Methadone: Substitution, Metaphor and Authenticity

2012

As figure, metaphor constitutes a displacement and an extension of the meaning of words; its explanation is grounded in a theory of substitution.

(Ricoeur, 1978)

Press coverage of addiction tends to be prolific, if not always accurate or considered. We begin our investigation of methadone maintenance treatment by examining the ways in which it is reported in three respected daily newspapers, the New York Times (US), The Times (London, UK) and the Sydney Morning Herald (Australia). What place does methadone occupy in Western liberal discourse? What does this place offer to policy and practice in terms of scope for the development of treatment? What does it tell us about clients in terms of their status either as liberal subjects or as Others of liberalism? To conduct this analysis we have chosen to focus on the role of metaphor in articles on methadone maintenance treatment. As will become evident, the use of metaphor is a primary way in which methadone treatment is given meaning in these texts. This is not to say that coverage of methadone treatment per se in the three papers under examination is voluminous; in fact, as we will be arguing, there is a particular kind of silence around the basics of the programs operating in each country. In part we ask what this silence means, and what effects the use of metaphor ― both to figure methadone and to mobilise it as a figure for other phenomena ― has in a context where addiction, including heroin addiction, is by contrast extensively discussed. In the process we consider the status of metaphor within Western liberal discourse, and trace the (in some respects damaging) ways in which methadone treatment can be seen not only as a resource for, and object of, metaphorical description and production, but itself as a kind of metaphor ― a metaphor for heroin.

Why is it important to map and analyse media accounts of methadone? A commonsense response might be: because these representations reflect specific understandings of it, influencing, by disseminating those understandings, the formation of policy and practice around it and the esteem in which those who participate are held in society (). As Isabelle Stengers and Olivier Ralet () have pointed out, public debate on drugs and drug treatment is regularly characterised in terms of a putative moral consensus: ‘don’t take drugs’. Related to this, perceived public opposition to methadone treatment is frequently cited as grounds for timidity or reserve in policymaking (). The literature examining representations of drug use and drug treatments in the press tends to take this approach, with some very useful results. It finds, for example, that coverage of drug use and drug services is often poorly informed, unbalanced and inclined to reproduce stereotypes (). Thus, Orcutt and Turner look at the ways in which particular research findings on student drug use were distorted in the US press, and explore the creative choices, organisational circumstances and other factors that drove the distortions. Other literature on drugs and the media argues that policy is shaped in the context of, and even by, media reports (). Elliott and Chapman, for instance, explore media treatment of a proposed trial of prescribed heroin in the Australian Capital Territory and the federal government’s withdrawal of support for the trial. They argue that it is important to analyse the ways in which drug use is presented in the media because (to paraphrase the work of Ericson et al., whom they quote) the media provide commonsense understandings of deviance and societal options for, and limits on, managing deviance. McArthur also investigates the coverage of the proposed heroin trial, concluding that ‘sections of the media had a hand in its demise’ (). Rowe examines a different period in press coverage of drug use, focusing on a flurry of reports in 1995 on a supposed heroin epidemic in Melbourne. He asserts that ‘”public opinion” and what the policy-making apparatus of governments understand to be real depend heavily on the mass media’ ().

This literature resembles in some respects our own approach to the relationship between the media, policy, the views of members of the public and drugs as material objects. We do, however, think it important to question this framing in that it tends to echo an unexamined inclination within Western thought to take for granted the ontological separateness of representation and reality, in this case, media discourse and drug use and drug treatment. For example, Elliott and Chapman () ask, ‘What was it about the nature of heroin users as portrayed in the press by supporters and opponents of the trial that may have contributed to a lack of political support for [the trial]?’ Terms such as portrayal imply prior categories, in this case, the ‘nature of heroin users’. While it is absolutely necessary to think about the ways in which media representations co-produce policy, daily life and politics, it is important not to reify ‘representation’ and ‘reality’ by treating them as separate entities with a priori attributes. In the Introduction we argued that to account better for the role of material objects such as drugs in producing realities, a theorisation of materiality is necessary that sees it as neither passive in the face of culture or discursivity, nor determining of it. In making these arguments we use Karen Barad’s work to formulate perspectives on the agency of objects that best express the co-constitutive nature of the relation between humans, objects and discourse. This relation is nowhere more usefully elaborated than in the discussion of the media, and Barad’s theories apply directly to the central issue structuring discussions of the media: the question, as noted above, of the relation between ‘representation’ and ‘reality’.

