Showing papers in "Health Sociology Review in 2010"
TL;DR: The authors examine three recent American cases, which involve suicide, to elucidate how the culture of hegemonic masculinity in the US creates a sense of aggrieved entitlement conducive to violence.
Abstract: School shootings have become more common in the United States in recent years. Yet, as media portrayals of these ‘rampages’ shock the public, the characterisation of this violence obscures an important point: many of these crimes culminate in suicide, and they are almost universally committed by males. We examine three recent American cases, which involve suicide, to elucidate how the culture of hegemonic masculinity in the US creates a sense of aggrieved entitlement conducive to violence. This sense of entitlement simultaneously frames suicide as an appropriate, instrumental behaviour for these males to underscore their violent enactment of masculinity.
163 citations
TL;DR: A brief review of how masculinity has been understood in men's health research can be found in this paper, where a vignette drawn from a study examining young men's responses to the death of a peer is used to illustrate how the communities of practice framework can be applied.
Abstract: Sex comparisons reveal men as more likely than women to die earlier and experience debilitating injury. Historically, this trend has been positioned as somewhat inevitable, an outcome of men’s ‘natural’ biologically charged tendencies for risk-taking and reluctance around help-seeking. More recently, gender research has emerged to describe cultural norms about masculinity and explore their relationships to men’s health and illness practices. Empirically, masculinities and men’s health research has revealed diverse practices that suggest some men’s risky health behaviours are amenable to change. This article provides a brief review of how masculinity has been understood in men’s health research before making recommendations for where we might next go in theorising social constructions of masculinities. Specifically, a vignette drawn from a study examining young men’s responses to the death of a peer is used to illustrate how the communities of practice framework can be applied, and might conceptual...
158 citations
TL;DR: Capacity-building interventions based on social capital, including empowerment, community youth development and collective efficacy models, which can work at the individual and community level in preventive and treatment-based interventions are described.
Abstract: There is an increasing understanding about the importance of social networks in the overall health of individuals. In the past year studies have found that strong social ties could promote brain health as we age; having obese friends increases the risk for obesity; and older people with many friends outlive those with fewer friends. This manuscript describes capacity-building interventions based on social capital, including empowerment, community youth development and collective efficacy models, which can work at the individual and community level in preventive and treatment-based interventions. These interventions allow public health practitioners working with low-income communities to reduce health disparities, promote well-being, and decrease inequalities.
106 citations
TL;DR: It is argued that an anti-colonial analysis of IM provides the ‘missing link’ to understanding the fundamental processes through which biomedicine appropriates CAM, and the reasons it continues to do so.
Abstract: The ideal of combining biomedicine with traditional, complementary and/or alternative medicine (CAM) is now widespread in global healthcare systems. Called integrative medicine (IM) or integrative healthcare (IHC), biomedicine and CAM are being combined in myriad healthcare settings; select medical curricula are incorporating CAM while new ‘integrative’ physicians are graduating; and widescale health policy on CAM is being created by such organisations as the World Health Organization (WHO). While the IM trend is fast developing, little theory has been applied to examining the epistemology of this new health phenomenon and if, in fact, integration between divergent health paradigms is possible. Drawing on an anti-colonial analysis of new IM settings in Canada, we suggest that fundamental challenges exist to integrating biomedicine and CAM that have been largely ignored in the push for integration. They are: (a) the devaluing of non-biomedical health knowledges; (b) accepting only biomedical eviden...
99 citations
TL;DR: The authors explored the intersections of stigma, masculinities, and contemporary fathering in the context of new fatherhood and found that fathers who smoke are viewed as disrupting their responsibilities of protector and provider.
