At the core of this PhD is a critical engagement with the project of translation. Methadone treatment, promoted within public health as an essential way to treat opioid addiction and prevent HIV infection among people who inject drugs, presents difficulties for translation into new settings. Post-Soviet prisons, where methadone uptake remains low despite an expanding HIV epidemic, are a particularly challenging, yet important, site for the implementation of methadone treatment. In this thesis, I treat the unique availability of methadone treatment in prisons in Kyrgyzstan, where informal prisoner governance prevails, as an opportunity to scrutinize how Western medical technologies travel. I mobilize materialist readings of governmentality, which provide a powerful conceptual lens for theorizing methadone as a form of, and resource for, governance. This mode of analysis marks a fracture from ‘evidence-based’ medicine—which treats methadone as a singular pharmacological object acting on a human body—to explore, instead, the relational and situated production of substances and bodies. Drawing on fieldwork from three Kyrgyz prisons for men, I argue that methadone, rather than having a presumed entitative status, is enacted through its environment, including the practices of informal prisoner governance. This produces methadone objects and subjects that depart sharply from those proffered by the global evidence base. I demonstrate how an assemblage made up of the prisoner code of conduct, the architecture of prisons, prisoner relations with state governance, and the relations between methadone and other drugs, produces a methadone of ill health and (un)virtuous methadone subjects. I conclude by reflecting on how this research itself is an intervention with ontopolitical effects, working to challenge mainstream conceptualizations of intervention translation in public health. These findings erode monopolistic assumptions of the dualism between evidence and practice to open up space for new interventions to be noticed and made through practice.
