This thesis aims to investigate and deconstruct the relationship between the narcotic, its narrative, and western modernity. To reveal the relationship, this thesis argues that it is possible to understand the philosophical, political, cultural and ethical dimensions of western modernity through the ulterior lens of the narcotic. As such, this thesis investigates western modernity's relationship to (a) cocaine as a specific narcotic, and (b) the concept of the narcotic with all its attendant connotations of addictions, illegitimacy, transgression, illegality, and so on. Accordingly, the thesis is both interpretive of the historical narrative of the narcotic of cocaine, and generative in its deconstruction of the relationship between western modernity and the concept of the narcotic. The deconstruction of this relationship ultimately reveals both prior narratives not as oppositional, but as supplementary. This has radical consequences for the manner in which we engage with narcotic use and the user - if the narcotic is supplement to the logic of western modernity, at each attempt to expel the use and user of the narcotic, rather then create difference, we self implicate ourselves in that expulsion and distance. To seek a new and more just means of dealing with the concept of the narcotic, and its use, therefore requires a new epistemological framework which can at once contemplate both narratives at the same time. To this end, the thesis suggests the use of critical complexity theory as one such methodological tool, if supplemented by the thoughts and strategies of Derridian deconstruction and Foucauldian discourse analysis.

Made available in DSpace on 2017-06-01T18:08:21Z (GMT). No. of bitstreams: 1 Eugenia Chaves.pdf: 1729965 bytes, checksum: 48ab84740ead0c769aeb7d5219756d5d (MD5) Previous issue date: 2006-04-28 / The objective of this present study is to give a little contribution to the answer that the psychoanalytic clinic is asked to give to the matter of drug addiction and its treatment. It is indeed a theoretical research, whose two main parts are linked to the matters of drug dependence and psychoanalytic transference. The theoretical reflections were clarified with the testimonies of some psychoanalysts that deaI. with drug dependants. On the part we tried to understand, through some fundamental references of the Freudian Meta psychology, the main characteristics of the psychic and pulsing life of the drug addict. On the second part, we dedicated to the problem of the psychoanalytical treatment of those patients, we tried to raise the problem of some specific aspects that present themselves as obstacles or possibilities for the constitution of a transferential field and the handling necessary for lhe creation of a analytic field, where the drug addict may be guarded and heard so as to be given an analytic treatment. The second part was algo divided into two chapters, the first one deals with the trajectory that Freud went through for a theoretical elaboration of the psychoanalytical concept of the transference thus showing its central importance in the analysis. The second one deals with the clinical news that drug addiction represents and the various problems that it raises; the arrival of the drug dependent to the analyst, his demands -that are not generally related to analysis -and the attitude in which these patients have the tendency of placing the analyst -We still make a reference to the complexity of the multiple transferences inherent to the institutional treatment an to the new challenge that they represent to the psychoanalytical clinic / O presente trabalho tem como objetivo trazer uma pequena contribuição à resposta que a clínica psicanalítica vem sendo solicitada a dar para a questão da toxicomania e do seu tratamento. Trata-se, pois, de uma pesquisa fundamentalmente teórica, cujas duas grandes partes articulam os temas da Toxicomania e da Transferência psicanalítica. As reflexões teóricas foram ilustradas com os testemunhos de alguns psicanalistas que lidam com toxicômanos. Na primeira parte, buscou-se compreender, mediante algumas referências fundamentais da Metapsicologia freudiana, as principais características da vida psíquica e pulsional do toxicômano. Na segunda parte, dedicada ao problema do tratamento psicanalítico desses pacientes, procurou-se problematizar alguns aspectos específicos, que se apresentam como obstáculos e/ou possibilidades para a constituição de um campo transferencial e os manejos que se fazem necessários para a criação de um espaço analítico, onde possa o toxicômano ser acolhido e escutado em vista de um tratamento analítico. A segunda parte, por sua vez, foi dividida em dois capítulos, o primeiro dos quais aborda a trajetória percorrida por Freud para a elaboração teórica do conceito psicanalítico de transferência, mostrando sua central importância na análise. O segundo trata da novidade clínica que a toxicomania representa e as diversas questões que levanta: a chegada do toxicômano ao analista, suas demandas que geralmente não são de análise , e a posição em que esses pacientes tendem a colocar o analista. Faz-se, ainda, uma referência à complexidade das transferências múltiplas, próprias do tratamento institucional, e ao novo desafio que elas representam para a clínica psicanalítica