Along with this different approach to the ontology of representation, our analysis departs significantly from the existing literature in two main ways. First, it is based on an international corpus of newspaper articles, and second, it focuses on the role of metaphor in generating meaning. As a result, the analysis takes a more abstract view of the production of meaning, looking at, for example, the role of images such as that of the silver bullet and its association with the occult. At the same time, it shares with its forerunners a conviction that representation matters for the world and for individuals, even if this mattering of representation is conceived in rather different terms.

Methadone: Theorising representation

Compiling texts

The material we analyse here was drawn from three newspapers, the New York Times, The Times and the Sydney Morning Herald. The articles were gathered by searching the online database Factiva using the search term ‘methadone’ and limiting the search to a two-year period: 2004-2005. All resulting citations (a total of 135) were retrieved in the first instance and examined for the purposes of our analysis. Those that made only isolated references to methadone in pieces of one paragraph or less, or were devoted to unrelated topics, were noted, and greater focus was placed on those articles that made more substantive references to methadone. This latter group included articles containing more than one reference to methadone, articles in which methadone was central to the overall story and articles in which the reference to methadone was especially vivid, suggestive or idiosyncratic (a total of 77 ― SMH: 29, Times: 27 and NYT: 21).

All three newspapers examined enjoy relatively high circulation and readership. The New York Times was the third-highest daily circulation paper in the US for the six months ending 30 September 2005 (1,682,644). The Times enjoyed the second-highest daily circulation among ‘quality’ newspapers in the UK for the period ending 30 November 2005 (671,666). The Sydney Morning Herald had the highest daily circulation among quality newspapers in Australia during the six months ending 31 March 2006 (211,700). Each one is a longstanding and generally well-respected daily journal, representing, for some, the liberal democratic ideals of journalistic independence and reasoned debate. In selecting these newspapers we leave unexplored representations of methadone in tabloid or ‘populist’ journalism. There is no doubt that an interesting study could be made of the material found in tabloids, but, being obliged to limit the scale of our search for practical purposes, we chose to explore the ideas and assumptions operating in relatively sober newspaper discourse. It seems to us that there is a great deal to be learnt from the limits of some of Western liberal democracy’s most trusted reporting.

Methadone: Metaphor

Methadone: Tracing metaphor

The ontology of methadone

Conclusion

In making the particular argument we have made here, we take for granted that the accounts of methadone given in the press are not straightforwardly separable from methadone as it operates in reality. To restate our approach, there is no methadone except that which is represented, and the differing ways in which methadone is represented produce not different ‘aspects’ of methadone, rather, different ‘methadones’ (). On this argument, matter such as methadone is not seen in terms of a priori attributes, rather as a phenomenon produced in specific intra-actions with other phenomena, including particular media accounts. It is in this sense that media accounts of methadone can be said to matter: they are profoundly implicated in methadone’s material becoming, and this constitutes their ethical action. Given that many of the references to methadone in the newspapers examined here are either isolated and poorly elaborated, or whimsical or comical in intent, this ethical burden may seem incongruous. Yet it is the spectre of ‘public opinion’ (partly revealed, it is often assumed, through press coverage) that politicians, legislators, policymakers and service providers regularly cite in formulating the legal and material conditions for harm-reduction strategies such as methadone provision (). At present, methadone is materialised in part through its representation in the print media as aligned with inauthenticity, disorder and the feminine, as well as, in an ontological sense, always already metaphor. All these alignments, indeed, all these ‘Others’ of liberalism () may need to shift together if the standing of methadone and those who take it is to change to any significant degree. Yet policy may have a small role here. Perhaps most straightforwardly, there is a role for policy in reconsidering the framing of methadone treatment as ‘replacement’ or ‘substitute’. These terms are always likely to invoke the inauthentic, and alternatives should be found. Different ways of naming and framing methadone will bear on how it is represented elsewhere ― indeed, this reframing will remake methadone in its materiality. This is, of course, no simple process (indeed, what follows in this book is as implicated in the remaking of methadone as are the texts analysed above). As Miller () has declared: ‘The world needs a multitude of new metaphors … but metaphor, like life, is full of risks.’ Because methadone is co-constituted in the media, it is here that some of these new metaphors must be performed, as well as in works such as this book (here we also return to Cixous’s conviction that representation is an opportunity for remaking). And this ― the need to remain open to media coverage rather than to hope for, or act to, minimise it as do some politicians, policymakers and providers ― constitutes one of the many productive risks methadone and those who support it must take. The next post extends this observation by considering the ways in which other texts, and the risks they entail, work to co-constitute methadone treatment.