“Buprenorphine doesn't hold me”: Neurochemical afterlives of state violence and the struggle for meaning in addiction treatment

This paper analyzes two disparate experiences of buprenorphine, a medication for opioid addiction, in California. Within the context of the U.S. War on Drugs and after decades of criminalization, buprenorphine represents a shift toward outpatient medical treatment of opioid addiction, but it has been unequally distributed and experienced across geographic settings and populations. Drawing on my interlocutor's description of buprenorphine's "hold," I interrogate how buprenorphine's symbolic and pharmacological power to embrace, restrain, and otherwise "hold" people arises through its social context. "Holding" is a patient-driven epistemology, working metaphorically and neurochemically, illustrating raced, classed, and gendered positionalities that simultaneously express and constrain forms of agency and resistance in ideological struggles over the meanings of care in addiction treatment. Buprenorphine's "hold," or lack thereof, can be read as a neurochemical embodiment of state violence, revealing intensities of carceral forms of "care" and possibilities for transforming addiction treatment meanings.