Exploring the moral frameworks for labeling, treating, and punishing drug addiction
Illness or Deviance?
Drug Courts, Drug Treatment, and the Ambiguity of Addiction
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Is drug addiction a disease that can be treated, or is it a crime that should be punished? In her probing study, Illness or Deviance?, Jennifer Murphy investigates the various perspectives on addiction, and how society has myriad ways of handling it—incarcerating some drug users while putting others in treatment.
Illness or Deviance? highlights the confusion and contradictions about labeling addiction. Murphy’s fieldwork in a drug court and an outpatient drug treatment facility yields fascinating insights, such as how courts and treatment centers both enforce the “disease” label of addiction, yet their management tactics overlap treatment with “therapeutic punishment.” The “addict” label is a result not just of using drugs, but also of being a part of the drug lifestyle, by selling drugs. In addition, Murphy observes that drug courts and treatment facilities benefit economically from their cooperation, creating a very powerful institutional arrangement.
Murphy contextualizes her findings within theories of medical sociology as well as criminology to identify the policy implications of a medicalized view of addiction.
"Murphy offers an important and illuminating analysis of the paradoxes and inconsistencies riddling the drug treatment field today. Utilizing qualitative methods, the author studied several sites, in an unnamed city, including two outpatient drug treatment centers and a drug court. Deftly summarizing the literature on drug addiction treatment and penology, Murphy lays bare the many inconsistencies in the field... She maintains that punitive attitudes toward addicts emanate from the public's condemnation of addicts as morally inferior and deserving of punishment... Murphy offers a creditworthy history of addiction-care institutions, cautiously applying her own research findings. Those wishing to better understand the shortcomings of modern American drug rehabilitation practices will find much value in this thoughtful work. Summing Up: Highly Recommended."
"[A] timely book.... Murphy has a level of expertise that makes her qualified to write this book and critique drug courts, drug treatment, and how the two strategies intersect with each other.... [Her] approach to research informative and rigorous."
"The core question in this book is whether addiction is a disease that should be treated or a crime that should be punished. Author Jennifer Murphy digs into this by means of an institutional ethnography of a drug court and affiliated treatment programs to see how they define and deploy the concept of addiction. Her inductive, grounded theory approach weaves together observations of a drug court and affiliated treatment programs, in-depth interviews with staff and participants, and an analysis of court documents. The result is a fascinating case study in social constructionism that illustrates the continuing relevance of labeling theory and raises critical questions about the medicalization of addiction."
"The strength of Illness or Deviance? is the particular attention Murphy gives to teasing out the competing, and sometimes conflicting, views of drug-using behavior articulated by practitioners and participants in...institutional contexts.... Murphy’s qualitative study is a refreshing addition to the literature.... [I]t does well in focusing on an important and under-analyzed feature of the movement. That is, through a concentrated ethnographic study, Illness or Deviance? underscores, unpacks, and usefully illustrates the ambiguities and contradictions found in the mixing of the treatment and law enforcement paradigms found in drug courts and the treatment facilities associated with them."
"It is rare that addiction literature is able to present detailed personal narratives within an informative and critical perspective that leave the reader feeling they have gained clear insight into a particular situation. Illness or Deviance? presents just such an account, engaging with the interaction between drug addiction and the American penal system.... The book provides a good overview of the nuances within the contemporary addiction discourse and the limits of the disease model. It also engages with challenging questions about basic social interactions and how labels powerfully affect our understanding of identity."
"This book is a most worthwhile read.... Murphy’s study provides the first realistic and critical look at how and why drug courts attempt to manipulate their clients, how clients adjust to these efforts, and what difficulties and confusions this leads to. In the process, she has created an analytical path for future studies of drug courts and laid the groundwork for more realistic evaluation of them."
Jennifer Murphy is Associate Professor of Criminal Justice at Penn State Berks.