Pleasure Consuming Medicine: The Queer Politics of Drugs

280 Pages·2009·1.281 MB·English

by  Kane Race

PLEASURE
CONSUMING
MEDICINE

PLEASURE
CONSUMING
MEDICINE
(cid:154)(cid:154)(cid:154)
The Queer Politics
of Drugs
KANE RACE
Duke University Press
Durham & London
2009
∫ 2009 Duke University Press
All rights reserved
Printed in the United States
of America on acid-free paper $
Designed by Amy Ruth Buchanan
Typeset in Whitman by
Keystone Typesetting, Inc.
Library of Congress Cataloging-in-
Publication Data appear on the last
printed page of this book.
CONTENTS
•••
Preface vii
Acknowledgments xv
1. PLEASURE CONSUMING MEDICINE
An Introduction 1
2. PRESCRIBING THE SELF 32
3. RECREATIONAL STATES 59
4. DRUGS AND DOMESTICITY
Fencing the Nation 80
5. CONSUMING COMPLIANCE
Remembering Bodies Inhabit
Pharmaceutical Narratives 106
6. EMBODIMENTS OF SAFETY 137
7. EXCEPTIONAL SEX
How Drugs Have Come to Mediate Sex
in Gay Discourse 164
Notes 191
Selected Bibliography 229
Index 245

PREFACE
•••
A group called Freedom from Fear can serve as a brief illustration and
entry point into the mutually transforming relations between medical
subjectivity and consumer society that underlie and inform this book. It’s
one example of the patient advocacy and support groups that character-
ize the scene of health and medicine today. The group is a not-for-profit
organization whose mission is to raise awareness about anxiety and
depression and their treatment. Since its inception in 1984 it has become
a national advocacy organization with many chapters and a significant
media presence in the United States. A large amount of its funding
comes from pharmaceutical organizations, which may help to explain its
growth. The group promotes a range of drug and behavioral therapies
and conducts awareness-raising activities, such as running the National
Anxiety Disorders Freedom Day—a major media event. Here, medi-
cal education becomes indistinguishable from marketing, and health is
thought to require consumer identification, as even the group’s founder,
Mary Guardino, advises: ‘‘One of the things I’ve found when you’re
reaching consumers is you have to have a good tag line. You have to give
them a quick message that raises their curiosity and interest and says,
‘Wow! That could be me!’’’∞
I first came across Freedom from Fear when Guardino was inter-
viewed for Selling Sickness, a documentary that investigates the relations
between medical science, the pharmaceutical industry, and contempo-
rary society.≤ Couched in a genre that is increasingly well adapted to the
intrigues of the contemporary pharmaceutical industry—detective jour-
nalism and exposé—the documentary forms part of a mounting critique
of ‘‘disease-mongering.’’≥ This term was coined by a loose coalition of
activists and medical professionals to describe the rapid expansion of
disease categories driven by the profit motives of pharmaceutical corpo-
viii PREFACE
.............................................................................................................
rations. While I don’t wish to deny the importance of this e√ort to ex-
pose corporate interests and investigate their sociomedical e√ects, I
did begin to wonder what would happen if we suspended its terms for
just a moment and took initiatives such as Guardino’s at face value for
the insight they provide into the terms of medical rationality today.
Guardino’s commitment to her version of therapeutic salvation is evi-
dent in the film: she describes her personal experience at a promotional
event where she suggests that, if all else fails, it is really worth trying an
antidepressant. In another scene she is shown, perhaps gratuitously,
recounting her story and exhorting her audience: ‘‘After I overcame all
these things I said ‘Why wouldn’t anybody really want to take some drugs
if it could help them to overcome their terrible life?’’’
Well, precisely. The starting point for this book is the irony of a
situation in which the medical industry persistently succeeds in widen-
ing the parameters of the uses to which drugs are put, while a punitive
war on drugs escalates that takes a similar form of widening as its
justification. I want to ask how, why, and with what e√ects contemporary
strictures around the ‘‘improper’’ use of drugs are so ruthlessly main-
tained, while in the medical sphere the liberal application of drugs for
varied purposes is increasingly promoted as a simple matter of consumer
choice. In the current biomedical context, corporeal existence has be-
come a privileged site for experiments with subjectivity.∂ This being the
case, what purpose does the legal distinction between licit and illicit
drugs serve, and why does it wield medical authority so selectively to
demarcate the bounds of moral citizenship and identity? My aim in
asking this question is not exactly to endorse a free market in drugs, for
drugs do demand great care, but rather to use this perverse coincidence
to open up a series of questions about how best to conceive the relations
between drugs, bodies, subjectivities, identities, and practices. For if
regulatory regimes determining the illicit use of drugs have acquired
excessive power to frame individuals as normal or abnormal, decent or
deviant—with criminal and damaging e√ects—as I will argue, then dif-
ferent conceptions and practices of responsibility—practices capable of
attending more carefully to particular uses of drugs and relations of
consumption—might have a better chance of preparing subjects for a
society already permeated by drugs.
Initiatives such as Freedom from Fear embody many of the paradoxes,
PREFACE ix
.............................................................................................................
possibilities, and tough dilemmas of a situation I refer to in this book as
‘‘pleasure consuming medicine.’’ This phrase aims to evoke the contem-
porary enthusiasm for drugs, in a deliberately ominous gesture. But it
also tries, however improbably, to inject an element of hope and em-
bodied inquiry into this situation—principally by activating the critical
agency of pleasure. Pleasure is more or less absent from serious talk
within public health, though it is a common enough motive for, and
element of, human activity.∑ When it comes to drugs, it could be said to
provide the basis upon which legal and moral distinctions (between licit
and illicit instances) are made. Taking drugs for pleasure would appear to
transgress the moral logic of ‘‘restoring health’’ that guarantees their
pharmaceutical legitimacy. But the undeniable importance and common
appeal of pleasure might lead us to wonder whether this routine exclu-
sion and disavowal of pleasure doesn’t serve to prop up the self-evidence
of medical rationality. Enabling pleasure is one of medicine’s most basic
concerns, after all. Though the pursuit of pleasure is frequently pro-
jected onto others in e√orts to expose them as intolerably indulgent—
positioned as a vice pursued only by the marginal or depraved, or a
luxury conceded only to the privileged—pleasure can be framed more
generally as a need or aspiration that informs all manner of human
activity. It has a generalizable or ‘‘whatever’’ quality that might also
prompt a more expansive inquiry into particularity. Anyone can relate to
the need for pleasure, though the precise content of what they are relat-
ing to may remain an open question. Against the blinking incomprehen-
sion that confronts unhealthy behavior, then, pointing to pleasure can
function as a claim on understanding, an insistence on agency, and a sort
of challenge. Situated in this way, pleasure o√sets the actuarial calcula-
tion of risks and harms with a more situated inquiry into the terms of
everyday life, while evoking a sense of agency and experimentation that
the redemptive category of ‘‘self-medication’’ is unable to capture. No
longer framed as restoring some natural order, drug use becomes intelli-
gible as a specific intervention with specific consequences that is at any
rate only one of a number of possible interventions.
Recent inquiries into pleasure provide an alternative vocabulary of
experience than that propounded by the pharmaceuticalization of every-
day life. Much of the recent work on a√ect seeks to value the sen-
sibilities, pleasures, odd feelings, and attachments that are not imme-