Abstract: In this article, we report on the experiences of men who are smokers in the context of new fatherhood and explore the intersections of stigma, masculinities, and contemporary fathering. The men in this ethnographic study reveal both internalised and externalised stigma and describe situations and feelings when they became aware of the stigmatising qualities of smoking as new fathers. Fathers, expectant and new, are beginning to experience the focus of a punitive gaze previously reserved for expectant and new mothers. This gaze is gendered, and fathers who smoke are viewed as disrupting their responsibilities of protector and provider. The findings provide detail for understanding men’s experiences of smoking-related stigma in Canada where smoking prevalence is relatively low, tobacco is denormalised, and smokers are increasingly stigmatised. To develop effective programming for this underserved group, health professionals must become aware of the unintended consequences of tobacco reduction pressu...
68 citations
TL;DR: In this paper, a qualitative study into Australian manhood featured 63 men discussing "acceptable" masculinity and the potential for violence and emotional damage when the 'humour' moved along a malleable continuum from good-natured banter to abuse.
Abstract: This qualitative study into Australian manhood featured 63 men discussing 'acceptable' masculinity. Homophobic humour emerged as central to the formation of Australian male identity, but it had the potential to induce violence and emotional damage when the 'humour' moved along a malleable continuum from good-natured banter to abuse. Significantly, it was men of all sexualities who were targeted, indicating that it was non-conformity to gender norms as well as sexuality being policed, as boys and men used humour to control and humiliate each other. Recollections of these instances ranged from 'it was just a joke' for some perpetrators, to 'orchestrated cruelty' for men who had been victimised. Some of the latter group reported depression extending into their adult lives based on their youthful experiences. Understanding the impact when humour goes 'beyond a joke' is important for policy makers, educators and healthcare workers, as a potential for emotional damage and physical violence is highlighted. The study highlights the importance of understanding masculinity as an influence on men's health and wellness.
66 citations
TL;DR: The cultural and historical background of the substantial deregulation of alcohol sales in Australia in the last quarter century is described and discussed.
Abstract: The cultural and historical background of the substantial deregulation of alcohol sales in Australia in the last quarter century is described and discussed. Drinking and intoxication was contested ground in Australian history, stereotypically split between the heavy-drinking male world of primary industries and the more feminine world of the suburb. In the temperance era of the late 19th and early 20th century, restrictions on alcohol sales gained ground, epitomised by six o'clock closing adopted during World War I. Alcohol's cultural position shifted after World War II: alcohol problems were redefined in terms of alcoholism, a personal failing, and a cultural-political movement led by the Sydney Bulletin led a successful cultural-political movement to caricature and derogate 'wowsers'. Meanwhile, the alcohol industry moved to identify itself with high-valued features of Australian life. By the 1960s, a dynamic of relaxation of alcohol controls had started, starting with repeal of six o'clock closing and continuing to the present day.
55 citations
TL;DR: This article examined the interplay between masculinities and depression among Canadian-based college men who self-identified or were formally diagnosed with depression and found that depression quashed men's aspirations for embodying masculine ideals, with depression potentially triggered by self-doubt and concerns about harbouring a faulty masculinity.
Abstract: Depression is a significant problem among college men. This qualitative study examines the interplay between masculinities and depression among Canadian-based college men who self-identified or were formally diagnosed with depression. The resulting three themes – mind matters, stalled intimacy and lethargic discontent – reveal the recursive relationships between masculinities and depression whereby depression quashed men's aspirations for embodying masculine ideals, with depression potentially triggered by self-doubt and concerns about harbouring a faulty masculinity. Key findings include participants' juxtaposing their private negative self-talk with attempts to pass as self-assured in public; anxieties about neediness and vulnerability negating their efforts to initiate or maintain an intimate relationship; and ruptured ideologies about a mind–body dualism whereby severe depression negatively impacted physical wellbeing.
51 citations
TL;DR: The authors used qualitative interviews to analyse gay men's embodiment practices in relation to discourses and norms that can be found across and beyond any coherent notion of ‘gay subculture' and reveal body image to be more complex than a limited focus on subculture or dissatisfaction can account for.
