The 'knowing' body in the becoming of buprenorphine depot treatment: A qualitative study.

There is a tendency to approach the body as if passive, and as acted upon, in medical treatment studies. We undertook a longitudinal qualitative study of monthly buprenorphine depot, with 36 participants (25 men, 11 women; of whom 32 were followed up over three years). Our analysis draws attention to the body as an active actor in the becoming of buprenorphine depot treatment. We trace two scenarios of agency in which bodies participate. The first is discovery and surprise. These are situations in which the body 'speaks', giving feedback in relation to its treatment, and contributing to an iterative process of learning. The second scenario is experimentation. Here, bodily feedbacks inform reasoned actions which give rise to purposeful experimentations in which the body is 'put to the test' or invited into a 'trial' of conjoint learning. Taken together, we show how the body plays a critical role in how buprenorphine treatment 'comes to be known' and how such treatment is made 'workable' in its situation. Our findings emphasize how clinical encounters might better listen to, and learn from, bodies in the implementation of treatments. A priori evidence-based standards and guidelines often shape clinical decisions, but there are other forms of situated and embodied knowing. Bodies are active in shaping what buprenorphine depot treatment comes to be.