Advocating for diamorphine: Cosmopolitical care and collective action in the ruins of the ‘old British system’

Original research
by
Dennis, Fay

Release Date

2020

Geography

UK

Language of Resource

English

Full Text Available

Yes

Open Access / OK to Reproduce

Yes

Peer Reviewed

Yes

Objective

Argue through the accounts of advocates and patients for the continuation of these flexible and hidden modes of caring with diamorphine as not merely a form of supporting individuals’ rights (to care) and services’ responsibilities to these rights (‘duty of care’), but a form of collective action and living. Q: how people who use heroin are cared for in contemporary UK society, especially considering rising opioid-related deaths.

Findings/Key points

See how ‘old system’ patients get silenced and the relational work that is needed for them to speak. Speaking is then translated into ‘being heard’. To be heard, advocate plays crucial role in knowledge production, turning patients’ embodied matters of concern (around the destructive potential of reducing/removing diamorphine for their vitality and livelihood) into matters of fact (such as, convertibility, cost-effectiveness and dose) for ‘expert’ consumption.

The advocate draws our attention to the role of diamorphine as not only a care preference or legal right, but an entangled substance for living, and a flexible technology for challenging moves to supervised regimes. Cosmopolitical advocate: recognition of the non-innocence of care that targets and silences PWUD as a stigmatized group.

Design/methods

Ethnography: observations + 10 patient interviews

Keywords

Policy/Regulatory
Advocacy
Barriers and enablers