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So much has been written about addiction, one can reasonably ask why we need another volume on the subject now. The pieces gathered here take up a number of current trends that make this exactly the right time to take a fresh look at addiction. These include: debates over the nosology of addiction as part of the revision to the Diagnostic and Statistical Manual of Mental Disorders (DSM); the expansion of addiction's meaning and spheres of control beyond alcohol and illicit substances; the rise of neuroscience; the increasing ‘pharmaceuticalization’ of everyday life and new pharmaceutical treatments for addiction; growing awareness about the intersection of the drug war and the mass incarceration of people of color; and new theoretical frameworks for understanding the role of addiction as a fundamental technique of social control. These trends are reshaping addiction in both new and not-so-new ways that warrant the interrogation this volume provides.

Purpose – This chapter explores how discourses of obesity as addiction are taken up by weight loss surgery patients and medical and scientific professionals.

Methodology/approach – Based on 14 semistructured interviews, I discuss the ways in which bariatric patients partially account for their presurgical bodies and contemporary struggles with weight loss and regain by referencing food addiction. This work is part of a larger project involving 35 interviews and participant-observation work and therefore these results should thus be considered preliminary.

Findings – I argue that bariatric patients and bariatric professionals portray weight loss surgery as an extraordinary tool that allows the “out of control” to become controllable. However, bariatric patients also emphasize the hard work that is entailed in both losing weight and maintaining a weight loss even after surgery.

Social implications – I suggest that this portrayal, in addition to being an accurate assessment of the potential for regain following weight loss surgery, is a technology of stigma management.

Originality/value – This work contributes to the sociology of the body and medical sociology literatures by illustrating that, within a neoliberal and anti-fat social context, highlighting the hard work involved in weight loss and weight maintenance allows bariatric patients to demonstrate proper subjectivity and thereby reclaim “proper selves” as they work toward a “proper bodies.”

Purpose – The chapter examines the historical pattern of interconnections between drug policy, research, and treatment in light of recent theoretical developments in the medicalization thesis advanced in the sociology of medicine.

Methodology/approach – The chapter uses interpretive methods to examine how the social construction of addiction as a “chronic, relapsing brain disorder” converges with or diverges from the conceptual framework offered by sociological theorists of medicalization and biomedicalization.

Findings – The approach adopted shows how the meanings of the bio/medicalization of addiction shifted and circulated within and beyond the institutions developed to respond to drug addiction as a hybrid social, medical, and biomedical condition during the 20th century.

Social implications – Bio/medical frameworks for addiction are the outcome of historical attempts to influence public attitudes and develop effective methods to treat and prevent this “disease” in ways that would positively affect the quality of life of people living with addictions.

Originality/value – This original contribution addresses both strengths and limitations of bio/medical models, assessing how their influence has changed over time.

Purpose – To compare the histories of two opioid medications that are pharmacologically similar but subject to contrasting regulations in their use in treatment of opiate dependence in the United States – methadone and buprenorphine – in order to analyze the role of racial imagery and racial politics in the legalization and clinical promotion of their use.

Methodology/approach – Historical methods of archival analysis of published articles and unpublished governmental records were used in researching methadone. Ethnographic methods of participant observation and semistructured interviews were used in researching buprenorphine.

Findings – Contrasting uses of racial imagery played a major role in shaping the current regulatory differences between the two treatments. The association of methadone with black and Latino heroin users has contributed to its increased federal regulation, while the association of buprenorphine with white, middle class prescription opioid users enabled its use in deregulated private physicians’ offices.

Originality/value of paper – Advocates of biomedicalization of behaviors and conditions thought of as social or moral, such as addiction, argue that biomedicalization reduces the stigma of the condition and imply that, in turn, it also reduces the racial inequalities associated with the condition. This study of the biomedicalization of treatment for opioid dependence indicates that the very process of biomedicalization depended on heightened racial imagery associated with each treatment and ultimately intensified, rather than reduced, the stigma of addiction for black and Latino low-income patients.