La présente recherche porte sur quelques contingences et destins de la libido unique des sujets concernés par notre étude et appelés couramment « toxicomanes ». La fonction de la drogue est parfois sujette à des bouleversements dans des conjonctures très précises que l’on peut bien appeler « contingentes ». En psychanalyse, la contingence est articulée au régime de la nécessité. Ces diverses conjonctures vont marquer un avant et un après inoubliable dans la vie du sujet. Ce sont des moments où une pratique de jouissance et une position narcissique inhérente à cette pratique commencent à être questionnées par le sujet. Rencontres traumatiques avec le réel de la sexualité et/ou la mort à partir desquelles il y a une remise en question des repères habituels de quelqu’un qui se prétendait un « in-dividu ». Cela nous montre que si les toxicomanies sont une préférence accordée à une certitude de jouissance-Toute, une préférence contre un désir ou contre une jouissance sexuelle, elle n’est pas définitive et fermée dans tous les cas. Il y a un reste de la sexualité qui résiste à toute guérison (un « a ») et dont le retour et l’insistance peut à des moments singuliers perturber l’économie libidinale d’un sujet toxicomane. Un reste dont un sujet peut tirer profit lors d’un traumatisme, par exemple, afin de se mettre au travail ou au moins pour qu’il nous adresse une souffrance qui l’interpellait avant le début de sa consommation. Bien que l’occasion soit contingente, sortir d’une toxicomanie par le biais d’un symptôme entendu comme une possible solution singulière reste une initiative du sujet qui portera la marque de la structure clinique. Il y a un remaniement des repères temporels du sujet d’une part, et un passage par l’affect de l’angoisse ou la honte d’autre part. Ces deux affects peuvent être des boussoles dans une cure, ainsi que des effets d’une destitution d’un narcissisme et d’une présence du signifiant dans le réel du corps et du langage. Une présence qui se fait de plus en plus évidente et indéniable, et qui mènera le sujet à s’adresser à quelqu’un qui prenne en compte le plus singulier de sa souffrance. Cette écoute est susceptible de mettre en place un transfert sur quelqu’un qui n’est pas un alchimiste mais quelqu’un qui, au contraire, apporte son manque. / The present investigation addresses certain contingencies and destinies of the subjects that were the object of this study, who are commonly referred to as "drug addicts". The function of the drug can, at times, be transformed in the context of precise conjunctures which we may characterize as "contingent”. In psychoanalysis, contingency is linked to the regime of necessity. These diverse conjunctures mark an unforgettable before and after in the life of a subject. They are moments where a practice of enjoyment is ruined and a narcissistic position begins to be questioned by the subject, traumatic encounters with the reality of sexuality and death, from which arises a questioning of the usual points of reference of someone who considered themselves an "individual". This shows us that if drug addictions are a preference for a certainty of total enjoyment, a preference against desire and against sexual enjoyment, it is not definitive and closed in all cases. There is a remnant of sexuality that resists any cure and whose return and insistence can at certain times disturb the libidinal economy of a drug addict subject. A remnant of which he can extract a benefit in the context of a trauma, to get to work or at least to direct us a suffering that had been questioning him for a long time, before his first consumption. Although the occasion is contingent, leaving a practice of drug addiction by way of a symptom, understood as a possible singular solution, is an initiative of a subject that will have the stamp of the clinical structure. There is a restructuring of the temporal references of the subject on the one hand, and a passage for the feeling of anguish or shame on the other hand. These two feelings can be guides in a cure, as well as the effects of destitution of a narcissism and a presence of the signifier in the real of the body and language. A presence that is becoming more and more inevitable and that will lead the subject to address someone who takes into account the most unique aspect of their suffering. This listening is susceptible to generate a transfer in someone who is not an alchemist, but someone who is able to put his fault in play for those who consult it. / La presente investigación trata acerca de ciertas