'Liquid handcuffs': The phenomenology of recovering on methadone maintenance.

摘要

This study offers an interpretive understanding (verstehen) and an empathetic explication (einfuhlen) of the recovery ideal through the experiences of methadone patients. The sociological literature is replete with efficacy studies on the methadone approach to wellness and health. Yet, there is an unmistakable meaning lacuna in the body of researches on methadone. By a meaning lacuna, I am referring to the wholesale exclusion, whether consciously or not, of the patient's voice in researches on methadone. Nowhere is the structure versus meaning chasm in the sociology of health and illness as manifest as in the literature on former heroin addicts who are now methadone patients. By structure, I am referring to Pearlin's (1992) categorization of the two researches in the sociology of health and illness. Structure research, or those agendas concerned with effects and outcomes, dominates the literature on methadone maintenance. There are a plethora of good studies that attempt to show the efficacy of this treatment alternative (Ball et al. 1995; Widman et al. 1996; Newman 1995; Liappas et al. 1988; Lehmann et al. 1993; Weinstein et al. 1993). Similarly, there is an overbearing amount of critical studies elucidating the many latent social problems with the maintenance option (Aileen et al. 1998; Best et al. 1999; Mino et al. 1998; Churnaud et al. 1998; Wasserman et al. 1998; Zanis et al. 1998; Magura et al. 1998; Chatham et al. 1995; Alterman et al. 1998; and Mangura et al. 1999). This study contributes to the literature on methadone maintenance through a meaning-based analysis of the recovery ideal. Hence, the central question for this enterprise is this: How do methadone patients make sense of---and understand---the meaning of recovery in their illness careers, and what meaning is ascribed to the drug methadone in that recovery process? Finally, by appropriating the depth ethnographic interview (Spradley 1979; Weiss 1994; Geertz 1983; Strauss and Corbin 1990) to understand the meaning of recovery for methadone patients, this study contributes key policy suggestions that might improve the way methadone is delivered and assuage many of the accompanying problems associated with the treatment.