QMJC May 2023: The lived effects of prison drugs policy

In May 2023, colleagues from Deakin University (Australia) held a meeting of the Qualitative Methods Journal Club to discuss an article about how drug use is problematised in prison drugs policy in Victoria (Australia).

Summary

Over the last decade, Carol Bacchi’s post-structuralist approach to policy analysis, “What’s the problem represented to be?”, has been used widely to explore ‘problematisations’ in alcohol and other drug policy. Informed by Foucault’s work on power and problematisations, Bacchi’s analytic approach poses a series of questions designed to make policy problematisations visible and to question often taken-for-granted policy framings and solutions, exposing the assumptions and norms underpinning them. To date, few studies have examined how policy problematisations are taken up, experienced, and disrupted by the targets of such policies.

May’s article for the Qualitative Methods Journal Club was authored by Shelley Walker and colleagues, and explores how the problem of drug use in prison is represented in prison drug policy in Victoria (Australia) and how incarcerated young men with histories of injecting drug use negotiate the discursive and subjectification effects of these problematisations.

First, the authors examine two policy and programme documents from the Identified Drug User Program (IDUP) that aims to address illicit drug use in prison. Applying Bacchi’s approach they identify how the IDUP is underpinned by two contradictory discourses:  one that centres care through drug treatment and another that prioritises control via disciplinary measures. Through these discourses, incarcerated young men are positioned on the one hand as ‘rational’ subjects deserving of treatment, and on the other, they are problematised as untrustworthy, deviant, offending subjects who require surveillance. The authors argue that these contradictory subject positions limit how the problem of drugs in prison is conceptualised, generating harmful outcomes for young, incarcerated men, such as sanctions that restrict contact visitation and family contact.

In the second part of the article, the authors explore how these policy problematisations shape the lived experiences of young, incarcerated men with histories of injecting drugs. Analysing interview transcripts with young men (aged 19–24) about their experiences of incarceration, drug use, and release from prison, they argue that the complex ways in which young men use drugs illegally in prison are silenced in the IDUP. For example, while the IDUP policy documents reduce the problem of drug use to a straightforward criminal problem requiring legal sanctions, participants describe multiple reasons for using diverted prescription medications such as buprenorphine (an opioid substitution treatment), for example, to manage withdrawal symptoms, pain, insomnia, anxiety, mental health conditions, and boredom.

Discussion

Members of the group thought this was an excellent example of combining Bacchi’s post-structuralist approach to policy analysis with an exploration of qualitative interview data to explore the lived effects of policy discourses. By combining these two forms of qualitative data, the authors were able to produce novel insights into the lived experiences of incarcerated young men as the targets of prison drug policy. For example, they identified that the IDUP obscures the reasons why young male prisoners resort to accessing and taking drugs illegally, namely the fact that they are denied access to medications for drug dependence and other health conditions. Importantly, they would have access to such medications if they were not incarcerated, which highlights how the prison system works to deny their legitimate rights to healthcare.

This problem was ignored and silenced in the IDUP, as were the many barriers young men reported in regard to accessing drug treatment and services in prison. By comparing policy problematisations with lived experiences, the authors were able to demonstrate how these structural impediments to social support and services actually help to produce the very ‘drug problem’ in prison that the IDUP aims to address.

A real strength of this article was the identification of how punitive responses to drug-related behaviour, such as the loss of contact visitation rights, produce the kinds of distress and harms that can, in some cases, lead to increased drug use. As the authors argue, criminal justice practices, such as those contained in the IDUP, can cut prisoners off from family and may contribute to reoffending and reincarceration.

Qualitative analysis of prison experiences is rare, and this article demonstrates the significant value of centring the voices of people with lived experiences of the criminal justice system to identify how drug policy can move away from punitive measures that entrench stigma and harm, and instead prioritise measures designed to foster social connection and positive outcomes for marginalised people.

by Dr Renae Fomiatti, Dr Kiran Pienaar, Dr Ashleigh Haw, and Dr Kyja Noack-Lundberg.

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