DRUG NEWS    Winter 96/97

TALKING TO DRUG USERS:

SOME PERSONAL EXPERIENCES OF QUALITATIVE RESEARCH METHODS

by Jane Fountain

Research into patterns of drug-using behaviour frequently use a quantitative methodology where, for example, a questionnaire is designed to conduct one-off interviews with up to several hundred respondents. Most of the answers are recorded as ticks or very concise responses and then entered into a data analysis package. This produces statistics such as x% of those who use heroin every day also use crack cocaine at least once a week. Such data is vital to building up a picture of drug-using behaviour.
Qualitative research involves less structured methods of collecting data than quantitative research, and in most cases, the sample is much smaller.
Methods include observation, conversations, and unstructured interviews.lnterviews are not conducted using a formal questionnaire, although there are usually various themes which are covered during them. Informants are often studied over a period of time, and in some studies, the researcher spends time 'hanging around' with them, observing and questioning them about their day-to-day activities.

Qualitative and quantitative research methods are complementary: they investigate the same topics, but result in different sorts of data.

Combined, however, data from research using the two methodologies can contribute to a fuller picture of the phenomenon under investigation. For example, whilst statistics do not convey any sense of what happens when a heroin user uses crack cocaine, an account of how it feels to use crack does not give any indication of how many heroin users use it.

The following presents a personal account of some of the techniques, problems, and successes involved in accessing and interviewing a group of drug users for a study using qualitative research methods.

Getting in

The target of the research was a group of around thirty individuals who were long-term, polydrug-using, opiate addicts. They were frequently to be found together in 'The Park,' where they bought, sold, and used several varieties of drugs. The aim of the study was to gain an insight into why they included some drugs in their drug-using repertoires, but not others.
To gain and maintain contact with such a group was difficult: I had to spend time building up a relationship with potential informants to gain their trust, and to become accepted by them to the point where my presence did not influence their individual or group behaviour.

Access to The Park's drug users was facilitated by a 'gatekeeper', Sarah, who was known to me from previous research projects. She had been an opiate addict for 25 years, and had known some of network for many years. She was well-thought of by them, lived nearby, and although she had not used drugs for 18 months, remained in contact with many of the group. She was therefore aware of events in The Park, not least because her husband, Andy, bought some his drugs. Andy's almost daily contact with The Park network meant that when something happened - such as a shortage of a particular drug or someone who has dramatically changed their drug-using pattern, I heard about it via Sarah, and could immediately go and talk to those involved. I was also equally, if not more, concerned about the unspectacular, day-to-day happenings in The Park.

My first visits to The Park were to familiarise myself with its inhabitants, and vice versa, as strangers there were treated with suspicion in case they were police officers. Sarah passed the time of day with people she knew, and introduced me. Initially, I concentrated on getting to know key members of the network, as acceptance by them meant acceptance by the rest of the group. All informants were guaranteed confidentiality: no details that could realistically compromise this were recorded, and all data were securely stored.

Getting along

After several weeks, when I had become known in The Park, individuals would talk about people they were waiting for, the drugs they wanted to buy, and conduct transactions in my presence. Often, they made jokes about my researcher role in such situations - 'Where's the hidden camera, then?' Indeed, so commonplace did my presence become that on several occasions I was asked by those who were unaware that I was a researcher if I had drugs for sale - once by a man Sarah assured me was a plain-clothes police officer. A major advantage of this level of contact was that I was aware of, and could monitor, changes in their drug-using behaviour. Several members of the group became very interested in the research project, and offered to introduce me to 'someone you'd be really interested in' or competed to tell me about a particular incident. There appeared to be a certain amount of status attached to 'working with Jane.'

I frequently spent several hours a day in The Park, but sometimes the drug users were absent because, for instance, the police had been particularly active earlier in the day, or because there had been an argument. Interviews were sometimes arranged but the respondent did not turn up. Such episodes are frustrating and time-consuming, but lessons can be learned from them. For instance, I realised that appointments to talk to some individuals could not be made too far in advance, because they would forget. Other informants ranked buying, selling, and using drugs above any arrangement they had made with me.

