Smith CBR (2018) Playing (Un)Dead: Interrogating Invocations of 'Monster' Metaphors in (Post-)MMT Service User Narratives of Methadone, Maintenance and Treatment. Int Arch Addict Res Med 4:028.


© 2018 Smith CBR. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

RESEARCH ARTICLE | OPEN ACCESS DOI: 10.23937/2474-3631/1510028

Playing (Un)Dead: Interrogating Invocations of 'Monster' Metaphors in (Post-)MMT Service User Narratives of Methadone, Maintenance and Treatment

Christopher BR Smith*

School of Social Work, St. John's College, Memorial University of Newfoundland, Canada



From social productivity to social costs to clinical stability, traditional outcome measurements employed in methadone maintenance treatment (MMT) serve to reinforce binary oppositions between sickness and health, 'dirty' and 'clean', stable and chaotic, life and death. Such binaries thus position the (post-)MMT service user according to a series of fixed axes that are in turn reproduced in popular and professional discourse. Destabilizing these binaries, 'monster' - and particularly zombie or 'undead'- metaphors have been a persistent feature of MMT culture since its inception in the 1960s. This paper thus argues that metaphorical invocations of zombies in (post-)MMT service user discourse functions as a regenerative trope, eroding the binary foundations of MMT.


Based on a comparative, qualitative, ethnographic analysis of two high-volume methadone clinics - one in Toronto, Canada and the second in Philadelphia, Pennsylvania (U.S.A.), this paper draws from qualitative interviews with 20 (post-)MMT service users, broadly defined as individuals with experience of methadone tapering or treatment discontinuation.


Analysis reveals three primary contextual deployments of zombie metaphors in (post-)MMT service user discourse, functioning as (1) A tactic of boundary negotiation; (2) A tool of critique; and (3) A means of articulating post-treatment 'after-lives'.


'Undead' monster metaphors in (post-)MMT service user narratives represent both a product of - and a destabilizing threat to - the binary foundations of traditional MMT discourse. Revealing a range of liminal subject positions in the reductive 'life and death' stakes of methadone treatment, findings reveal how undead metaphors embody a reflexive space through which users re-negotiate identity, agency and autonomy. Exhuming users' agency and 'political pharmacology', analysis demonstrates three interrelated themes characterizing users' tactical discursive deployments of the undead: (1) Relapse as resistance; (2) Recovery as radical reassertion of autonomy; and (3) Harm reduction as anarchist practice.