`ADHD patient' or `illicit drug user'? Managing medico-moral membership categories in drug dependence services

Abstract

Amphetamine-dependent patients seeking treatment are diagnosed with ADHD at a significantly higher rate than members of the general population. To study this relationship as it is constructed in everyday life, we draw on membership categorization analysis to examine how individuals account for their candidate memberships in two social categories — `illicit amphetamine user' and `ADHD patient'. We analyse interviews with four drug-dependent individuals, diagnosed with adult ADHD, undergoing detoxification treatment in Perth, Western Australia. Participants formulated their problematic behaviour via membership in the morally neutral category `ADHD patient' and methodically constructed symptoms as predicates of this category, despite the availability of the equally valid alternative category `illicit amphetamine user'. The category `ADHD patient' is shown to be functional: it absolves drug users from responsibility for troublesome conduct, and provides continued access to amphetamines as `medication'. In such cases, the diagnosis of ADHD arguably affords the conditions of possibility for an iatrogenic disorder in that the prescription of ATS medication provides for a morally and legally sanctioned form of drug dependence.