Contested Identities: Qualitative research and the politics of injecting drug use

Abstract

Despite the celebrated pluralism and diversity of liberal Western societies, people who inject drugs remain beyond the bounds of the socially acceptable. They occupy a uniquely stigmatised position. This thesis is about the politics of the social practice we know as ‘injecting drug use’ and those we identify as ‘people who inject drugs’: a politics less concerned with institutionalised governmental processes and more with the contest over forms of knowledge, identity and representation. It is about the innovative potential of qualitative research to recover and reconstitute the voices, the lived experiences, of some of society’s most socially excluded and disadvantaged citizens, both in Australia and elsewhere. Drawing primarily on qualitative interview accounts with both people who inject drugs and a mix of health professionals, this thesis challenges the narrow normativity and discredited identities that dominate representations of injecting drug use(rs) in contemporary social, treatment and research settings. And in so doing, maps the contexts and conditions under which new and alternative understandings and possibilities are realised. My thesis extends the rich tradition of qualitative drugs research which first begun occurring regularly in the 1920s, its methods proving well suited to respond to the challenges posed by working with often ‘hidden or hard-to-reach’ populations experiencing significant social isolation and stigmatisation. The thesis includes seven empirical chapters, each of which features a detailed analysis of a distinct qualitative dataset, accompanied by comprehensive introductory and concluding chapters. My Introduction is organised into three sections. In the opening section, I briefly establish the context of Australian drug policy and practice; in the second, I review the key conceptual and theoretical tools which underpin my analysis; and in the final section, I briefly discuss my research methods before providing a thorough overview of the chapters to come, including a detailed exposition of how each chapter and each analysis align to form a coherent whole. My Conclusion reflects on the politics of knowledge production in the illicit drugs and addictions field. Recognising the ineluctable nexus between knowledge and power, I argue that the peripheral place qualitative research methods occupy relative to the longstanding dominance of positivist approaches is not simply an issue confined to the world of scholarly research, but one with direct implications for the broader social world. How drug use is understood or constructed within different knowledges has real-world ramifications for the people who use them. I question the effect on knowledge production and identity formation within the illicit drugs and addictions field when certain ways of knowing and certain kinds of (‘rational’ and ‘objective’) voices are valorised to the exclusion of others. Nonetheless, I also note the flourishing over recent decades of innovative, social-theory-driven qualitative scholarship which has sought to challenge and unsettle the ways in which we make sense of the empirical. I briefly review the contribution my thesis has made within this tradition. I conclude by positing the critical contribution qualitative methods can make in shaping political, policy and programmatic responses to the issues affecting those who inject drugs.