contingencias y destinos singulares de los sujetos que fueron objeto de este estudio y que comúnmente se los denomina “toxicómanos”. La función de la droga puede estar, a veces, sujeta a transformaciones en el marco de coyunturas precisas que podemos caracterizar como “contingentes”. En psicoanálisis, la contingencia está ligada al régimen de la necesidad. Estas coyunturas diversas marcan un antes y un después inolvidable en la vida de un sujeto. Son momentos donde una práctica de goce se arruina y una posición narcisista comienza a ser puesta en cuestión por parte del sujeto. Rencuentros traumáticos con lo real de la sexualidad y de la muerte, a partir de los cuales surge un cuestionamiento de los puntos de referencia habituales de alguien que se tomaba por un “in-dividuo”. Lo que nos muestra que si las toxicomanías son una preferencia por una certeza de goce-Todo, una preferencia contra el deseo y contra el goce sexual, ella no es definitiva y cerrada en todos los casos. Hay un resto (a) de la sexualidad que resiste a toda cura y cuyo retorno e insistencia puede en ciertos momentos perturbar la economía libidinal de un sujeto toxicómano. Un resto del cual él puede extraer un beneficio en el marco de un traumatismo, para ponerse a trabajar o al menos para que nos dirija un sufrimiento que lo interpelaba hacía tiempo, antes de su primer consumo. Si bien la ocasión es contingente, salir de una práctica de toxicomanía por la vía de un síntoma entendido como una posible solución singular, es una iniciativa de un sujeto que tendrá el sello de la estructura clínica. Hay una reestructuración de las referencias temporales del sujeto por un lado, y un pasaje por el afecto de la angustia o de la vergüenza por otro lado. Estos dos afectos pueden ser orientadores en una cura, así como los efectos de destitución de un narcisismo y de una presencia del significante en lo real del cuerpo y del lenguaje. Una presencia que se hace cada vez más inevitable y que llevará al sujeto a dirigirse a alguien que tome en cuenta lo más singular de su sufrimiento. Esta escucha es susceptible de generar una transferencia en alguien que no es un alquimista, sino alguien que es capaz de poner en juego su falta para quien lo consulta.

abstract: Intermittent social defeat stress induces psychostimulant cross-sensitization, as well as long-lasting social avoidance behavior. Previous data reveal heightened expression of AMPA receptor (AMPAR) GluA1 subunits in rat ventral tegmental area (VTA), which occurs concurrently with social stress-induced amphetamine (AMPH) cross-sensitization. These studies described herein examined whether VTA GluA1 AMPARs are important for the behavioral consequences of social stress and investigated the role of the infralimbic (IL) to VTA pathway in the induction of these responses. Functional inactivation of GluA1 in VTA DA neurons prevented stress-induced AMPH sensitization without affecting social avoidance behavior, while GluA1 overexpression in VTA DA neurons mimicked the effects of stress on AMPH sensitization. Female rats were more sensitive to the effects of stress on AMPH administration than males, specifically during proestrus/estrus, which is characterized by higher circulating estradiol. Fluorescent immunohistochemistry revealed that females expressed higher GluA1 in VTA DA neurons as a result of intermittent social defeat stress, independent of estrus stage; by contrast, females during proestrus/estrus displayed higher tyrosine kinase receptor type 2 (TrkB) expression, which is the receptor for brain derived neurotrophic factor (BDNF), in VTA DA neurons, independent of stress exposure. Functional inactivation of GluA1 in VTA DA neurons prevented stress-induced AMPH sensitization and overexpression mimicked the effects of stress on AMPH sensitization. This suggests that BDNF-TrkB signaling may work concomitantly with GluA1 signaling in the VTA to drive sex-dependent differences in stress-induced locomotor sensitization effects. Optogenetic inhibition of the IL-VTA pathway in male rats prevented stress-induced AMPH sensitization compared to control animals. In addition, fluorescent immunohistochemistry displayed less Fos labeling in the nucleus accumbens (NAc) of rats with IL-VTA light inhibition compared to control animals. This suggests that the IL-VTA pathway plays a critical role in the induction of stress-induced sensitivity to AMPH, and blocking this pathway prevents mesolimbic DA signaling to the NAc. We conclude that IL glutamate projections onto GluA1-homomeric AMPA receptors in VTA DA neurons play a critical role in driving the stress-induced sensitization response in males and females. Therefore, GluA1 VTA DA neurons could potentially be a therapeutic target to prevent stress-induced drug susceptibility in the future. / Dissertation/Thesis / Doctoral Dissertation Neuroscience 2020