Abstract: The emphasis on a sexualised muscular body ideal in gay social and cultural settings has been described as facilitating body image dissatisfaction among gay men. Drawing on a concept of reflexive embodiment, this paper uses qualitative interviews to analyse gay men’s embodiment practices in relation to discourses and norms that can be found across and beyond any coherent notion of ‘gay subculture’. The findings reveal body image to be more complex than a limited focus on subculture or dissatisfaction can account for. In particular, gay men negotiate a gay pride discourse in which the muscular male body generates both social status and self-esteem, and deploy notions of everyday masculinity that imply rationality and control to resist gendered assumptions about gay men’s body image relationships.
47 citations
TL;DR: The authors examined the perspectives on fatness and food choice among Black and White women and men living in Vancouver and Halifax, Canada, and found that people do generate, reflect and resist the norms and standards set for them, including those that relate to food/weight.
Abstract: Despite recent critiques of contemporary obesity discourses that link ‘modern Western lifestyles’ to an ‘obesity epidemic’, the population’s weight remains a central concern of current dietary guidelines. Food choices that are considered beneficial to maintaining a certain weight are understood to play a key role in one’s health. This concern reflects medico-moral assumptions about the properties of food and what people should eat. However, the impact of obesity discourses on different individuals and social groups is rarely considered, although there is some evidence that people do generate, reflect and resist the norms and standards set for them, including those that relate to food/weight. In this paper, we will examine the perspectives on fatness and food choice amongst Black and White women and men living in Vancouver and Halifax, Canada. With this examination, we will challenge conventional assumptions about the singular ‘modern Western lifestyle’ that leads to obesity concerns by teasing out...
46 citations
TL;DR: In this article, the authors examine the mobilisation of notions of responsibility and consumption in these discussions, and consider the implications they have for women as mothers, and explore the potential conflicts mothers face as care providers and nurturers when responsible care is framed as withholding or managing the food consumption of children.
Abstract: Contemporary Western societies focus considerable policy and media attention on the 'epidemic of childhood obesity'. In this paper we examine the mobilisation of notions of responsibility and consumption in these discussions, and consider the implications they have for women as mothers. In particular, we are interested to explore the potential conflicts mothers face as care providers and nurturers when responsible care is framed as withholding or managing the food consumption of children. We argue that the competing discursive frameworks around mothers' food provision invite further theorisation that explicitly addresses nourishment and consumption as elements of maternal practice and care. We draw on the work of Neysmith and Reitsma-Street (2005) regarding 'provisioning' to undertake a critical examination of the discourses in the 'childhood obesity' epidemic, with particular attention to Australian media and policy discussions. According to Neysmith and Reitsma-Street, mothers are central to social 'provisioning', that is, the labour that secures the necessities of life. This provisioning framework captures paid market work and unpaid caring labour, policy settings and social locations, allowing for a rich conceptualisation of the conditions mothers negotiate as they provide for their children. Taking up the possibilities of this framework, we argue that, insofar as health risks and responsibilities are largely individualised, mothering is framed as primarily about giving, and childhood obesity is considered a disease of affluence and over-consumption, imperatives for maternal provisioning and nurture are potentially in conflict with critiques of consumption and excess.
TL;DR: In this article, a visual discourse analysis of food-related editorial and advertorial content sourced from the long running and popular Australian Women's Weekly to investigate how lifestyle magazines have been one important locus for constituting health conscious consumers is presented.
Abstract: Over the past decade consumers in Australia and elsewhere have increasingly been confronted with a fast growing number of health food products. This profusion of health foods is accompanied by a proliferation in popular culture of professional nutritional advice on what is 'good to eat'. The genre of lifestyle magazines is one popular medium via which healthy practices and health foods are frequently reported. In this paper we use a visual discourse analysis of food-related editorial and advertorial content sourced from the long running and popular Australian Women's Weekly to investigate how lifestyle magazines have been one important locus for constituting health conscious consumers. Taking up a Foucauldian governmentality perspective we trace how this active, responsible conceptualization of the consumer, which we refer to 'healty food consumer', has increased in prevalence in the pages of Australian Women's Weekly over time. Based on our analysis we suggest that the editorial and advertorial content offers models of conduct to individuals about what possible preventative activities in which to engage, and plays an important role in shaping how we think about taking care of our health through eating.
