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Open Access Publications from the University of California

Scholarly Works (42 results)

  • Peer Reviewed
UCLA Previously Published Works (2015)
    Cover page: Postface
    • Article
    • Peer Reviewed
    UC San Francisco Previously Published Works (2001)
      Cover page: “The Power of Violence in War and Peace: Post-Cold War Lessons from El Salvador
      • Article
      • Peer Reviewed
      UCLA Previously Published Works (2018)
      The cultural and political-economic valences of psychoactive drugs in the Global South offer critical insights on local and international fault lines of social inequality and profiteering. Historically, in a classic primitive accumulation process the trafficking of industrially produced euphoric substances across the globe have wreaked havoc among vulnerable populations while extracting profit for the powerful. The complex flows of capital generated both by illegal addiction markets and also by the mobilisation of licit public funds to manage their mayhem, however, suggest the contemporary utility of the concept of 'predatory accumulation'. The Enlightenmentera concept of 'primitive accumulation' usefully highlighted state violence and forcible dispossession in the consolidation of European capitalism. A contemporary reframing of these processes as predatory accumulation, however, highlights contradictory, nonlinear relationships between the artificially high profits of illegal drug sales, repressive governmentality and corporate greed. It sets these patterns of destructive profiteering in the context of our moment in history.
        Cover page: Decolonising drug studies in an era of predatory accumulation
        • Article
        • Peer Reviewed
        UC San Francisco Previously Published Works (2001)

        The Cold War sanitized the author’s analysis of political violence among revolutionary peasants in El Salvador during the 1980s. A 20 year retrospective analysis of his fieldwork documents the ways political terror and repression become embedded in daily interactions that normalize interpersonal brutality in a dynamic of everyday violence. Furthermore, the structural, symbolic and interpersonal violence that accompanies both revolutionary mobilization and also labor migration to the U.S. inner city follows gendered fault lines. The snares of symbolic violence in counterinsurgency war spawn mutual recrimination and shame, obfuscating the role of an oppressive power structure. Similarly, everyday violence in a neo-liberal version of peacetime facilitates the administration of the subordination of the poor who blame themselves for character failings. Ethnography’s challenge is to elucidate the causal chains and gendered linkages in the continuum of violence that buttresses inequality in the post-Cold War era.

