In America, the desire for a dream echoes in personal, popular, and political narratives like a refrain promising inevitable progress. I regard addiction as the mirror of this dream in which capitalist processes of production and consumption are embodied at their imaginable limits and addicts[1] appear as perfected capitalist subjects. Drug addicts produce to consume and consume to reproduce themselves, a cycle of reproduction that tightens as their world shrinks, as they increasingly withdraw from social relations to become an economy of one—an autonomously productive and consumptive individual who destroys themselves to reproduce themself (Pine 2019). Addiction emerges as a problem alongside the fantasy of a “good life” characterized by “upward mobility, job security, political and social equality, and lively, durable intimacy” (Berlant 2011: 3). What habits and histories shape the endurance of this dream and why do we imagine anything different as a failure?
Anthropology that deals with addiction in America tends to displace this problem of desire—the need to do or have something coupled to the impossibility of its doing or having—and focus instead on the contradictions embedded in frameworks of diagnosis, treatment, and criminalization (Bourgois and Schonberg 2009; Garcia 2010; Zigon 2019). This literature often asks, is addiction a medical or social phenomena? Is it a moral or economic failure? Is it best addressed by police or doctors? The answer is always both/and with an emphasis placed on one cause or the other, depending on who speaks. General practitioners, clinical specialists, and psychologists diagnose addiction as a problem of maladaptive behaviors learned through repeated experiences shaped by one’s environment, locating the problem in the gray matter between feelings, biology, and political-economy (Campbell 2007). Psychoanalytic scholarship describes it as a problem of melancholic subjects mourning a loss they can’t identify and, therefore, can’t relinquish (Garcia 2010). Biomedically, psychoanalytically, and ethnographically relapse is seen as hardwired into an addict’s mind, inscribed into their being, and promised by the diagnosis it grounds (ibid.). In these professional discourses, addiction is interpreted as the impossibility of agency in a person who is hopeless to choose differently and, cruelly, only capable of recovering from their condition by making the choice to change. This paradox weighs heavily on addicts and the people who struggle to understand, reduce, or account for their suffering.
Scholars who work around the points where American trajectories of addiction, empire, and capital meet must address which “addiction” and what “America” we are concerned with. A permanent condition? A real place? A matter of fate or projection of fantasy? What do I, as an anthropologist, think can be accounted for by turning to this strange kind of suffering-as-failure that permeates the social fabric of the nation?
Photo by Author. Taken At Fieldsite “Heroin Highway”
As fentanyl seemingly appears everywhere across America, occupying and corrupting the unproductive, empty spaces left between people increasingly understood as “winners and losers,” addiction provokes an unparalleled anxiety (Stewart 2007: 93). In April 2023, Dr. Rahul Gupta, Director of the White House Office of National Drug Control Policy, released a statement designating fentanyl combined with the tranquilizer xylazine[2] as “an emerging threat to the United States” (The White House 2023). How is American desire historically constructed and connected to the dream and life of a nation now threatened by the chemicals seeping into its body politic? The overlapping epistemic framings of addiction—as illness, as economic and social aberration, as disciplinary object—form an analytic architecture through which to approach this question in the spatial and temporal landscapes where the American Dream and a particular kind of American abjection articulate with and against one another.
The increasing ubiquity of suffering and death related to addiction across the nation means that the ethnographic field can be anywhere and everywhere.[3] I began working in upstate New York along a rural road known, to the locals who use it every day and the federally funded task force that polices its length, as “heroin highway”: a network of federal, state, county, and town roads traversing places shaped by the still unfolding destructive processes of deindustrialization and an opioid epidemic. I became fixated on the intimate connection between dispossession and dreams in this space that marked some of the earliest settler expansions “l[ying] at the hither edge of free land” (Turner 1998[1893]: 33).
