The Conditions of Possibility for Being Someone Else

Louise Bourgeois. Femme Maison. 1946–1947.

Classification, Addiction, and Identity

Consider a scene familiar in hiring processes: a candidate sits across from an interviewer and, when asked about a gap in their employment history, responds with brutal honesty: “I was an addict.” A cathartic exercise in transparency.

By uttering the word “addict,” the candidate does more than describe a past: they lock themselves into an unchanging identity. The interviewer, conditioned by the prejudices of common sense, tends to adopt a reductive perspective: the nuances of a life disappear, and everything revolves around that label. The assumption is that someone going through that experience reveals an inability to govern themselves. At the same time, a battle begins within the candidate: they may feel like an impostor as a result of another person’s judgment and abandon their search.

This situation evokes Foucault’s (2003/2005) reflections on psychiatric power and discourses of normalization. Foucault argued that modern institutions do more than repress: they help produce subjects through clinical labels. When medicine or society stamps a label on someone’s forehead, it confines their vital potential within the boundaries of that definition.

Let us bring in the story of Cheryl Strayed, adapted for the big screen in 2014 from her memoir, Wild (Strayed, 2012/2013). At twenty-two, Cheryl lost her mother and, over the following years, went through a period marked by heroin use and severe family problems. At twenty-six, she decided to leave the cycle of destruction her life had become and begin a solitary hike of nearly two thousand kilometers along the Pacific Crest Trail, in Northern California. The account of that period of her life brings together grief, substance use, mistakes, and the effort to reclaim her own life. Reducing Cheryl’s experience to the label “addict” would have prevented us from seeing the true scope of her individuality: a process in which she rewrites her history, questions her decisions, and forges a new relationship with herself. Cheryl’s story helps us frame more adequately the need to recover the whole person by moving beyond our own stigmas. Beyond any reductive label, we see a complex existence emerge that cannot be absorbed into the imposed designation of addiction.

Thomas Szasz (1985/1990) argues that the label “addict” functions as a stigmatized identity, frequently applied to someone against their will; Maximiliano Zeller (2023), in turn, shows that the social use of the word “drug” carries associations of crime, harm, addiction, and vice. Hanna Pickard (2021), for her part, reminds us that, for some people, identifying as addicts also offers the shelter of a community, recognition, and an explanation of who they are. Clearly, the label “addict” has a devastating character in its relationship with society at large, while also providing an identity anchor that is difficult to relinquish. I therefore ask: how does a social category or diagnosis enter a person’s life to the point of producing the very reality it claims to describe?

Initially, the category “addict” groups heterogeneous behaviors under an apparently uniform social type. Consequently, institutions and the social environment project certain predetermined expectations onto that type: chronic substance use, loss of decision-making autonomy, or the presumption of latent risk. These expectations negatively influence interpersonal relationships and restrict the options available to those affected. Finally, the classified subject may subvert the category, use it strategically, or incorporate it into their own subjectivity; any of these responses modifies their behavior and, by extension, the label’s public meaning. It should be made clear that the existence of this process does not imply that problematic substance use is a fiction; rather, it points to how a social category can become part of the structural conditions shaping the phenomenon.

To explore this, I will first examine the boundaries implied by the word “drug” and how this conceptual demarcation facilitates the construction of the “addict” type. The concept of “looping effects,” formulated by Ian Hacking (1996), will allow me to connect Szasz’s (1985/1990) critique of the manufacture of deviance with Pickard’s (2021) model of the category’s role in identity. Finally, I will analyze the agency of those who identify as addicts, distinguishing their subjective responses from the harms that persist independently of that classification.

I. Before the Person, the Category

The noun “drug” appears to designate a clearly identifiable category of objects. Yet Zeller (2023) introduces a crucial distinction between its technical meaning—referring to the pharmacological class of psychoactive substances—and its social dimension, which restricts the term to substances made illegal. Substances such as alcohol and caffeine alter cognitive states without usually receiving the same designation as cocaine. This divergence depends on legal decisions, social norms, and moral judgments. Accordingly, Zeller challenges the naturalization of a social boundary whose nature is, strictly speaking, historically variable.

