At the 2012 AAA meeting in San Francisco last November, the Alcohol, Drugs, and Tobacco Study Group sponsored three panels, each of which addressed the conference’s central theme of “Borders and Crossings”. The papers, and subsequently, the panels, explored the construction and navigation of borders shaping types of drugs, ways of using, types of users, and the sociocultural and political-economic contexts in which use, regulation, and distribution occur.

Papers in these panels demonstrated cohesiveness, exploring notions of stigma, social construction, and cultural and political economic contexts of drugs, drug use, and addiction. Meeting panelist Juliet Lee and discussant Geoffrey Hunt’s recommended standard for research on alcohol, tobacco and other drugs, the papers on these panels showcased one of the greatest strengths of anthropologists in this field: the successful integration of research on licit and illicit drugs, providing a venue for the exploration of how and by whom the boundaries and definitions of drug use and addiction are constructed, how they change, and how they are navigated by users, the medical and psychiatric communities, and even researchers. En route to addressing these common themes, each paper took a unique approach.

Several papers offered a theoretical and empirical backdrop for the remainder of the discussions. Geoffrey Hunt and Vibeke Frank explore the meaning of intoxication and key characteristics that have been identified by anthropologists and other social scientists in their study of it. These characteristics include: drug use setting, the relationship between intoxication and sociability, the learning process of achieving intoxication, and the use of intoxication as a ‘time-out’. Juliet Lee discusses not only how social constructions and social structures impact drug use but also ways these constraints shape drug research. In an effort to elucidate the changing nature of drug use overt time, Lee followed a cohort of drug users over a two year period.

Juliet Lee presenting at AAA 2013.

Of particular timeliness, a number of papers examined the ways that drugs themselves cross borders, challenging the notion of a licit versus illicit drug dichotomy and illuminating the blur that separates these categories. Allison Schlosser explored the role of prescription “medicines” in the context of an addiction treatment facility, examining the fluid boundaries and meanings associated with these drugs from the perspectives of both clients and providers. This studied highlighted issues of stigma and the subjective construction of “good” versus “bad” drugs. In a similar vein, Michael Oldani discusses management of drugs, mental health diagnoses and “compliance” in a psychiatric clinic. Kimberly Sue follows the drug treatment, Suboxone, from the clinic to the street. This elucidation of the movement of a drug from licit to illicit contexts highlights the relationship between the formal economy of drug treatment and the illicit, underground economy of drug use. In their papers, Gilbert Quintero, Laura Howard and colleagues, and Chris Elcock consider the redefinition of illicit drugs as ones of medical benefit. Quintero chronicles Montana’s recent “medical marijuana” movement and the social and cultural conflicts that emerged in its wake, focusing on how this example highlights the social construction of illness and the boundaries between medicine and drug. Howard et al. explore how college students manage anxiety using prescription drugs, alcohol, and marijuana, revealing the subjectivity of intoxication versus treatment and highlighting the importance of sociocultural context as well as individual perspective. Taking an historical approach, Elcock argues that the psychedelic movement of the sixties – one that promoted these drugs to foster enlightenment and spirituality – continues in a modern form, where psychadelics are used to treat mental health issues and promote general psychological well-being.

Panelists further explored the boundaries of drug use, distribution, and addiction from the perspectives of users, dealers, and those involved in drug prevention, intervention, and regulation efforts. Considerable attention was payed to users’ navigation of drug boundaries, processes of stigma, and the meanings of use and addiction. Roland Moore and colleagues examined ways that medical marijuana patients experienced, made sense of, and coped with stigma. The persistent stigmatization of medical marijuana illuminates the blurred boundaries between drug and medicine, illicit and licit. Stacey McKenna explored the ways female methamphetamine users establish and enact group identity while distinguishing themselves from the stigma of their status as user and addict. Nicole Laborde followed a group of new mothers to elucidate the changing meanings of alcohol use in relation to personal experiences and expectations and cultural standards for motherhood and femininity. Situating the lives of HIV+ MSM who use meth in the broader contexts of survival and the sociocultural structures and processes he refers to as the “anti-meth apparatus”, Theodore Gideonse examines his participants’ navigation of cultural definitions of morality and resources for care. Taking an autoethnographic approach, Santiago Guerra explores the historical and contemporary contexts of his hometown to consider the subjectivity of addiction; construction of boundaries separating one’s own use and that of the addict; and the geographical and political-economic borderlands that shape drug use and trafficking along the Texas-Mexico border. Marco Borria explored the role of the club in creating a safe haven for drug use and sexual expression. In this context, the men in his study found themselves insulated from the moral restrictions of mainstream society and forged a degree of group identity with others engaging in similar behavior(s). Tazin Karim took a slightly different approach in her discussion of the meaning of (il)licit drug use and distribution from the perspective of students who supply Adderall. Karim found that, like users, dealers develop boundaries based on social criteria of ethics and morality to characterize themselves as different from popular constructions of the “corrupt, self-interested, thuggish ‘drug dealer’ who deals in street drugs.

Marco Borria presenting at AAA 2013.

Others explored these boundaries through an examination of the regulation of licit and illicit drugs. Kristen Ogilvie considers the intersection of Alaska’s community-level laws limiting access to alcohol and individuals’ management of their own use and addiction, examining how these limitations affect who uses and which substances people use in particular context(s). In her paper, Jennifer Murphy explores the role of the drug court in constructing and valuing the drug addict. Her research highlights the dichotomization of drug use behavior along rigid lines labeled as “moral” or “immoral” behavior, defining all drug-related activity (whether use or trafficking) as a sign of addiction.

These panels offered an opportunity for an extension of traditional research on alcohol, tobacco and other drugs in which each category is considered separately. By challenging the rigidity and clarity of boundaries used to label drugs and how they are used, these papers and their intersections serve as an example of how researchers may approach the concept of intoxication broadly and collaboratively, highlighting the holistic strength of anthropological research as applied to drug research.