TL;DR: This article found that men understand and practice dieting within the framework of gendered discourses and gendered relations that can make healthy eating hard to sustain, and some were eager to reframe their dieting in "more manly" terms.
Abstract: Despite heightened concerns about levels of obesity and overweight in Western societies, there is a relative absence of sociological research into the subjective experience of dieting, especially for men. This paper focuses on findings related to the male participants from a qualitative study of fourteen volunteers (six female and eight male) drawn from a larger clinical trial comparing two diet conditions. Semi-structured interviews were conducted in two stages to gain an in-depth understanding of the experience of dieting, and found that these men understood and practiced their dieting in different ways from the women, but also from each other, depending on their notions of masculinity. Some were eager to reframe their dieting in ‘more manly’ terms. The social support or sabotage received from friends and family is significant to these experiences of dieting. This paper discusses how men understand and practice dieting within the framework of gendered discourses and gendered relations that can make healthy eating hard to sustain. © eContent Management Pty Ltd.
TL;DR: In this article, the authors present the current position of Australian midwifery by examining the recently published Commonwealth Report of the Maternity Services Review, as well as looking at some South Australian Department of Health birth-related policies.
Abstract: Australian midwifery is at a crossroads, and the 2009 Maternity Services Review and subsequent Report by the Australian federal government have revealed significant issues that were previously obscured. This article outlines the current position of Australian midwifery by examining the recently published Commonwealth Report of the Maternity Services Review, as well as looking at some South Australian Department of Health birth-related policies. The Report recommends important and positive changes for midwifery, but with caveats that may lead to greater restrictions on midwifery practice. The policies, while endorsing possible alternatives for women, also illustrate how birth options are 'problematised'. Relationships between government, medicine and midwifery are explored throughout the article, illuminating the tension for midwives between aligning with professional and scientific discourses, and those that are woman-centred. Free-standing birth-centres are presented as a possible way forward in order to ease the present dichotomy between 'scientific' and 'experiential' birthing care.
TL;DR: In this paper, the authors used cross-sectional periodic data collected at the Sydney Big Day Out music festival between 2006 and 2009 to examine several aspects of normalisation among festival patrons.
Abstract: There is evidence to suggest that illicit drug use is increasingly a 'normal' part of the lives of many young people in Australia. The normalisation framework has been applied in limited contexts in Australia, and has not been assessed using longitudinal data. This paper uses cross-sectional periodic data collected at the Sydney Big Day Out music festival between 2006 and 2009 to examine several aspects of normalisation among festival patrons. Over the 4-year period high proportions of respondents reported that cannabis and ecstasy were 'very easy' or 'fairly easy' to obtain. In most years, over half the respondents reported 'any illicit drug use' in the past 12 months. A statistically significant relationship was found between recent illicit drug use and degree of contact with other people who use drugs (X2= 64.391, df = 4, p = 0.001). Such results suggest that certain aspects of drug use are normalised among festival patrons and that these are particularly concentrated among certain groups of young people. These groups could to be targeted when delivering drug education and prevention activities.
TL;DR: In this paper, food is a significant part of the daily worship, health and social life of individuals across cultures and religions, and this is especially the case for vegetarian religious minorities such as the Ind...
Abstract: Food is a significant part of the daily worship, health and social life of individuals across cultures and religions. This is especially the case for vegetarian religious minorities such as the Ind...
TL;DR: In this paper, a textual analysis of media and government documents was conducted in order to uncover the social representations implicit in these accounts and demonstrated a symbolic framing of avian influenza with reference to the Spanish Influenza pandemic (1918).
