of medical practitioners. Consumers today are instead active participants in the medication-choosing process. They ask their doctors if Nexium or Celebrex or even Viagra are right for them. They engage in a clinical conversation now structured to respect their opinions and desires. And once they return home from the doctor’s office, they ultimately decide whether to take the medication as directed or go to another doctor and request something else.

One might think, then, that the present day might hold liberatory promise for drug consumers. Yes of course, these consumers risk becoming what Stuart Hall called “cultural dupes,” subjects continually forced to ingest the invisible trappings of capitalist consciousness.¹ Yet the present day also offers new modes of individuation and individualized medicine in which new agents and actors can mold drugs to their own lifestyles, object choices, or personal proclivities.

Kane Race’s serious, erudite, and wholly brilliant book, Pleasure Consuming Medicine: The Queer Politics of Drugs, provides a vital analysis of this seemingly new mode of consumption. Race anatomizes how the progressive possibilities of drugs are undermined by moralizing assumptions about health, behavior, and, ultimately, pleasure. Here the abject desires of patients, rave-goers, illicit drug users, and other persons who produce anxiety in the system beget modes of surveillance that make the panopticon seem quaint by comparison. In Race’s analysis, consumer, patient, legal, and other forms of choice paradoxically produce new forms of “exemplary power” vested in medical authorities, markets, and states. Medicine dictates new modes of self-conduct, and pleasure-producing drugs instead enforce a series of normativizing scripts.

At the same time, Race disrupts the learned helplessness of the Foucauldian inside by demonstrating how real people also derive real forms of agency, control, and, ultimately pleasure in relation to drugs. HIV-positive patients redefine healthy bodies while experiencing the side-effect profiles of anti-HIV medications. Patient communities enact campy game shows that instruct participants about the risks and benefits of medications in nonmoralizing ways. Doctors learn from patients. In these instances and others, Race shows how the meanings of health, illness, pleasure, and consumption are rearticulated in deeply productive ways.

Pleasure Consuming Medicine takes as its jumping-off point the cultures of pleasure surrounding queer party culture in Sydney, Australia, in the late 1990s and early 2000s. A series of parties, events, raves, and other gatherings, intended to provide opportunities for public health officials to promote messages of acceptance, instead created excuses for police and conservative politicians to crack down on “deviant groups and liminal practices” (12). Race highlights the tensions of these moments, in which drug use encapsulates the risks of “postmodern consumption,” to explore how prescription and illicit drug use emerge as tropes “through which different relations to pleasure, consumption, embodiment, and medical authority are sensationalized” (12). Race’s analysis traverses post-1960s discourses — the medical discourse about patient “compliance” and the legal discourse of drug abuse — in which notions of the proper use of drugs become proxies for defining moral personhood. He spends the remainder of the book describing how particular groups of persons subvert moralizing drug economies in ways that create new notions of health and longevity.

To be sure, Pleasure Consuming Medicine promotes a set of arguments that deeply challenges the project of modern “medicine” (a term that Race at times fails to fully define). In line with recent cultural studies critiques of pharmaceuticals, Race positions popular culture as a site that subverts medical and legal knowledges. Race boldly describes medical authority as a...