Society For The Study Of Addiction

QMJC Sept 2018 – Using Drugs in Un/safe Spaces

Paper under discussion:

Using drugs in un/safe spaces: Impact of perceived illegality on an underground supervised injecting facility in the United States

Peter J. Davison, Andrea M. Lopez, & Alex H. Kral. (2018). International Journal of Drug Policy, 53, 37-44

The University of British Columbia and British Columbia Centre on Substance Use’s inaugural Qualitative Methods Journal Club meeting discussed Davidson, Lopez and Kral’s (2018) research on an unnamed and unsanctioned safe injection facility (SIF) operating in the United States. Findings build upon qualitative literature demonstrating the effectiveness of unsanctioned harm reduction interventions, including our group’s past research on unsanctioned supervised consumption facilities in Vancouver (see, for example, McNeil et al., 2015). This article further demonstrates the importance of qualitative research amidst socio-political barriers to safe injection and harm reduction interventions, while also demonstrating how researchers can ethically intervene in a politically contentious environments.

Thorough description and justification of methods

Davidson, Lopez, & Kral are careful to provide thorough explanation regarding how their methods align with ethical community-based research practices. For example, we appreciated that the authors described the time point at which participants were provided compensation—immediately following consent procedures. Discussions of when participants are compensated are rare, but this critical step in the research process can have significant implications for the framing of research interactions. By emphasizing this, the authors demonstrated to readers their commitment to reinforcing participant agency in their decisions to participate in research. Issues surrounding research compensation are complex in substance use research (see also Collins et al., 2017), and there remain few empirical studies describing these practices with sufficient depth. Additionally, the authors were also clear in their partnership with the SIF operators, and the high level of involvement SIF operators had in the project. Their protectiveness of this community partnership was apparent in their refusal to disclose where in the United States this research took place – an approach ever-pertinent to harm reduction research undertaken in hostile environments.

Picture of an intervention in progress

The strong partnership between researchers and the SIF allowed this article to demonstrate its real-world implications in real-time. Throughout their article Davidson, Lopez, & Kral highlight how ongoing dialogue with SIF-operators allowed the SIF to be responsive to research findings—and therefore to user needs of people who use drugs. Indeed, the changes already implemented as a result of this project were woven through the paper. This is particularly effective in the findings section, where discussion of the SIF’s responses both contextualize the findings and serve as measurable outcomes. We believe that positioning the organization’s responses in this way lends credibility to this work and its positioning as a community-based research study.

Writing qualitative research articles for public health journals

In addition to its important findings regarding the relative impact of unsanctioned harm reduction services, this paper also adds to an ongoing discussion on the applicability of public health and medical publishing standards to qualitative research (see Bell, 2018). Here, there are important questions that we must ask ourselves. How can we ensure that applied qualitative research articles capture the complexity of our work? How can we challenge norms in research reporting to demonstrate the unique contributions of qualitative research? This reflexive and community-based ethnographic study deftly integrates qualitative interviews and ethnographic research alongside descriptions of how this research was operationalized in ‘real time’ to improve practice.

The Vancouver Reading Group: Alex Collins, Samara Mayer, Taylor Fleming, Michelle Olding, Cara Ng, Scott Neufeld, Jenna Valleriani, Lisa Strada, Jennifer Lavalley, Ryan McNeil

Further reading:

Bell, K. (2018). Whatever happened to the ‘social’ science in Social Science & Medicine? On golden anniversaries and gold standards. Social Science & Medicine, 214, 162-166.

Collins, A. B., Strike, C., Guta, A., Turje, R. B., McDougall, P., Parashar, S., & McNeil, R. (2017). “We’re giving you something so we get something in return”: Perspectives on research participation and compensation among people living with HIV who use drugs. International Journal of Drug Policy, 39, 92-98.

McNeil, R., Kerr, T., Lampkin, H., & Small, W. (2015). “We need somewhere to smoke crack”: An ethnographic study of an unsanctioned safer smoking room in Vancouver, Canada. International Journal of Drug Policy, 26(7), 645-652.

The opinions expressed in this commentary reflect the views of the author(s) and do not necessarily represent the opinions or official positions of the Society for the Study of Addiction.