Qualitative Research: Contributions to the Study of Drug Use, Drug Abuse, and Drug Use(r)-Related Interventions

Abstract

This article describes how qualitative social science research has and can contribute to the emerging field of drug and alcohol studies. An eight-stage model of formative-reformative research is presented as a heuristic to outline the different ways in which qualitative research may be used to better understand micro and macro dimensions of drug use and distribution; more effectively design, monitor and evaluate drug use(r)-related interventions; and address the politics of drug/drug program representation. Tobacco is used as an exemplar to introduce the reader to the range of research issues that a qualitative researcher may focus upon during the initial stage of formative research. Ethnographic research on alcohol use among Native Americans is highlighted to illustrate the importance of closely examining ethnicity as well as class when investigating patterns of drug use. To familiarize the reader with qualitative research, we describe the range of methods commonly employed and the ways in which qualitative research may complement as well as contribute to quantitative research. In describing the later stages of the formative-reformative process, we consider both the use of qualitative research in the evaluation and critical assessment of drug use(r)-intervention programs, and the role of qualitative research in critically assessing the politics of prevention programs. Finally, we discuss the challenges faced by qualitative researchers when engaging in transdisciplinary research.

• Action research
• Formative research
• Qualitative research
• Context
• Dependency
• Political economics

Notes

¹For a more generic description of formative research see: http://medantrho.net/academic/tools/nichter_formative_research.pdf.

²We acknowledge Hunt and Barker's (2001) caution against this dichotomous categorization of drugs, yet employ it as a heuristic bearing in mind that such categorization reflects a society's ideological positions as well as the political economic interests and clout of stakeholders. For a good discussion of cross-cultural attitudes toward drugs building on an analysis of drunken comportment see MacAndrew and Edgerton (1969) and Room (2001). For a good discussion of U.S. policies toward marijuana and other drugs, see Schlosser (2003) and MacCoun and Reuter (2001).

³For other examples of trend analysis see Barry (1991) and Stebbins (2001) research on the transnational tobacco industry and its impact on local worlds.

⁴Big Tobacco promised the Attorney General it would stop product placement in 1998. Stanton Glanz found that 80% of PG13 movies included smoking before the agreement and 80% after the agreement. What was notable was that smoking screen-time in PG13 movies increased by 50% (Glanz: www.SmokeFreeMovies.ucsf.edu).

⁵Consumption events punctuate the flow of everyday life and rekey our moods and states of mind. Consider the importance of the cocktail hour in some strata of American society or stopping for a pint after work in the United Kingdom. Other drugs serve similar purposes in other cultures. For example bhang (a mild cannabis preparation) is used by some strata of Indian society for social as well as ritual purposes (Morningstar, 1985).

⁶Bateson (1972) describes a continuum between play (which entails flexibility and agency) and its opposite, compulsion/addiction (in which flexibility and agency are lost). Personal identity, social roles and reference-group identity may be expressed through drug use/nonuse, as well as use in particular contexts.

⁷Practical logic entails common-sense reasoning about one's world engaged by agents who share a common embodied history (habitus) and set of transposable dispositions. These dispositions act as guiding principles and are adapted as well as adopted by actors. Hot cognition refers to thinking during a state of high arousal during which one's immediate gratification needs guided thought and actions. It may be juxtaposed to cool cognition, which more often approximates rational man thought.

⁸“Complexity” and “complicated” are often confused and used interchangeably. They are quite different in their essence. We need to be sensitive to their distinctions particularly when we “medicalize” and “pathologize” people, their behavior and lifestyles. A complicated system is a combination of many units, each maintaining its identity along the way and outside of the system. Consider a screw in a 747 Jumbo jet. If you modify the screw a little bit the system won’t work; complications will occur. In a complex system each component changes, over time, losing its identity outside of the system. caterpillar • cocoon • butterfly • egg •

Additional information

Notes on contributors

Mark Nichter

Mark Nichter, Ph.D, MPH, is Professor in the Departments of Anthropology, Family and Community Medicine, and Public Health at the University of Arizona. He coordinates the University of Arizona's graduate training program in medical anthropology and is also the President of the Society for Medical Anthropology. His interests include the interface between medical anthropology and public health, local perceptions of risk and harm reduction, the study of tobacco use, and the etiology of addiction. Mark has published widely in these subject areas. He is social science advisor to the International Network of Clinical Epidemiology, a member of the Robert Wood Johnson's sponsored TERN network investigating the etiology of tobacco dependence, and is co-principal investigator on a Fogarty grant exploring ways of introducing tobacco cessation in South and Southeast Asia. Mark received his doctorate in Social Anthropology in 1977 from Edinburgh University and his MPH from Johns Hopkins in 1978.

Gilbert Quintero

Gilbert Quintero, Ph.D., is Research Associate Professor at the Center for Health Promotion and Disease Prevention at the University of New Mexico. His research focuses on social and cultural aspects of substance use, abuse, and addiction in Native American and Hispanic populations in the Southwest. He received his doctorate in Cultural Anthropology from the University of Arizona in 1997.

Mimi Nichter

Mimi Nichter, Ph.D., is Associate Professor in the Department of Anthropology at the University of Arizona. She is also a Faculty Scholar with the Tobacco Etiology Research Network of the Robert Wood Johnson Foundation. Her interests include tobacco use among adolescents and young adults, dieting among teens, and the relationship between dieting and smoking. She has also conducted tobacco research in South and Southeast Asia. Dr. Nichter has published numerous articles and is the author of a book entitled, Fat Talk: What Girls and their Parents Say about Dieting (Harvard University Press, 2000). Dr. Nichter received the Margaret Mead Award from the American Anthropological Association and the Society for Applied Anthropology in 2001. She received her doctorate in Adolescent Development from the Department of Family Studies and Human Development at the University of Arizona in 1995.

Jeremiah Mock

Jeremiah Mock, Ph.D., is an Assistant Research Scientist in the Division of General Internal Medicine at the University of California, San Francisco. His interests included research on wellness and prevention of tobacco use in Southeast Asia and among Southeast Asian immigrants in the United States. He received his Masters in Science degree in international agricultural development at U.C. Davis, and his doctorate in the Joint Program in Medical Anthropology at the University of California, San Francisco and Berkeley in 2001.

Sohaila Shakib

Sohaila Shakib, Ph.D., is Research Associate at the Institute for Health Promotion and Disease Prevention Research at the University of Southern California. Through a National Cancer Institute postdoctoral fellowship, she received training in transdisciplinary prevention research at the USC Institute for Health Promotion and Disease Prevention Research. She is a Senior Research Associate in the Department of Preventive Medicine at the USC Keck School of Medicine. She is a Project Leader on the Transdisciplinary Tobacco Use Research Center (TTURC) and a consultant on the Transdisciplinary Prevention Research Center. Her published research focuses on the sociology of adolescent health, and includes studies of gender inequalities in physical activity and family characteristics influencing smoking. She received her doctorate from the Department of Sociology at USC in 2002.