“A moment of self discovery”: Navigating Healthcare Through the Illicit use of Prescription Stimulants

• In Event: 50611 - Drugs, Society, and Health: Sociological Perspectives on Substance Use

Abstract

Amidst the growing concern surrounding prescription stimulants (PSs) and their (mis)use, the questions of how such drugs should be accessed and by whom have grown. A practice that speaks to such questions is asking potential patients if they previously (mis)used PS’s without a prescription. The practitioner often denies treatment if the patient answers yes. Research on illicit PS use finds that individuals often turn to self-medication in response to financial or bureaucratic challenges leaving them no longer able to access the formal healthcare they were previously receiving, including access to their ADHD medication. Consequently, individuals often rely on the tools gained throughout their formal PS use when navigating informal PS use. Although robust, self-medicated PS use literature is limited to focusing on a particular set of individuals whose stories start in healthcare, leaving the experiences of those in different stages of treatment and access to care unexamined. Addressing this gap, I conduct 30 interviews with people who have illicitly used PS’s for self-medication. Participants viewed their unprescribed PS use not exclusively as self-medication, but rather, as a diagnostic tool. Rather than using PS’s to alleviate the symptoms associated with confirmed or speculated ADHD, participants identified their illicit use as an evaluative process whereby they took prescription stimulants to gain insight into their condition. This diagnostic practice was a strategy addressing feelings of frustration and disempowerment surrounding mental health services. Illicitly taking drugs in an analytic and self-monitored way, participants used the information gained from their experience to create certainty in a precarious system. Distinguishing alleviation from evaluation, this research reveals how individuals use illicit drug use experiences as knowledge to create patient agency. Illuminating how individuals navigate the medical field, this research gives a window into the ever-changing relationship between the patient and their healthcare.

Author

• Katherine Clarke, University of Oregon