From the notion of “drug,” a typology of use is inferred and, by extension, a class of users. The automatic entanglement of “drug” and addiction—which Zeller (2023) identifies as one of the term’s inherent connotations in social use—encourages a discursive slide from the statement “they use a substance that has been made illegal” to the diagnosis “they are an addict” and, finally, to the premise “they are incapable of governing themselves.” We must be clear that there are no grounds for inferring a systematic pattern from occasional use, a disorder from a particular pattern of use, or a lack of autonomy from a specific condition.

Within the social meaning of “drug,” illegal status functions as the vector grouping heterogeneous substances together. That same category is used to legitimize prohibition, on the assumption that its members share an intrinsic dangerousness. A kind of tautological circularity thus takes shape: they are prohibited because they are “drugs,” and they are coded as such by virtue of being prohibited.

Once the social type of the “addict” is established, a tendency emerges to explain all of their actions in terms of that assigned identity. If the person uses substances, the diagnosis is confirmed; if they demonstrate an ability to stop, this is interpreted as a mechanism of “denial” regarding the severity of their condition; if they stop using, the outcome is presented as an anomaly in the face of the substance’s power. So-called “pharmacological determinism” endows the substance with an almost magical agency that obscures the specific characteristics of its use (Zeller, 2023).

In Drogas y ritual, Szasz (1985/1990) develops this suspicion further. He maintains that the concept of “addiction” operates as the designation of an ethically condemned deviation rather than an objective clinical entity. From this perspective, the “addict” is simultaneously produced as patient and transgressor: their supposed loss of control is invoked to justify their need for supervision, while they are criminalized for embodying a social risk.

This theoretical dilemma cannot be resolved merely by replacing “drug” with a technical term that leaves the underlying discursive structure intact. Zeller (2023) opts for naming each substance separately or, alternatively, using the expression “psychoactive substances made illegal” to refer to the legally delimited group. This formulation makes the political criterion of grouping visible, avoiding the attribution of an intrinsically harmful essence.

II. Classification Turns Back on the Classifier

The language of medicine and psychology has a concrete impact on a patient’s life. A diagnosis can penetrate a person’s identity and modify their physical and emotional reactions. This porosity between word and subject is what the philosopher of science Ian Hacking (1996) called “looping effects.” The classifications of the natural sciences—rocks, elements, viruses—remain indifferent to our attempts to pigeonhole them. But human beings possess the uncomfortable property of self-awareness: we inhabit the descriptions imposed on us, measure ourselves against them, negotiate them, and suffer them. Within this logic, we can understand how a clinical diagnosis can become a script that traumatizes a patient’s existence.

A social or clinical label is built upon an infrastructure of psychologists, judges, relatives, employers, and others, which translates into concrete consequences: a medical prescription, social ostracism, dismissal from work, or even hospitalization.

The psychiatrist Thomas Szasz (1985/1990) glimpsed the other side of this process. His analysis of the ritual persecution of difference shows that categories such as “dangerous drugs” or “addict” operate not merely as disinterested descriptions of public health, but as technologies of control. The police, the justice system, medical records, the media, and social networks are not neutral observers looking at the phenomenon from outside; they are active participants. When a classification becomes embedded in these practices of power, its effects extend beyond the specific issue of stigma: they may translate into a deterioration of the individual’s material conditions, precarious employment, the erosion of family ties, and eventual social withdrawal. The interviewer’s bias in the opening scene represents the weakest link in an institutional chain that seems designed to exclude.

The loop, however, reaches its most traumatic point when the external description is assimilated and adopted as the definitive answer to the question of one’s own identity. Hanna Pickard (2021) raised a fundamental objection to contemporary medical orthodoxy: reducing addiction to a mere “neurobiological disease of compulsion” cannot explain why people continue using despite catastrophic consequences. Rigorous clinical observation shows that people with addiction problems retain their autonomy: they can postpone use, respond to financial incentives, weigh risks, and make strategic decisions. Reducing them to automatons ruled by an indeterminate mental lapse is an inaccurate simplification. If the behavior persists despite apparent harm, Pickard argues, it is not because of a complete absence of will, but because substance use fulfills a vital function within the individual’s psychic and social economy.

As already mentioned, for many individuals, the identity of “addict”—with all its tragic weight—may be the only available refuge for their sense of self. Stopping use no longer means simply going through physical withdrawal; it means accepting social eviction, the loss of friends, the collapse of everyday habits, and a confrontation with a suffocating sense of emptiness.