Abstract: Since 2003, avian influenza has recently spread around the world sparking fears of a potential pandemic. As a result of this, a range of explanations and expectations surrounding the phenomenon were generated. Such social representations of disease depict the issue under discussion and frame reactions to the event. This paper explores the social representations surrounding avian influenza in Australia. Methodologically, a textual analysis of media and government documents was conducted in order to uncover the social representations implicit in these accounts. This demonstrated a symbolic framing of avian influenza with reference to the Spanish Influenza pandemic (1918). Analytically, the study draws upon the concepts of social representations from Durkheim and of risk and symbolic risk in the work of Beck. Overall, it is argued that the framing of avian influenza as a risk, mediated through the collective memory of Spanish Influenza, characterised the nature of the social representations surrounding the phenomenon. This resulted in the production of symbolic solutions to the threat.
TL;DR: Qualitative data on how men conceptualise responsibility for health is drawn on, finding that the desire to be responsible for health was borne by most of the men in the study, but this was not always reflected in practice.
Abstract: Contemporary health policy increasingly positions responsibility for the management of health with the individual which reflects newer neo-liberal discourses of health. Such an approach can be seen as problematic in the context of men’s health, with men tending to be seen as largely ‘irresponsible’ towards their own health. This paper addresses this question by drawing on qualitative data on how men conceptualise responsibility for health. Whilst the desire to be responsible for health was borne by most of the men in the study, this was not always reflected in practice. There was also evidence of strategies that men adopted for either divesting themselves of responsibility for health or for legitimising lack of responsibility. In some instances, acting ‘irresponsibly’ was what defined participants as ‘real men’. The implications of these findings for men’s health policy are discussed with specific reference to the recent publication of Ireland’s National Men’s Health Policy.
TL;DR: An overall inadequacy in the scientific quality of the newspaper reporting about the two CM studies in major metropolitan and national Australian newspapers conveyed a very limited understanding of biomedical research methodologies and a subsequent inability to scrutinise these methodologies with rigour.
Abstract: Objectives: The study is an exploratory study of a media event in Australia based on the publication of two separate systematic analyses of complementary medicine (CM) therapies. The objective of t...
TL;DR: It turns out that it is possible to distinguish independent income, education, and class gradients in SRH, and all three components of SES are clearly closely connected with SRH.
Abstract: It is well known that socioeconomic status (SES) is highly correlated with health. An important question is whether SES is, in this regard, a single, unified concept or a collection of related but distinct statuses. This study disaggregates SES into constituent components of income, education, and occupational class to investigate whether or not these correlate with health independently of each other. A series of multilevel regression models are estimated to predict self-rated health (SRH) as reported by 15,022 individuals in 44 countries participating in the World Values Survey. It turns out that it is possible to distinguish independent income, education, and class gradients in SRH. Two interpretations of this result are possible: each component of SES may affect health independently of the others, or each may simply capture additional information about SES that is not captured by the others. Either way, all three components of SES are clearly closely connected with SRH.
TL;DR: This article found significant support for the down low among Blacks and Latinos and its association with high-risk sexual behaviour, and highlighted the need for future research that better understand the impact of the phenomenon within a cultural and community context.
Abstract: The down low has recently emerged as phenomenon where men have sex with men (MSM), but identify as ‘heterosexual’ or ‘straight’. Although the down low has received considerable attention in United States media, little empirical research has sought to investigate this phenomenon beyond anecdotal evidence. Utilising data from the Urban Men’s Health Study (UMHS) (n = 2881), this research offers a unique opportunity to investigate empirically claims of the down low beyond small opportunistic samples. We find significant support for the down low among Blacks and Latinos and its association with high-risk sexual behaviour. These findings highlight the need for future research that better understands the impact of the phenomenon within a cultural and community context.
TL;DR: The paper finds that normality, morality, impression management and esteem are central to the operation of respectability in the paid caring occupations and concludes with recommendations for rethinking the relationship between respectability and these occupations.
Abstract: Feminised caring occupations like nursing and social work are popularly considered to be respectable occupations for women. The objective of this paper is to investigate the role of respectability in paid caring work by women within nursing and social work. This paper draws on Ball's conceptualisation of respectability as a heuristic device in the analyses of 39 in-depth interviews with women who work and study in nursing and social work. The paper finds that normality, morality, impression management and esteem are central to the operation of respectability in the paid caring occupations and concludes with recommendations for rethinking the relationship between respectability and these occupations.
