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Steps toward a theory of place effects on drug use: Risk, marginality, and opportunity in small and remote California towns
گامهایی برای دستیابی به نظریه اثرات مکانی بر مصرف مواد مخدر: خطر ، حاشیه و فرصت در شهرهای کوچک و دور افتاده کالیفرنیا-2020 The risk environment concept provides a framework for documenting ecological influences on drug use, and a
platform to engage with social theory to identify mechanisms behind place-based health disparities. Health
scientists conceptualize these mechanisms in terms of social determinants of health, social scientists in terms of
syndemics and structural violence. I supplement these perspectives with Pierre Bourdieus concepts of social space,
practice, and habitus to offer a broader analysis of how place shapes drug-related health risks, particularly outside
of the large cities where most research is conducted. This approach encompasses inequality, conflict, and social
change at multiple levels of social organization, from macrodistributions of power to trajectories of individual
drug use. I offer three pointers for scholarship on drug use in nonurban places, which I illustrate with findings
from an ethnographic study of opioid use and opioid-related services in California. First, replace the folk notion
of “rural” with geographic categories grounded in relevant social structures and institutions, such as social
networks or illicit drug markets. Second, examine how variation in the structure of social and physical space
affects processes of marginalization and criminalization. Third, avoid negative definitions of nonurban places,
and instead explore their distinctive institutions and opportunity structures. Following this approach, I define
acquainted marginality and small-town habitus to explain how dense networks and geographic isolation shape local
government and survival strategies among people who use drugs. I find that in small and remote towns, personal
and professional relationships overlap in ways that augment surveillance and stigma, but can also facilitate
leniency and progressive policy change. I conclude by using these findings to outline a theory of place effects on
drug use and addiction to encourage future research in these directions. Keywords: Risk environment | Rural | Social space | Practice | Acquainted marginality | Small-town habitus |
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