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Righteous Dopefiend By Philippe Bourgois Essay

886 words - 4 pages

In Righteous Dopefiend, Philippe Bourgois and Jeff Schonberg provide a powerful and poignant account of the culture and challenges faced by homeless heroin addicts in San Francisco. Numerous factors, including structural violence, affect the health and quality of life held by the addicts creating a unique set of challenges for health care providers and law enforcement agencies. The problem of heroin addiction is not one-dimensional and many issues go into creating a “syndemic” (Sobo 193). Heroin addiction deserves to be looked at from many angles so that effective solutions can be introduced to help those affected, including the unique community of the Edgewater homeless.
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I believe for the problem of heroin addiction to be truly solved, social and medical services must work together instead of separately. Working disjointedly, they do not provide healthcare to its full potential. Social and healthcare services working together in San Francisco should serve as a model; these programs were cost effective by decreasing utilization of hospital emergency rooms and the county jail, making them valuable for the economy and addicts (Bourgois and Schonberg 304).
One of the largest problems facing the homeless heroin addicts was the structural violence they encountered. Structural violence occurs when “the shape of a given social structure harms or is harmful to the people who occupy certain positions within that social structure” (Sobo 190). American society dictates a social structure in which the value of a person is measured in material goods and wealth, causing the poor and destitute to be looked down upon or even treated as second-class citizens. This is just the case with the Edgewater homeless; take for example Petey and his experience with the county hospital: following a two-month hospitalization, Petey was forced to move back to the poor living conditions of the street because hospital administrators, at the time, were instituting “early release plans” as a result of steep Medicare budget reductions (Bourgois and Schonberg 235-237). Petey fell back into heroin addiction and continued to live in squalor causing his liver to deteriorate further instead of improve (Bourgois and Schonberg 237-238). Into the twenty-first century, “access to basic medical care became even more difficult for the uninsured” (Bourgois and Schonberg 238). This social structure in which profits were prioritized over patients caused people like the Edgewater homeless to face structural violence in the form of reduced...

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