Introduction: Making Gender Matter: Drug-Using Women, Embodiment, and the Epistemologies of Ignorance
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Notes Introduction: Making Gender Matter: Drug-Using Women, Embodiment, and the Epistemologies of Ignorance 1. N. Tuana (2006) in ‘The Speculum of Ignorance: The Women’s Health Movement and Epistemologies of Ignorance’ argues that social movements have often resisted ‘epistemologies of ignorance’ and that this tactic was a ‘key strategic technology of the women’s health movement’. Tuana urges scholars studying knowledge production practices, as we are in this book, to ‘account for not knowing, that is, for our lack of knowledge about a phe- nomena [sic] or, in some cases, an account of the practices that resulted in a group unlearning what was once a realm of knowledge’. 2. This term first appeared in the editorial introduction to Deviant Bodies, edited by Jacqueline Urla and Jennifer Terry (1995), and was defined as ‘the historically and culturally specific belief that deviant social behaviour (how- ever that is defined) manifests itself in the materiality of the body, as a cause or an effect, or perhaps as merely a suggestive trace’ (2). 3. D. Weinberg (2002), ‘On the Embodiment of Addiction’, Body and Society, 8, 4: 1–19. 4. Throughout we use ‘postclassical paradigm’ and ‘epistemological paradigm’ or ‘mode of knowledge’ interchangeably to emphasize the epistemology of embodiment on which knowledges of the gendered body are based. 5. Riska (2010) lays these out in ‘Gender and Medicalisation Theories’, in A. E. Clarke, L. Mamo, J. R. Fosket, J. R. Fishman, and J. K. Shim (eds), Biomedicalization: Technoscience, Health, and Illness in the U.S. Durham, NC: Duke University Press. 6. The emphasis on drug addiction changing brain structure and function in permanent and irreversible ways (Leshner, 1997) has been superseded by dominant notions of neuroplasticity and adaptation (Malabou, 2008). What effect these will have on the drug field remains to be seen, as we are aware of few scholars who take these ideas up outside the neurosciences. 7. For an example of the divergence between two movements that share mutual interests, see L. M. Paltrow (2001), ‘The War on Drugs and the War on Abortion: Some Initial Thoughts on Their Connections, Intersections, and the Effects’, Southern University Law Review, 28, 201. 8. See http://www.avaproject.org.uk/our-projects/stella-project.aspx (accessed 7 October 2010) (emphasis ours). 9. See ‘Report of National Advocates for Pregnant Women, Submission to the United Nations Universal Periodic Review, Ninth Session of the Working Group, Human Rights Council’, April 2010 at http:// advocatesforpregnantwomen. org/NAPW_UPRSubmissionUSA.pdf (accessed 1 August 2010). The NAPW report documents human rights abuses to pregnant women in the US, stat- ing that ‘pregnancy can make women the target of criminal investigation, incarceration, counterproductive civil child welfare interventions, and forced 203 204 Notes medical procedures in the United States. At the same time, access to services that ensure dignity and informed medical decision-making are being limited arbitrarily’ (1). 10. For instance, see ACMD (2007b) Drug Facilitated Sexual Assault. 11. The conceptual underpinnings of epigenetics concern gene-environment interactions. Today the field often conflates epidemiology and genetics – and has been offered as a potential harbinger of a new era of attention to ‘social’ or environmental factors in genetic research. 12. See also for example, Jellinek (1960); Vaillant (1973); Edwards et al. (1976); and Plant (1981). 13. Interview conducted by E. Ettorre with C. Fazey, 15 November 2009. 14. In the US, medical care for pregnant women is referred to as ‘prenatal care’, whereas in Britain it is called ‘antenatal care’. 15. Interview conducted by N. Campbell with B. G. Reed, 16 January 2008. 16. Interview conducted by N. Campbell with B. G. Reed, 16 January 2008. 17. Although the terms ‘expressive’ and ‘instrumental’ are often attributed to Talcott Parson, they are from the work of Morris Zelditch (1955) that appeared in a co-edited book of which Talcott Parsons was an editor. For Parsons’ own work on the family, see T. Parsons (1942), ‘Age and Sex in the Social Structure of the United States’, American Sociological Review, 7, 5: 604–16; T. Parsons (1959), ‘The Social Structure of the Family’, in R. Ashen (ed.), The Family: Its Functions and Destiny, New York: Harper and Row. 18. Interview conducted by Elizabeth Ettorre with Betsy Thom, 13 November 2009. 19. TRANX was the National Tranquilliser Advisory Council, which was funded for two years by the Department of Health in December 1983. It was founded by the co-ordinator, Joan Jerome, who had been a benzodiazepine user for 17 years (see Ettorre 1986e). 20. Concerns about suicidality and increased ‘suicidal ideation’ of both adults and children on antidepressants have mitigated the triumphalism in both the US and the UK. 21. See Spivak’s 1993 interview with Sara Danius and Stefan Jonsson in Boundary 2, 20.2, 24–50. 