2013/11/18 by Allison McKim
Health Professions · Psychology · Social Sciences · #Criminal Justice and Corrections Analysis #Homelessness and Social Issues #Psychopathy, Forensic Psychiatry, Sexual Offending
paper · doi:10.1086/673089
openalex publication_date 2013/11/18 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30
Addiction treatment is central to state governance, particularly to systems that manage crime and poverty. While a growing body of research on penal treatment suggests that it reflects punitive, neoliberal trends in punishment, we know much less about how these programs compare to treatment outside the criminal justice system. This article ethnographically compares two “gender-sensitive” addiction treatment programs for women: one is an alternative-to-incarceration facility, while the other is funded by health insurance and has no ties to the penal state. It analyzes how and why women’s appearance and gender presentation became an important target of reform at the penal program but not at the health-care program. Their practices reflect different understandings of addiction and reveal the intersection of class, race, and gender in systems that govern crime and substance use. For the penal program, addiction stems from women’s deficient self-esteem, and this degraded self manifests in their failure to meet gendered appearance norms. Through this, women’s class- and race-based material constraints are turned into psychological problems. The health-care program did not give its clients makeovers, because the clients were constructed as respectable people whose main problem was substance abuse. I chart how race, class, and gender distinctions are built into the discursive and institutional organization of the addiction treatment field—and how, through treatment, the carceral state imparts distinctively racialized, classed, and gendered stigmas. Ideas about addiction thus operate as a framework for understanding and governing social marginality and must be understood intersectionally.