In the early days of my contact with The Park network, small successes filled me with elation. For example: I was about to leave The Park because no-one I recognised was there, when a man left a group of alcoholics he was talking to and came over to me. It was an opiate user I had interviewed a few months earlier for another project, and he recognised me. Unprompted, he began to talk about himself and his drug use. On another occasion, an individual who I particularly wanted to talk to, but who had ostentatiously ignored me for weeks, cooly nodded at me, and, after several more weeks, agreed to be interviewed.

The interview guide

An interview guide was compiled after preliminary fieldwork identified the issues which were significant to the interview groups under study. Further fieldwork refined it considerably. The guide was designed to cope with data gathered using qualitative research techniques - several interviews with a respondent over a period of time; individual and group interviews; casual conversations; and from observation. Although the interview guide was a list of questions, it was not used as a questionnaire. Rather, the themes (see box) were used as tools to help establish consistency in the areas to be covered, identify gaps and patterns in the data, suggest further lines of inquiry, and to organise and present the findings systematically. Although a few informants preferred me to ask formal questions, most appeared empowered by the experience of taking part in an unstructured interview, and enjoyed the liberty to 'tell it like it is.' Some issues were more pertinent to one informant than to others, and in some cases, a lengthy interview was devoted to a single theme.

Usually, the guide was not consulted in the presence of the respondent - especially at the first contact with them - and was not completed in their presence. To have done so would have formalised and constrained the proceedings too much: an interview which appeared to be more like a conversation led to fuller responses, and allowed me to probe deeply into relevant issues.

Themes covered in the interview guide:

demographics
drug use history
sources of supply
social networks
treatment experiences
knowledge of drugs
harm reduction techniques
severity of dependence
injecting behaviour
sexual behaviour

Interviews

Interviews with members of The Park network were carried out in a quiet corner of The Park, or in their homes, and could take up to an hour. All the formal interviews were tape-recorded and transcribed, whilst notes from informal conversations and fieldwork
observations were made from memory.

Before each interview, I would examine the information I already had about the individual - from a previous interview, from gossip in The Park, and from observation. I then structured the interview to clarify some points and to elaborate on potentially relevant issues. At a first interview, however, in order to build up the respondent's trust in me and put them at their ease, I often let the direction be dictated by them. Regular informal contact and several interviews with some informants frequently led to increasingly intimate revelations about their drug use and other aspects of their lives.

I also used interviews to discuss wider issues with informants, and these sometimes turned into sessions where they and I would thrash out an explanation of a phenomenon I could not understand. For instance, I was puzzled why a particular client bothered to go every day to a methadone maintenance clinic to collect 55m1 of methadone mixture. She could not drink alcohol until after her appointment in case she was breathalysed and failed the test, and had to return for her methadone later; she used a wide variety of other drugs, too, spending up to £60 a day on them; and she could have bought the amount of methadone she was prescribed for £5 in The Park. I discussed this with another informant, who made me realise that there was more involved than just simple economics:

Maybe, at one point, she may choose to sort herself out with the stuff she,'s using on top of that methadone - this is my personal comment, but she might come to a point where she thinks 'Enough is enough - I can't handle this' and then slowly stop using all the other stuff. But she'll know she's still got the clinic as something to fall back on. It's like a back door. Methadone enables her to lead a normal life. It enables her to get up and go and get her other drugs for a start - if she didn't have that, she'd be in no fit state to buy anything else. But if she chooses to come off and stick to the maintenance [programme], which she knows is long-term - and she knows she's got no chance of getting cut off unless she does something drastically, drastically wrong, then she knows she's got something - a back door - her methadone. 'Fuck all the other shit, I've still got that - I'm still covered.'

This article has been able to give only a very brief account of some personal experiences of one researcher. For a more comprehensive insight into qualitative research methods, the following are recommended:

Adler, PA (1985): Wheeling and Dealing: An ethnography of an upper-level drug dealing and smuggling community. Columbia University Press. Burgess RG (ed) (1982): Field Research: A source book and field manual. Allen and Unwin.
Denzin NK and Lincoln YS (eds) (1994): Handbook of Qualitative Research. Sage.
Hammersley M and Atkinson P (1983): Ethnography: Principles in practice. Tavistock. Hobbs D and May T (eds) (1993): Interpreting The Field: Accounts of ethnography. Oxford University Press.

Dr Jane Fountain is a researcher at the National Addiction Centre

Published by the Maudsley/Regional Drug Training Unit