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Abstract: This paper seeks to make sense of the sleeping practices of people who are recovering from heroin use. It brings together two hitherto unrelated literatures: the sociology of sleep and studies on heroin use and recovery. Conceptual resources developed within the sociology of sleep are deployed to facilitate the analysis of interview data generated as part of a qualitative investigation into the everyday lives of recovering heroin users living in England. Twenty one men and 19 women were interviewed with 37 of the 40 being interviewed twice, giving a corpus of 77 interviews. Without exception all the participants in the research experienced extensive sleeping problems that were not only exacerbated by the pharmacological effects of heroin, but were made worse by the way of life that accompanied their using. Irregular and anarchic sleeping practices mirrored the study participants’ disrupted and difficult lives. Attempts to establish sleep routines, and normative sleeping patterns, constitutes an important marker of recovery, but after years, and for some decades, of chaotic, intermittent and irregular sleeping, cultivating sleep presents a series of difficult challenges. Their embodied biographies of heroin use constrain the promotion of sleep, and attempts to develop rituals and routines to restore sleeping patterns are confounded by the involuntary aspects of sleep and their recalcitrant bodies. These findings are significant because not only is the quality of sleep critical to health outcomes but it also forms an important but hitherto relatively overlooked aspect of recovery from heroin use. [Copyright &y& Elsevier]

The contemporary social organisation of medical work is characterised by internal hierarchies and stratification in the form of professional elites and managerial hybrids. This paper examines the changes in medical restratification brought about by the introduction of inter-organisational care networks. The study focuses in particular on the social position of doctors and the contingencies that enable or constrain intra-professional hierarchies across inter-organisational boundaries. This ethnographic study of major system change within the English healthcare system finds that a relatively small group of 'multiplex' elites have significant influence in both national policy-making and regional service re-configuration based upon multiple sources of clinical and reputational capital. Subsequent forms of restratification at the regional level are found to mirror such status markers whilst also revealing important local contingencies, especially where professional markers of distinction are coupled with and dependent upon organisational markers of distinction. • Major system change triggers inter-organisational medical restratification. • Multiplex elite are well-placed to acquire network elite roles. • Network restratification is contingent on concessions to less influential doctors. • Network restratification is contingent upon organisational markers of distinction. [ABSTRACT FROM AUTHOR]