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'Workers', 'clients' and the struggle over needs: Understanding encounters between service providers and injecting drug users in an Australian city

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  • Moore, David

Abstract

A feature of contemporary Western, neo-liberal democracies is the frequent interaction between representatives of health and social services and the members of stigmatised and 'unruly' populations, such as injecting drug users. Previous research on drugs has tended to ignore the power relations and cultural dynamics at work in these encounters, and the ways in which they are framed by the wider neo-liberal context. Drawing on an ethnography of street-based heroin use in Melbourne, Australia's second largest city, I show how the discourses of both service providers and injecting drug users draw on wider neo-liberal values of independence, autonomy, rationality and responsibility. Service providers negotiate a framework of needs interpretation that creates and reproduces professional identities, and maintains boundaries between 'workers' and 'clients'. It also includes tensions around the definition of injecting drug users as 'chaotic' (i.e., failed neo-liberal) subjects, and slippage between service philosophies that emphasise a social model of health and forms of service delivery that emphasise the production of responsibilised subjects. For their part, street-based injectors construct an alternative framework of needs interpretation that emphasises their self-reliance, autonomy and independence, attributes and capacities largely denied them in service-provider discourse. In encounters with service providers, street-based injectors respond in various ways that include elements of resistance, strategic accommodation and the incorporation of therapeutic discourse. I conclude by considering the implications of my analysis for the future development of drug policy and practice.

Suggested Citation

  • Moore, David, 2009. "'Workers', 'clients' and the struggle over needs: Understanding encounters between service providers and injecting drug users in an Australian city," Social Science & Medicine, Elsevier, vol. 68(6), pages 1161-1168, March.
  • Handle: RePEc:eee:socmed:v:68:y:2009:i:6:p:1161-1168
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    References listed on IDEAS

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    1. Moore, David, 2004. "Governing street-based injecting drug users: a critique of heroin overdose prevention in Australia," Social Science & Medicine, Elsevier, vol. 59(7), pages 1547-1557, October.
    2. Fraser, Suzanne & Moore, David, 2008. "Dazzled by unity? Order and chaos in public discourse on illicit drug use," Social Science & Medicine, Elsevier, vol. 66(3), pages 740-752, February.
    3. Moore, David & Fraser, Suzanne, 2006. "Putting at risk what we know: Reflecting on the drug-using subject in harm reduction and its political implications," Social Science & Medicine, Elsevier, vol. 62(12), pages 3035-3047, June.
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    1. Lazarus, L. & Chettiar, J. & Deering, K. & Nabess, R. & Shannon, K., 2011. "Risky health environments: Women sex workers’ struggles to find safe, secure and non-exploitative housing in Canada’s poorest postal code," Social Science & Medicine, Elsevier, vol. 73(11), pages 1600-1607.
    2. Matthew Bacon & Toby Seddon, 2020. "Controlling Drug Users: Forms of Power and Behavioural Regulation in Drug Treatment Services," The British Journal of Criminology, Centre for Crime and Justice Studies, vol. 60(2), pages 403-421.
    3. Di Ruggiero, Erica & Cohen, Joanna E. & Cole, Donald C. & Forman, Lisa, 2015. "Competing conceptualizations of decent work at the intersection of health, social and economic discourses," Social Science & Medicine, Elsevier, vol. 133(C), pages 120-127.

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