Book Review

This book explores “habit” as an alternative or as Fraser et al. would say “otherwise” to addiction. Habit is seen not only as a way of understanding the repetitive yet changing and complex patterns of drug use, but also as a way of capturing the making and remaking of “addiction”, in which, furthermore, “reality is habit” (p. 238). Taking the ubiquity of habit as one of the books central tenets, the authors question “addiction”, which is increasingly narrowly defined in line with neuroscience, as a useful concept to explore the complexities of “habitual” behaviour. Using a Science and Technology Studies (STS) approach, they show how addiction is being made and remade in three diverse areas of practice on meth/amphetamine, alcohol and food, and the work being done to hold it together as a singular, independent reality.

The book draws extensively on John Law’s (2011) notion of “collateral realities” – that is, very simply put, the realities made “collaterally” in constituting a reality “out there” – to capture the multiple realities being produced in stabilising “addiction” in the three areas noted above. To this end, the authors reviewed hundreds of policy documents, research papers and consumer accounts from their own research to explore how addiction realities were being produced in practice and the simultaneous work being done “to wash away practices and turn representations into windows on the world” (p. 20–21, citing Law, 2011: 171). Therefore, this book endeavours to open up these “assemblages”-turned-“windows on the world” and expose the collateral realities within:

If the minimum unit of reality is the assemblage, then addiction is an assemblage of material and non-material phenomena, its reality held stable by the enactment of particular collateral realities. These must be identified and examined if any thorough comprehension of addiction and its changing shape can be achieved. (p. 167)

The first chapter looks at some of the generic realities being made on addiction in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and neurosciences, which is said to produce “collateral realities” on “‘drugs’ as a cohesive category, the subject of health as unified and self-aware, the body as stable, [and] the social context or environment as a simple set of variables or influence” (p. 59). The book is then divided into its three sections, with two chapters each on meth/amphetamine, alcohol and food, looking at how addiction is being made and remade in these specific areas.

The authors first explore the way amphetamine dependence and methamphetamine addiction are stabilised, the former in research texts by the National Drug and Alcohol Research Centre (Australia) and the latter by the National Institute on Drug Abuse (USA). They then show how this is manifested in drug policy and the collateral realities produced as a result, and how these are reproduced and challenged in consumer accounts. For example, the collateral realities being made in US drugs policy include: “addiction is a brain disease being progressively revealed by advances in neuroscience; methamphetamine is highly addictive; and methamphetamine is a malevolent agent” (p. 106), but this is challenged by consumers who see addiction as co-produced in “experience, subjectivity and material and discursive contexts” (p. 118).

The middle section of the book then looks at the collateral realities being enacted in sociological, psychiatric, genetic and epidemiological research on alcohol. The authors explore the way an “alcohol dependence syndrome” is being held steady in research, but then, in reviewing consumer accounts, how it becomes unstable and slippery.

The last section looks at food and obesity, and how addiction is being remade to fit this new area of public concern. Again a number of collateral realities are produced, including: “‘drug addiction’ which is referred to as though no controversy exists over its interpretation; … [the body is] unchanging and stable; … [and] complex social and cultural aspects of food and eating are reduced and scientised as ‘environment’” (p. 189). The authors argue that this area of concern, more so than meth/amphetamine and alcohol, highlights the problems of a neuroscientific approach for explaining complex socially embedded practices (p. 189). That is, whilst addiction is being increasingly narrowly and singularly defined, it is being used to explain even more diverse and pervasive practices.

The concluding chapter links back to and further theorises the concept of habit. It is particularly in relation to food that the ubiquity of dependency (“we are all “dependent”- upon breathing, eating and so on” [p.199]) and habit (repetitive practice) is made clear and the utility of “addiction” is questioned once more. It is for these reasons that habit is put forward as its rival:

Whereas addition is rigid, narrow and linear, habit is flexible, encompassing and diffuse. Addiction and habit both describe repetition and pattern, but only habit can recognise change, not as the end or antithesis of repetition but as part of it, entailed in it. (p. 238)

Therefore, it seems, in “remaking addiction” – both ontologically in practice and conceptually – habit offers a way of understanding the complex materially and discursively embedded and assembled enactments of “drug use” in its widest sense.

Fay Dennis

The Centre for Research on Drugs and Health Behaviour

London School of Hygiene & Tropical Medicine

London, UK

E-mail: [email protected]