DISSERTATION ABSTRACT:
In Uzbekistan, as in most countries of the former Soviet Union, the medical discipline of narcology is a subspecialty of psychiatry from the Soviet era that focuses on treatment of problematic use of alcohol and illicit drugs. An institution of the Uzbek Ministry of Health, operated in cooperation with other state agencies charged with law enforcement and drug control, the system of narcological dispensaries is given warrant to define the scope of health activities with regard to alcohol and other drug use, drug users, and related problems, and is in turn constrained by the State. The goal of this research was to contribute to a critical understanding of narcological discourse—the dispensary system, its history, its scientific knowledge, practices, practitioners, and culture-- and to identify the factors that have caused it to be unresponsive to the emergence of widespread opiate use and HIV in the decade and a half following the collapse of the Soviet Union.
The specific aims of this study were to (1) describe the scope of the problem and contributing factors, (2) to examine the perspectives of narcologists as well as other social actors in the field, including drug users, their relatives, as well as those of NGOs, specialists, donors, and sociologists; (3) to provide a analytic framework to understand not only how the system is reproduced but to identify mechanisms and sites for change inside and outside of the narcological system, and (4) to identify areas for further research and exploration.
The research design of this study is a descriptive-critical ethnography. Multi-sited fieldwork and observations, qualitative interviews and oral histories with narcologists, drug users, and their relatives, and an extensive photo ethnography were the main sources of data for this study.
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