Methadone

Abstract

What is the difference between heroin and methadone? Is this difference one of interpretation, where an `opiate-like' substance is `labelled' differently through social processes that arbitrarily describe methadone as `legal' and `therapeutic', and heroin as `illegal' and `harmful'? To study the nature of this difference, I follow two experiments in the United States and in France of methadone substitution, where medical practices attempt to replace heroin by methadone, and thereby to reduce the user's (illegal) drug use. In these trials, the experimenters ask precisely this question. The question of the nature of the difference between the substance's actions is further illustrated by the comparison between the substitution trials: when the experimenters describe methadone differently in different places and times, do they `interpret' the drug differently, or is the drug itself different? I show that far too many elements vary from trial to trial to say that the `interpretation' of the substance is all that varies. In order to explore the variation in detail, then, I draw on works about `performance', and on the actor-network `theory of action': what heroin and methadone do, but also the very way in which they `pass into action', is what varies in each trial. In the end, this question about difference is a question about action. In each trial, there is not from the start one substance with fixed or vague properties which one can then interpret in various manners. `Substance' does not contain inherent actions from the start (`properties'). Rather, following the experimenters, it is possible to say that `effects' are primary and that only at the end of the trial do the experimenters laboriously `find substance' to effects.