TL;DR: The authors examined how older Australians' accounts of family meals mirror shifts in the Australian way of life over the second half of the twentieth century coupled with their changing personal circumstances as they age.
Abstract: Here we examine how older Australians' accounts of family meals mirror shifts in the Australian way of life over the second half of the twentieth century coupled with their changing personal circumstances as they age. We provide qualitative accounts of these changes drawn from in-depth, semi-structured interviews with 111 men and women resident in greater Melbourne and born in the 1920s and 1930s. Mostly, study participants have retained many of the habits and practices of their youth, although changing domestic arrangements, aging and health concerns have impacted on their culinary habits. When young they learned to view food as a utilitarian necessity and this attitude has translated, in later life, into a concern for its health effects, often signalled by changing body weight and shape. The most obvious impact of evolving Australian foodscapes on their culinary habits is that they now dine out more frequently and consume a great diversity of food.
TL;DR: This paper analyses one such set of agents in the process of disease knowledge negotiation: self-help books on hepatitis C and aims to make sense of the complexity of disease, its social constitution and its role in shaping social phenomena such as stigma.
Abstract: Knowledge about disease and illness usually emerges as a result of complex social negotiations among those with a stake in the outcomes of this knowledge. These negotiations can involve a range of agents and discursive avenues, some of which are contradictory and paradoxical. This is especially true for the blood-borne virus hepatitis C, the medical, social and political features of which - associations with injecting drug use, 'tainted blood' scandals and HIV - render it a controversial disease involving a range of highly motivated stakeholders. In this paper I analyse one such set of agents in the process of disease knowledge negotiation: self-help books on hepatitis C. In conducting this analysis I offer insights into the content of the books and the way they construct hepatitis C and those who have it. I do this by mapping three key issues helping to shape the way hepatitis C is constituted in these books: HIV, injecting drug use and iatrogenic (medically caused) transmission, and by exploring the implications of the themes of emotion, risk and guilt that arise in the playing out of these issues. In the process I aim to make sense of the complexity of disease, its social constitution and its role in shaping social phenomena such as stigma.
TL;DR: In this article, the authors report on a qualitative study of the onset of acquired hearing impairment and conclude that norms of disease are complex and epistemologically contested and can help explain why noncompliance is dominant when it comes to hearing rehabilitation for hearing impaired adults.
Abstract: This paper reports on a qualitative study of the onset of acquired hearing impairment. The focus of attention is why a person seeks treatment. The Danish welfare state serves the population 'in need' such as those with an audiological need and gives them guidance on becoming hearing aid wearers in order to rehabilitate them back to 'normalcy'. However, within audiological research, noncompliance has attracted much attention as investigations have shown that more than 20 percent of hearing aids are very seldom, if ever, in use and 19 percent are used only occasionally. As shown in the paper the form a problem takes is in large part a product of micro-political struggles. Hence, at the onset 'need' is often embedded in social pressure from significant others. The paper examines these two discursive frameworks and their constitution of (hearing) problems and concludes that norms of disease are complex and epistemologically contested and can help explain why noncompliance is dominant when it comes to hearing rehabilitation for hearing impaired adults.
TL;DR: Understanding the decision making of young males’ around physical activity and dietary behaviours will play a significant role in the health outcomes of adult men by through improved targeted health education and health promotion programs for this cohort.
Abstract: This paper draws on focus groups with young Australian males across a range of social demographics and ages in primary school years (5-12 years). It investigates the role of physical activity and dietary behaviours in the lives of young males. The paper will articulate the way in which young males come to perceive physical activity and dietary behaviours, including broader constructions of health, within the context of their lives. Understanding the decision making of young males' around physical activity and dietary behaviours will play a significant role in the health outcomes of adult men by through improved targeted health education and health promotion programs for this cohort.
