In biomedical and public health discourses, "chronicity" has emerged as the prevailing model to understanding drug addiction and addictive experience. This approach is predicated on constructing and responding to addictive experience in ways that underscore its presumed lifelong nature. In this essay, I examine the phenomenon of heroin addiction and heroin overdose in northern New Mexico’s Española Valley, which suffers the highest rate of heroin-induced death in the United States, and explore how the logic of chronicity is dangerously reworked through the Hispano ethos of endless suffering. Focusing on the narrative of Alma, a Hispana heroin addict who died of an overdose after many previous overdoses, I evoke a sense of the physical, historical, and institutional refrains in which she felt herself caught. By tracing Alma’s death back to these refrains, I describe the complex of entanglements in which her addiction took form and show how the discourse of chronicity provided a structure for her suffering and, ultimately, her death.
Cultural Anthropology has published many essays on public health and biomedicine. See, for example, Deepa Reddy’s "Good Gifts for the Common Good: Blood and Bioethics in the Market of Genetic Research" (2007); Stacy Leigh Pigg’s "Languages of Sex and AIDS in Nepal: Notes on the Social Production of Commensurability" (2001); and Mei Zhan’s "Does it Take a Miracle? Negotiating Knowledges, Identities and Communities of Traditional Chinese Medicine" (2001).
Cultural Anthropology has also published a number of essays that critically analyze uneven distributions of risk and privilege in the United States. See, for example, George Lipsitz’s "Learning from New Orleans: The Social Warrant of Hostile Privatism and Competitive Consumer Citizenship" (2006); Henry Jenkins’s "'People from that Part of the World': The Politics of Dislocation" (2006); and Joseph Masco’s "Mutant Ecologies: Radioactive Life in Post–Cold War New Mexico" (2004).
About the Author
Angela Garcia is Assistant Professor of Cultural Anthropology at Stanford University. Professor Garcia’s work engages historical and institutional processes through which violence and suffering is produced and lived. A central theme is the disproportionate burden of addiction, depression and incarceration among poor families and communities. Her research is oriented toward understanding how attachments, affect, and practices of intimacy are important registers of politics and economy. She is also interested in the literary integrity of anthropological writing.
Garcia’s book, The Pastoral Clinic: Addiction and Dispossession Along The Rio Grande (University of California Press, 2010) explores the relationship between intergenerational heroin use, poverty and colonial history in northern New Mexico. It argues that heroin addiction among Hispanos is a contemporary expression of an enduring history of dispossession, social and intimate fragmentation, and the existential desire for a release from these. Ongoing work in the U.S. explores processes of legal “re-entry” and intimate repair that incarcerated and paroled drug users undertake, particularly within kin networks. She is currently engaged in research in Mexico City that examines emerging scientific and juridical discourses related to narcotics addiction. This work focuses on the implications of these discourses to support Mexico’s governance strategies and their consequences for families and communities addicted to narcotics in the setting of urban poverty. (Source: http://www.stanford.edu/dept/anthropology/cgi-bin/web/?q=node/939)
"The Elegiac Addict: History, Chronicity, and the Melancholic Subject" was awarded the 2009 Stirling Prize for Best Published Work in Psychological Anthropology by the AAA’s Society for Psychological Anthropology.
Public Radio program "State of the Re:Union" provides in-depth radio reporting on the Española Valley, in an episode entitled "Española – The Land Remembers":
"Settled by Spanish conquistadors in 1598, the area’s rich cultural past is still evident today in its music, art, and way of life. But changing demographics, along with a shift in the local economy has left many residents without land, water, and a sense of identity. State of the Re:Union travels to the Española Valley of Northern New Mexico to explore the area’s history of dispossession, and to discover what the rest of the country can learn from this still vital region of the American Southwest. From ancient water distribution methods to low riders, SOTRU goes to find out."
The program focuses specifically on the prevalence of heroin use in the Española region from minutes 17:00 to 23:00 (full episode here: http://stateofthereunion.com/home/season-2/espanola-nm). This segment of the show features a 27-year old recovering heroin addict, a Lieutenant with the Española Police Department, and Angela Garcia’s commentary on the history of dispossession of land and language in the region, and how she began to do research in the area.
A local Independent newspaper, High Country News, covers issues and stories that define the American West. Angela Garcia has written two articles for the paper:
"Land of Disenchantment." High Country News, April 3, 2006.
"Digging deep: Addicts get back to the land in northern New Mexico." High Country News, December 8, 2008.
Angela Garcia has also published op-ed pieces about heroin use and treatment in New Mexico in mainstream newspapers:
"How Dion Died." Los Angeles Times, July 17, 2010.
"Heroin Vaccine Won't 'Cure' What Ails Addicts." April 2012, Los Angeles Times, April 15, 2012.
Questions for Classroom Discussion
1. Garcia describes multiple dimensions of chronicity that converge in the Española Valley. What are the different discourses that structure time in the context of heroin use in New Mexico, and how do they come to be expressed through the lives of individuals like Alma?
2. Consider the genre of the single-person ethnography: what do you find most valuable or most surprising about the way this article recounts the life story of a single person? What does Garcia’s article allow us to see that a more typical ethnographic account might not, and what might be obscured through her focus on Alma as a central figure?
3. What does Garcia mean by "ideological frameworks for drug use"? What examples does she give of how those ideological frameworks become instituted in practice?
4. Several institutions appear in Garcia’s piece – hospitals, drug courts, the treatment facility Hoy Recovery, an evangelical church, and even Los Alamos National Laboratories. What role do institutions play in shaping the circumstances of Alma’s life?
5. What is psychological anthropology? In what ways do you think such an approach shapes Garcia’s analysis?
In the November, 2008 issue of Cultural Anthropology, Angela Garcia examines heroin addiction and overdose in northern New Mexico's Española Valley, currently home to the highest rate of heroin-induced death in the U.S. Garcia explores how a Hispano ethos of endless suffering dangerously reworks logic of "chronicity" – the prevailing model of drug addiction and addictive experience. Through the narrative of Alma, a Hispana heroin addict who died following repeated overdoses, Garcia describes the structuration of Alma's suffering and death within the discourse of chronicity.
Garcia closely followed Alma for two years as she moved within and between the clinic, drug courts, "picaderos" [shooting galleries], home and church, attempting to reconcile the inherent contradictions of heroin addiction. Through this work, Garcia demonstrates how the interplay of local and biomedical discourses compelled the "endlessness" Alma felt herself prisoner of, caught between the recurring pains of Hispano life in Española Valley and the preparation for "recovery" from a condition defined by the chronicity model as unending. Of primary concern for Garcia is the "experiences of loss and memories of it, how intersecting forms of history come to bear on the present, and how heroin use-and overdose in particular-exposes the painful recognition that the future has been swallowed up by the past."
Drawing upon past anthropological literature on the effect of medical and technical forms of knowledge on subjectivity, Garcia develops a critical phenomenology of heroin addiction, evoking what she terms the "elegiac" nature of heroin addiction in the Hispano millieu.