Animals respond to changes in the environment and internal states to modify their behavior. The basal ganglia, including the striatum contribute to action selection by integrating sensory, motor and reward information. Therefore, dysregulation of striatal function is common in many neuropsychiatric disorders, including Parkinson’s disease, Huntington disease, schizophrenia, and addiction. Here, using fiber photometry, pharmacology, and behavioral approaches in transgenic mice, I explored the cellular and circuit mechanisms underlying key striatal functions. In Chapter 1, I begin by presenting the existing literature on the anatomy and physiology of the striatum. Next, I review the important functions of the striatum. Within this general review, I highlight the specific roles that striatal (DA) and acetylcholine (ACh) play in striatal circuitry and function. In Chapter 2, I demonstrate the naturally evoked ACh dip has a DA component and a non-DA component. Specifically, I show that DA via cholinergic DA D2 receptors (D2Rs) modulate the length of the ACh dip and rebound ACh levels following the dip. In addition, I show that DA coordinates the activity between DA and ACh during behavior. Finally, I present data that supports a role for ACh in motivated behavior. In Chapter 3, I show that cholinergic D2Rs are not necessary for reward learning but do facilitate reversal learning in a probabilistic choice task. In addition, I show that changes in DA and ACh levels contribute to reversal learning in a probabilistic choice task. Finally, in Chapter 4, I discuss the general conclusions and study implications, as well as future directions.

[pt] O uso de substâncias psicoativas sempre esteve presente na sociedade (de forma recreativa, terapêutica ou religiosa). A dependência em relação a essas substâncias, por sua vez, tem ocupado cada vez mais espaço na mídia e em discussões político-sociais que buscam entender o fenômeno. Questões culturais, sociais, econômicas, farmacológicas e psíquicas devem ser consideradas quando se propõem teorias e ações de tratamento. Esse trabalho investiga as principais concepções teóricas acerca das toxicomanias no campo da psicanálise e analisa seus percursos teóricos. Destaca os principais conceitos que embasam as teorias, apura as divergências e convergências e verifica a evolução destas a partir do surgimento de novas perspectivas e da influência do contexto social contemporâneo a elas. Para melhor compreensão do contexto no qual essas teorias foram elaboradas, foi feito um levantamento da história do uso de drogas e do tratamento dos toxicômanos ao longo da história. Em seguida, investigou-se as principais concepções teóricas no campo da psicanálise através de um mapeamento de obras de autores clássicos e contemporâneos. Destacou-se e analisou-se os principais conceitos-base para as teorias encontradas. Como resultado, identificou-se alguns eixos teóricos, que partem do narcisismo, identificação, destrutividade, compulsão à repetição e relações objetais. Também observou-se variações no estatuto psicopatológico, classificado como sintoma, estrutura, quadro, dentre outros. Por fim, constata-se que, apesar das divergências existentes, o recurso aos tóxicos predomina enquanto uma tentativa de remediar uma angústia, ainda que tenha consequências nocivas. / [en] The use of psychoactive substances has always been present in society (in a recreational, therapeutic or religious way). The addiction to these substances, in turn, has been more and more present in the media and in political-social discussions that try to understand the phenomenon. Cultural, social, economic, pharmacological and psychological aspects must be considered when theories and treatment actions are proposed. This work investigates the main theoretical conceptions about drug addictions in the psychoanalysis field. It also analyzes their theoretical paths. It highlights the main concepts that underlie the theories, refines divergences and convergences, verifies their evolution from the emergence of new perspectives and verifies the influence of the social context to them. In order to understand the context in which these theories were elaborated, a survey of the history of drug use and treatment of drug addicts was made throughout history. Moreover, the main theoretical concepts in psychoanalysis were investigated through a bibliographical analysis of works in both classic and contemporary authors. The main basic concepts for the theories found were highlighted and analyzed. As a result, some theoretical biases were identified, from narcissism, identification, destructiveness, repetition compulsion and object relations, for instance. There were also variations in psychopathological status, classified as symptom, structure, condition, among others. Finally, it was noted that despite the disagreements, the use of toxic substances predominates as an attempt to relieve anguish, even if the psychotropic medication has harmful consequences.