At this point, the looping effect takes on a tragic character. The label “addict” carries a strong social expectation of relapse, failure, and chronicity. If the person incorporates it into the center of their life, that expectation becomes almost a norm: continuing to use is the perverse way of confirming who they are, while sobriety is experienced as a betrayal of their own community. So, if we compel someone to abandon the identity that sustains them, what other relationships, environments, and narratives are we prepared to offer so that they can reinvent themselves?

III. The Self Between Accusation and Refuge

Although Szasz (1985/1990) and Pickard (2021) converge in certain respects, their perspectives occupy opposite poles. Whereas Szasz focuses on macroinstitutional violence—the state and psychiatry repressing heterogeneity—Pickard turns toward the intimacy of the first person to understand how that same label, born of an affront, can be inhabited with pride. We thus face the danger of caricaturing both perspectives: on one side, a passive victim, an automaton that merely repeats the stigma injected by power; on the other, an excessively voluntarist individual, a liberal atom in complete control of their desires. Reality, of course, is more complex: human beings do what they can with the categories installed in them.

Pickard (2021) illustrates this dilemma through the testimony of a woman who nostalgically recalled the technical and street knowledge accumulated during her years of heroin use; for her, these skills were her only source of pride and competence. In moving toward sobriety, she encountered not freedom but a kind of desert: abandoning substance use left her without routines, community, or a social fabric in which to recognize herself. Recovery is not a matter of switching off a faulty mental mechanism through willpower; it is a reconstruction of one’s identity. The word “recovery” is often used naively, as though it meant returning to a previous, healthy self. But for there to be a return, that earlier self must have existed, and the social ties sustaining it must still exist. When substance use begins in youth or devastates work, housing, and relationships, the idea of “going back” is an absurd metaphor.

On this issue, Szasz (1985/1990), with his sharp libertarian perspective, would warn that turning existential emptiness into a therapeutic obligation administered by the state is merely another mutation of medical guardianship, another attempt to normalize the dissenter under the guise of compassion. From his perspective, then, if someone finds a genuine sense of belonging in a community organized around substance use, no outside observer has the right to declare their life worthless and replace it with a bureaucratic ideal of sobriety.

Even accepting Szasz’s (1985/1990) argument, respecting that community cannot become a pretext for abandoning those desperately seeking a way out. The ethical boundary separating emancipation from tyranny lies in the difference between offering the material conditions for a chosen transformation and imposing a correct identity from above.

IV. The Objection: A Label Can Also Open Paths

Up to this point, the discussion has focused on suspicion toward the act of classification. One could reasonably object that this approach exaggerates the threat of the label and underestimates its therapeutic and communal virtues. After all, a firm declaration of “I am an addict” allows the person to stop punishing themselves for their defeats and find common ground with others. Pickard (2021) draws on sociological studies showing that those who manage to identify as “ex-smokers” sustain abstinence with considerably greater success than those who continue to think of themselves as “smokers taking a break.” If a category can organize a destructive routine, it also has the power to redirect a life toward a better course. Are we right, then, to insist on treating the label solely as a problem?

Hacking’s looping thesis does not require such reductionism. If Hacking (1996) speaks of an open circuit, it is precisely because those classified respond and deviate and, in doing so, crack and transform the taxonomy that sought to contain them. Someone may say “I am an addict” as a cry of resistance, a plea for help, a ritual of belonging, or an exclamation in the face of pain overcome; its meaning lies in the power asymmetry of the situation in which it is asserted. What serves as a condemnation in a job interview becomes a sign of belonging within the trusted circle of a peer group.

For this reason, it is imperative to draw a boundary between voluntary self-identification and external assignment, without naively believing that the former is immune to the pressures of the world. A person can take ownership of the insult intended to hurt them and give it a new meaning, turning it into a banner; but they may also embrace that name simply because their culture offers no alternative.

When Zeller (2023) proposes dismantling the concept of “drug” rather than trying to reclaim it, he does so because he recognizes that its punitive connotations are too heavy and tend to reinforce themselves.

At this point, we should ask: are we giving language an excessive role? Pickard’s (2021) response to this skepticism displays considerable intellectual honesty: rather than elevating classification to the sole cause of the phenomenon, she works with hypotheses about its heterogeneous nature.

