“Substitutions,” in Toxicomanie et Devenir de l’Humanité, edited by Claude Olievenstein (Paris: Odile Jacob, 2001), 81–108.

Discussion of the work of psychiatrist Claude Olievenstein, director of the Marmottan Medical Center, and the work being done there for the treatment of drug addiction.

Substitution, or substitutions, because there are always more than one of them— how to treat this subject? There are, for that matter, you will immediately notice, not so secret affinities between the words “substitution” and “subject,” even if they cultivate the elective underside of two words in “sub,” as if a subject were that which in advance submits itself to, or subjects itself to, what we call a substitution. How, then, to treat this subject that we call “substitution”?

Among those who treat [traiter] drug addicts just as among those who deal with [traiter de] drug addiction, some accredit, without reservation, the word “substitution,” I am to understand, and especially the expression “substitute product.”

There is here, as though contained in these words, “substitution” and “substitute product,” a wealth of semantic confidence. This credit is in no way diminished by the debates that are raging over substitute products, for example, methadone or Subutex.

Because even when one is suspicious, for thousands of reasons, of so-called “substitute products,” the meaning of these words is in no way discredited.