Background World Drug Report estimates the number of opioid users at 53 million and identifies opioids as responsible for two thirds of the 585,000 people who died as a result of drug use in 2017. Purpose The purpose of this study was to analyze the testimonies of 30 people regarding their journeys from drug addiction to drug withdrawal in Taiwan. Methods This was a qualitative research design. The sample inclusion criteria were as follows: (a) being a drug abuser, (b) completed the Christian Gospel Drug Withdrawal Program or church-sponsored program, and (c) shared their related testimony on the Good TV television channel in Taiwan. The participants' stories were posted in Chinese, transcribed by the author, and translated from Chinese into English. Content analysis was used to identify the major themes. Results Of the 30 participants, 24 were male (80%) and six were female (20%). The major themes identified in their testimonies were: (a) Using illegal drugs related to peer recognition, lack of knowledge, and temptations; (b) drug addiction was an endless pain cycle; (c) turning points related to love, repentance, and hope; (d) drug withdrawal was related to avoiding temptation and overcoming the drug withdrawal syndrome through the Holy Spirit; and (e) outcomes were faith and new life. Conclusions/Implications for Practice In this study, people who received the gospel drug withdrawal programs expressed that their lives had changed, they had withdrawn from drugs successfully, they had become volunteers to help others, and interactions with their family had improved. These programs may be applied in the mental health nursing profession.

Thesis (M.S.)--Boston University / The purpose of this study is to learn to what extent the various treatments available for alcoholics and drug addicts, in addition to detoxication and drug withdrawal, were used by patients who were admitted to the Washingtonian Hospital; to ascertain to what extent social work services were used, and to ascertain, as far as possible, what services were offered by either the medical staff or the social service department but not accepted.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

This dissertation advances our understanding of the variability and contingency of addiction treatment, a consequential social institution that simultaneously helps and regulates populations within criminal justice and healthcare systems. To do so, this dissertation draws on administrative and survey data, as well as archival and ethnographic research. I show that addiction treatment is structured by social, institutional, and historical contexts within which Americans are embedded. Together, the three chapters demonstrate the utility of venturing across time and place as a method of interrogating the distinction between care and control. Using macro-sociological theory and research, aspects of the project also help broaden our understanding of addiction treatment as vital to the enactment of contemporary state governance. I refer to this as therapeutic statecraft. Chapter 1 looks at how legal coercion is used to force people into rehab and how this practice is influenced by the interplay between state welfare and punishment systems. I find that coerced treatment is less common in states with broad and benevolent welfare systems that offer alternative pathways for residents to receive care and avoid minor encounters with the criminal justice system. Moreover, the extent to which poverty affects a state’s reliance on the criminal justice system as a referral source is contingent upon the degree of interpersonal surveillance facilitated by the broad administrative reach of state welfare systems. Furthermore, coerced treatment typically has a more disruptive, institutional character under punitive state contexts (i.e., strong-arm rehab). Chapter 2 reveals how racial disparities in state-mandated, community-based drug treatment referrals are exacerbated in places with racially punitive criminal justice systems and surveillance-oriented welfare systems. These systems work together to discreetly extend penal power in the name of recovery for a population segment. Chapter 3 examines changes in the care of sexual minorities at a specialized drug treatment facility over the past 30 years. The study finds that while staff members previously saw sexual stigma and discrimination as the source of addiction, current staff members use sexual stigma to regulate patients' "addictive tendencies," and may risk exacerbating stigma and inequality by losing sight of the broader underlying causes of addiction. Taken as a whole, the project’s findings contribute to our understanding of the significance of addiction treatment in contemporary times, particularly within the context of social policy and population management in the United States.