Likewise, we must guard against the opposite argument: observing that someone defines themselves as an “addict” and continues using does not justify concluding that the label explains the persistence of their behavior. They may have adopted the label precisely because substance use had already taken over their existence.

V. Changing the Name, Changing the Possibilities

What, then, follows from this journey through the loop for our everyday and political ways of speaking? A first conclusion may be that we perhaps need to eradicate universals; to name, as Zeller (2023) suggests, the specific substance, its pattern of use, and its particularities, rather than continuing to speak of “drugs” as a homogeneous, undifferentiated entity.

A second implication arises at the institutional level, when a hospital form, a court form, or a pre-employment medical assessment offers only the binary boxes “addict (yes/no).” If those structures are built on the dogma that a substance user is a being stripped of all agency, stigmatization becomes inevitable. If an employer turns a past diagnosis into an inexorable prognosis for the present, they leave little or no room for better alternatives.

The third conclusion points to the very heart of what we call “recovery.” Pickard (2021) describes how imagining oneself in sobriety, as in Cheryl’s case discussed earlier (Strayed, 2012/2013), resembles a painstaking craft of personal invention. But we must understand that this change requires a support network: physical places in which to establish new bonds and community roles in which the person receives genuine recognition.

Conclusion

Substance use involves an irreducible neurochemical dimension that no linguistic construct or theoretical rationalization can or should supplant. Nevertheless, the experience of substance use is embedded in a historical, political, and social space that extends beyond the boundaries of pharmacology. Reducing it to its organic materiality means ignoring the collective forces that shape it in advance.

In this regard, several of the authors discussed have helped us unravel this complexity: Zeller (2023) showed us how the signifier “drug” distorts reality by amalgamating radically different substances under a single identifier; Szasz (1985/1990) warns that the label “addict” frequently operates as a deviant identity, meticulously produced and administered by apparatuses of control; and Pickard (2021) forced us to look at the other side of stigma, discovering that this same identity can harbor refuges and genuine relationships that explain its persistence, and even its intrinsic value.

With all this in mind, introducing Ian Hacking’s (1996) concept of “looping effects” allows us to make sense of these authors’ ideas: human taxonomies guide institutional practices and collective expectations; the people thus categorized respond to, negotiate, or embody those descriptions; and these responses ultimately alter the very nature of what classification sought to capture. Scientific and social language is not merely a chronicler of reality; it is an architect building the ground of the reality of which it becomes a part.

My conclusion is that this loop need not lead to linguistic fatalism. To maintain that calling someone an “addict” inexorably condemns them to chronic relapse would be to fall into the very determinism under criticism: it would strip them, once again, of their status as a subject and of their agency.

A shared label can also be the territory that provides a substance user with a community of equals, a shared memory, and the clinical or political language needed to ask for help.

Whoever observes, diagnoses, and classifies is never a neutral spectator; they actively participate in configuring the precise space in which those observed will be situated. Although this may seem problematic, it constitutes an inevitable pragmatic commitment, since I believe it is impossible to approach addiction from an absolute outside.

Ultimately, no apparatus of control or administrative label has the legitimacy to determine in advance the agency that a person retains to rewrite their own life.

References

Foucault, M. (2005). El poder psiquiátrico: Curso en el Collège de France (1973–1974) (H. Pons, Trans.). Fondo de Cultura Económica. (Original work published 2003).

Hacking, I. (1996). The looping effects of human kinds. In D. Sperber, D. Premack, & A. J. Premack (Eds.), Causal cognition: A multidisciplinary debate (pp. 351–394). Oxford University Press. https://doi.org/10.1093/acprof:oso/9780198524021.003.0012

Pickard, H. (2021). Addiction and the self. Noûs, 55(4), 737–761. https://doi.org/10.1111/nous.12328

Strayed, C. (2013). Salvaje (I. Ferrer & C. Milla, Trans.). Roca Editorial. (Original work published 2012).

Szasz, T. (1990). Drogas y ritual: La persecución ritual de drogas, adictos e inductores (A. Escohotado, Trans.). Fondo de Cultura Económica. (Original work published 1985).

Zeller, M. (2023). La importancia de llamar a las drogas por su nombre. Eleusis, 1(1), 50–71. https://ridaa.unq.edu.ar/handle/20.500.11807/6455