TL;DR: The links between the social and material conditions of women's lives in Papua New Guinea and their poor physical and psychosocial health has had limited examination as mentioned in this paper, and the link between women's physical and psychological health has not been examined.
Abstract: The links between the social and material conditions of women’s lives in Papua New Guinea and their poor physical and psychosocial health has had limited examination. This article describes a quali...
TL;DR: The rationale behind GPs’ reluctance to follow guidelines is explored through focus group interviews with Norwegian GPs and the need to ground the debate about standardisation of practice in the practitioners’ professional identity is highlighted.
Abstract: Earlier studies, mainly based in the UK, the US, Canada and the Netherlands, indicate that GPs are reluctant to follow guidelines. This study explores the rationale behind GPs' reluctance to follow guidelines through focus group interviews with Norwegian GPs. A central concern appearing in the interviews is the GPs' notion of professional identity. The GP was identified as an autonomous generalist with a close alliance to the patient and a sceptical distance to academic medicine and health authorities. Guidelines are seen to conflict with the GPs' sense of clinical autonomy. Another aspect discussed by the GPs was an authority-based clinical insecurity which made them sceptical about the evidence. The findings highlight the need to ground the debate about standardisation of practice in the practitioners' professional identity. The study also underlines the importance of transparency in the standardisation process.
TL;DR: This article explored the multiple extant accounts of Ben Cousins' drug use and examined media representations of his drug use, including accounts from a range of key stakeholders, and also looked at Cousins' public accounts of his own drug use.
Abstract: Australian Football League (AFL) player Ben Cousins is one of the most highly acclaimed and recognised athletes in Australia Followed closely in the media, his off-field activities are subject to as much attention and speculation as those on the field In 2007, Cousins and his family confirmed long- standing rumours that he was an illicit (non-performance enhancing) drug user Following a series of incidents, his football contract was terminated and Cousins publicly entered drug rehabilitation In this article we explore the multiple extant accounts of Cousins' drug use We examine media representations of his drug use, including accounts from a range of key stakeholders, and we also look at Cousins' public accounts of his own drug use What emerges is paradoxical picture both of Cousins himself and of drug users more broadly Cousins is simultaneously positioned as in control and out of control, as manipulative and as subject to the manipulations of his 'addiction', as criminal and victim, as culpable and innocent In the process, he acts as a figure through which contemporary understandings of the nature and implications of addiction are produced and reproduced What is addiction? If, as many now take for granted, it is a disease requiring a medical response, what can be said about the agency and responsibility of the 'addict' in the context of elite sport? How do mainstream understandings of elite sportsmen as intrinsically masterful, commanding and physically exemplary mesh with assumptions about drug addicts as passive and physically compromised? In considering this intersection of discourses of elite sports and of addiction, we also explore some of the unique dimensions of the Cousins case including the challenge his embodied athleticism poses to understandings of his drug use, and the significance attributed to his rehabilitation and 'comeback' in 2009 We conclude with some reflections on the ways in which Cousins' case troubles certainties about drug use, and on the strategic efficacy of disease models of addiction in Australia
TL;DR: This paper used the stories of interviewed former heroin addicts, published autobiographies, biographies and even some fictional accounts to come to an understanding of the difficulties of dealing with intoxication and the drug-using subject.
Abstract: O'Malley and Valverde point out that in the 21st century, pleasure is a warrantable motive for drug and alcohol use only when it is attached to the idea of moderation. This presents a problem for those researchers who wish to theorise about those individuals who use drugs deliberately to induce intoxication. This paper uses unconventional means to come to an understanding of intoxication. It uses the stories of interviewed former heroin addicts, published autobiographies, biographies and even some fictional accounts to come to an understanding of the difficulties of dealing with intoxication and the drug-using subject. It also uses the accounts that Michel Foucault gave about his own use of drugs and its relationship to an ethics of pleasure and resistance. The article uses theories of risk and edgework to understand the underlying meanings of intoxication to many drug users.