22. In the UK, the national agencies are the Department of Health, the Department for Work and Pensions, and the Department of Communities and Local Government. The NTA is a special health authority within the National Health Service, established by the British Government in 2001 to improve avail- ability, capacity and effectiveness of treatment for drug misuse in England. As part of the NTA, the National Drug Treatment Monitoring System (NDTMS) collects, collates, and analyses information from and for those involved in the drug treatment sector. The NDTMS is a development of the Regional Drug Misuse Databases, which have been in place since the late 1980s (see: http://www.nta.nhs.uk/ndtms.aspx (accessed 7 October 2010). In the US, the federal Department of Health and Human Services houses SAMHSA, which contains the Center for Substance Abuse Prevention and the Center for Substance Abuse Treatment. Research is located in the National Institute on Drug Abuse, an institute within the National Institutes of Health, which also contains the National Institute on Alcohol Abuse and Alcoholism. State agencies, which combine drug and alcohol Notes 205 prevention and treatment services, have oversight of treatment provision and service delivery, which is administered at the local county level in the US as well as through private healthcare providers. Treatment services vary state to state, so women’s access to treatment depends largely upon in which state they reside. 23. However, SAMHSA and some of the state agencies, such as California and Massachusetts, have been friendly to women’s movement actors and thus women’s treatment guidelines in the US have adopted an approach con- sonant with the ‘relational’ aspects of the postclassical epistemology (see Treatment Improvement Protocol 51, which we analyse later). 1 Getting Gender on the Agenda: A History of Pioneers in Drug Treatment for Women in the United States and the United Kingdom 1. The New York City Welfare Council indicated a 700 per cent increase in 1950 over 1946, although the total number of teenagers involved remained unknown. No one knew how many addicts there were. The figures came from the Research Center for Human Relations, New York University, then con- ducting the classic study published as The Road to H (New York: Basic Books, 1964). 2. L. Bender (1961). ‘State Care of Emotionally and Socially Disturbed Adolescents’, in E. M. Thornton (ed.). Planning and Action for Mental Health. London: World Federation for Mental Health. 200–15; and ‘Drug Addiction in Adolescence’, Comprehensive Psychiatry, 4, 3 (1963): 181–94. The first peak arose in the wake of the Harrison Act from 1918–19. 3. The institution at Bedford Hills was named the Westfield State Farm from 1932 to 1970, when it was changed to the Bedford Hills Correctional Facility. It is now a maximum security facility for approximately 800 women over age 16. The original New York state reformatory for women was legislated in 1892, and operated by the State Board of Charities once it opened in 1901. One year after the name was changed to Westfield, a separate prison section was opened – thus there was both a prison and a reformatory operating on the site. The facility was also referred to as ‘Hudson’. 4. Segregation of specific populations was not a new idea at the Westfield State Farm, which had operated a Division for Mentally Defective Delinquent Women on the site of the former Rockefeller Laboratory of Social Hygiene after news of ungovernable inmates became a public scandal between 1915 and 1919. From 1920 to 1932 women found to be of ‘low intelligence’ were transferred to the DMDDW. After 1932 the name of the institution was changed to the Bedford Hills Correctional Facility. See http://www. archives.nysed.gov/a/research/res_topics_legal_corrections_inst_bedford. shtml (accessed 10 April 2011). 5. Correspondence from J. Lowry to J. V. Bennett, 27 January 1955. 6. Memo to US Marshals from J. V. Bennett, 9 April 1957; cf. 26 June 1956. All correspondence quoted in this section from the National Archives and Records Administration in College Park, Maryland, RG 129, Box 25, ‘Lewisburg to Lexington, Bureau of Prisons’. 206 Notes 7. Connecticut had one of the earliest state-funded public inebriate hospitals in the country, founded on the notion that inebriety was a disease appro- priately treated through medical means (see S. W. Tracy (2005). Alcoholism in America: From Reconstruction to Prohibition. Baltimore, MD, Johns Hopkins University Press. 123–9). 8. Mann was one of the most powerful women within Alcoholics Anonymous, working to found NIAAA in 1970. Her book was an important touchstone for those seeking to treat alcoholics. 9. On Blume’s role in the fight for labels warning consumers of alcoholic beverages of their dangers during pregnancy, see J. Golden (2005). Message in a Bottle: The Making of Fetal Alcohol Syndrome. Cambridge, MA: Harvard University Press, 88–9. 10. The 1957 article was based on study of 46 alcoholic women and 55 alco- holic men in Connecticut outpatient clinics and an additional 37 alcoholic women committed to State Farm.