          Cover page: The power of violence in war and peace: Post Cold-War lessons from El Salvador
          • Article
          • Peer Reviewed
          UC San Francisco Previously Published Works (2016)
          This commentary revisits the political turmoil and scientific controversy over epidemiological study findings linking high HIV seroincidence to syringe exchange attendance in Vancouver in the mid-1990s. The association was mobilized polemically by US politicians and hard-line drug warriors to attack needle exchange policies and funding. In turn, program restrictions limiting access to syringes at the Vancouver exchange may have interfaced with a complex conjunction of historical, geographic, political economic and cultural forces and physiological vulnerabilities to create an extraordinary HIV risk environment: (1) ghettoization of services for indigent populations in a rapidly gentrifying, post-industrial city; (2) rural-urban migration of vulnerable populations subject to historical colonization and current patterns of racism; and (3) the flooding of North America with inexpensive powder cocaine and heroin, and the popularity of crack. In fact, we will never know with certainty the precise cause for the extreme seroincidence rates in Vancouver in the early to mid-1990s. The tendency for modern social epidemiology to decontextualize research subjects and assign excessive importance to discrete, "magic bullet" variables resulted in a counterproductive scientific and political debate in the late 1990s that has obfuscated potentially useful practical lessons for organizing the logistics of harm reduction services - especially syringe exchange - to better serve the needs of vulnerable populations and to mitigate the effects of political-economically imposed HIV risk environments. We would benefit from humbly acknowledging the limits of public health science and learn to recognize the unintended consequences of well-intentioned interventions rather than sweep embarrassing histories under the rug.
            Cover page: Injecting drugs in tight spaces: HIV, cocaine and collinearity in the Downtown Eastside, Vancouver, Canada.
            • Article
            • Peer Reviewed
            UCLA Previously Published Works (2019)
            Mr. M., an uninsured, 44-year-old Puerto Rican man with chronic back pain, diabetes, hypertension, asthma, and a history of incarceration presented to a free clinic with acute exacerbation of back pain triggered by carrying heavy loads of trash at work. A premedical student acting as his health care advocate accompanied him. Mr. M. was hesitant to seek health care because he had no health insurance and mistrusted institutions as a result of his extensive negative experiences with the criminal justice system. He was visibly nervous in the unfamiliar institutional environment of the clinic, which had no Latino staff and was located in a middle-class neighborhood far from his home. The advocate reassured him in Spanish that the doctor was trustworthy and urged him to speak frankly about his health problems, including his challenges in obtaining medication. Embarrassed, Mr. M. reported that during recent back-pain exacerbations he occasionally resorted to purchasing one or two 5-mg oxycodone tablets in the open-air drug market operating on the inner-city block where he lived. The physician gave Mr. M. ibuprofen and a prescription for five 5-mg oxycodone tablets, enrolled him in the clinic’s diabetes and hypertension programs, and scheduled a follow-up visit. Mr. M. never filled the prescription and did not return to the clinic, despite repeated entreaties by the advocate both in person and over the phone. Mr. M.’s pain had eased, and he claimed to be managing his diabetes, hypertension, and asthma by splitting medication with insured family members. To stretch their supply, they rationed their doses for use only on the days when they “felt symptoms.” Finally, 8 months later, Mr. M. admitted that he had not dared fill his prescription or return to the clinic for fear of being rearrested after admitting to the doctor that he had purchased oxycodone illegally.
              Cover page: The Structural Violence of Hyperincarceration — A 44-Year-Old Man with Back Pain
              • Article
              • Peer Reviewed
              UC San Francisco Previously Published Works (2005)
                Cover page: Missing the Holocaust:: My Father’s Account of Auschwitz from August 1943 to June 1944
                • Article
                • Peer Reviewed
                UCLA Previously Published Works (2010)
                  Cover page: Science, Religion and the Challenges of Substance Abuse Treatment
                  • Article
                  • Peer Reviewed
                  UCLA Previously Published Works (2022)
                  Multiple transformations-referred to as "waves" in a panoply of recent public health and law enforcement publications-have rendered North American drug markets increasingly toxic since the early 2010s. The introduction of exceptionally potent synthetic sedatives and stimulants is initiating a new generation of drug injectors into co-use of opioids and methamphetamine, catapulting rates of deadly overdoses and infectious diseases. Drawing on extensive participant-observation research in Philadelphia (2007-present) and Tijuana (2018-present), we document the experience of street-based drug users across these two North American cities to focus on regional shifts in narcotics supplies and endpoint user preferences. We link the dramatic proliferation of fentanyl, methamphetamine, xylazine, and Mexican white powder heroin to: 1) pre-existing drug supply networks on the western and eastern coasts of the North American subcontinent; 2) material characteristics of local heroin supplies in pre-fentanyl opiate markets (Mexican black tar vs. Colombian off-white powder heroin); and 3) racialized repression/incarceration of drug sellers and users on both sides of the Mexico-US border. The article combines economic and medical anthropology to develop an ethnographically-informed political economy approach to an urgent public health challenge among street-based drug users with the highest overdose mortality rates in the US Northeastern Rust Belt and the Northwestern Mexican borderland metroplex anchored by Tijuana. It foregrounds street users' experiences in real time amidst rapidly shifting narcotics supply chains, linking market-driven logics of profit-seeking to the war on drugs' prohibitionist policy context, highlighting increasing toxic impacts on vulnerable sectors across regions.
                    Cover page: Potency-Enhancing Synthetics in the Drug Overdose Epidemic: Xylazine (“Tranq”), Fentanyl, Methamphetamine, and the Displacement of Heroin in Philadelphia and Tijuana
                    • Article
                    • Peer Reviewed
                    UC San Francisco Previously Published Works (2002)

                    ABSTRACT

                    OBJECTIVE: To identify ways in which undocumented day laborers’ social context affects their risk for occupational injury, and to characterize the ways in which these workers’ social context influences their experience of disability.

                    DESIGN: Qualitative study employing ethnographic techniques of participant-observation, supplemented by semi-structured in-depth interviews.

                    SETTINGS: Street corners in San Francisco’s Mission District, a homeless shelter, and a non-profit day labor hiring hall.

                    PARTICIPANTS: Thirty-eight Mexican and Central American male day laborers, 11 of whom had been injured.

                    PRIMARY THEMES: Anxiety over the potential for work injury is omnipresent for day laborers. They work in dangerous settings, and a variety of factors such as lack of training, inadequate safety equipment, and economic pressures further increase their risk for work injury. The day laborers are isolated from family and community support, living in a local context of homelessness, competition and violence. Injuries tend to have severe emotional, social and economic ramifications. Day laborers frequently perceive injury as a personal failure that threatens their masculinity and their status as patriarch of the family. Their shame and disappointment at failing to fulfill culturally defined masculine responsibilities leads to intense personal stress and can break family bonds. Despite the high incidence of work injuries and prevalence of work-related health conditions, day laborers are frequently reluctant to utilize health services due to anxiety regarding immigration status, communication barriers, and economic pressure.

                    IMPLICATIONS: Based on this ethnographic data we recommend strategies to improve ambulatory care services to day laborers in three areas: structural changes in ambulatory care delivery, clinical interactions with individual day laborers, and policymaking around immigration and health care issues.

                      Cover page: Social Context of Work Injury Among Undocumented Day Laborers in San Francisco
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