Remaking hospital space: The health care practices of injection drug users in New York City

Background: Medical care has long been depicted by social scientists as a field of social control, as well as a branch of Foucauldian disciplinary power. This report focuses attention on the hospital, a highly regulated place in the United States, and examines how injection drug users (IDUs) negotiate the medical social control and institutionalised disciplinary power they encounter in this place. Methods: Twenty-eight qualitative interviews were conducted in New York City with low-income people who inject drugs on a regular basis. Interview questions focused on their health and drug use and interactions with health care providers. Results: A variety of practices were employed to avoid, defy and subvert medical power. Study participants reported leaving the hospital when they felt ready rather than waiting to be discharged, actively seeking the type of care they wanted and ignoring medical advice. Conclusion: The hospital is not a site of total control in the narratives of IDUs, but rather a space to seek a self-determined amount and type of care. These results can re-orient providers of health care services towards understanding the productivity of the relationship between IDUs and the hospital. (C) 2013 Elsevier B.V. All rights reserved.