These recurring disjunctions mapped a history of how the built environment—roads, factories, homes, gas stations, garbage dumps, town lines—and “infrastructure of feeling” (Berlant 2022)—the conditions of emotional and imaginative possibility—affect and envelop one another so that a certain kind of place looks and feels like somewhere naturally devastated by addiction. The anxious power of that look and feel emerges through its difference from what those of us whose desires have been educated by the American dream expect to find: the world as a territory without resistance, inevitably moving towards increasing abundance and comfort. National fantasy is inscribed in this fantasy of everyday life: historical, social, and political narratives weave together into the “promise of a totality” that exceeds individual lives while defining the exceptional potential that flickers between being a promise or a threat (Berlant 1991: 25).
Tracing these expectations that make up the “national fantasy… whose ‘Americanness’ is… central to [our] sense of entitlement and desire,” my ethnographic attention turned to Northern New Mexico as a site where fantasy and failure are in explicit and constant, not only historical, tension (Berlant 1991: 4). Working through archives of the federal Overdose Response Strategy, I read something relevant to work back East where the heroin moving along “heroin highway” was, according to my interlocutors, barely heroin at all in recent years. In a Los Angeles Times article, Miranda Lopez, the public health analyst with the state’s ORS office, was quoted: “We don’t even really see heroin overdoses in New Mexico anymore…Fentanyl has changed things in ways that are unimaginable” (Fleishman 2023). What does it mean for a problem to become unimaginable to the people and institutions tasked with its repair, especially in a place that has previously been the focus of critical work on the national struggle with addiction? How does the construction of what can be imagined, and for whom, affect how addiction has become so threatening to a nation that, since the earliest colonial accounts, “[has been] described as a promised land” (Jackson 1994: 18)?
How can anthropology approach such a convoluted problem? Foucault wrote that the question of how to choose our critical object was a matter of “determin[ing what] is the main danger” at the moment (Foucault 1982: 232). Understanding why addiction—particularly to narcotizing drugs like fentanyl and xylazine—is so dangerous to the continued existence of the nation as well as to individual drug addicts, and therefore so important to a critique of the everyday world of American, capitalist, and imperial subjects, requires thinking across many analytic terrains.
Addiction affects bodies by shaping individual lives, requiring scholars to ask questions about how those individuals are seen and treated as subjects. This means interrogating illness narratives, treatment modalities, and disciplinary regimes through ethnographic work with addicts, medical, and legal professionals in clinics, courtrooms, and prisons. These analyses move medical, scientific scholarship to social, economic, and political territory, orienting individual suffering in larger structural frameworks. Social, psychological, and economic analyses all bear out the claim that the addict is inseparable from their environment (Bourgois and Schonberg 2009; Garcia 2010; Knight 2015). These approaches to addiction understand the problem to be that the structural arrangements of our shared world—late industrial capitalism and the durability of imperialism—are operating poorly insofar as they’re unable to accommodate every person within the framework of a recognizably “good life.”
Regarded as a problem of desire, however, addiction threatens the ongoing American nation-building project not because it reflects a failure of those structural frameworks but because it demonstrates the destructive nature of their “fantasy of boundless identity” (Berlant 1991: 216). It reveals the damage caused by the self-evident expectation of the “good life,” and means taking seriously that addicts are not subjects marking where America fails to meet its potential but those that best illustrate the effects of its realization.
Notes
[1] I use the word addict with trepidation but intention. I don’t wish to reify the dehumanizing representation of all drug users as addicts or all addicted drug users as the same. However, I also don’t want to diminish the real effects of categorization on addicted drug users nor dilute the specificity of their particularly intense and damaging attachment by comparing them to drug users in general—a broad though humanizing category which reduces the specificity of suffering in the name of softening stigmatization. I also choose to use the world based on my own experience as a drug addict.
[2] The combination of the synthetic opioid fentanyl and non-opioid sedative xylazine, known colloquially as “tranq” or “tranq dope,” produces particularly visible necrotic wounds due to xylazine’s effect of slower blood flow and, therefore, reduced healing capacity (Malayala et al. 2022).
[3] According to weekly reports published by the U.S. Department of Health and Human Services, fentanyl and other synthetic opioid-related deaths across the country have risen over one thousand percent since 2013 (Mattson et al. 2021).
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