Paper short abstract:

This paper explores some of the ambiguities between globalized and global health discourses on addiction.

Paper long abstract:

Since the seminal volume, Global Mental Heath (Oxford 1995), Global Health has accepted behavioral-based pathologies as significant contributors to excess morbidity and mortality rates in those areas of the world where it has worked. Amongst the most elusive of these behaviors to both confidently track (and in which to intelligently intervene) has been drug use and abuse. On the one hand, some countries most impacted by the classic killers in Global Health, such as Tanzania, now has recognized significant rates of indigenous IV drug-use that would have been seen as impossibly exotic only fifteen years ago. At the same time, since effective interventions into addiction in the global North have nowhere near the consensus as other psychiatric interventions, it has not been especially clear what to do about such use, despite the obvious implications for, say, HIV spread that IV drug-use poses. On the other hand, the discourse of drugs in the Global North has been globalized for decades, with consumers (never mind law enforcement agencies) knowing that local use is connected to primary producers as far afield as Afghanistan, South-East Asia, and South America and embedded in international production-distribution-consumption systems of almost breath-taking flexibility and complexity. Nonetheless, neither the use of illegal drugs nor off-label use of legal pharmaceuticals (which has also grown substantially worldwide during this same period) are typically discussed within the same frame. This piece reflects on these contradictions and offers some (tentative) ideas of how we might examine addiction as a truly global phenomenon.