International Journal of Drug Policy 15 (2004) 395405

Talking about drug use: what are we (and our participants) doing in qualitative research?
Anthea Martina, , Paul Stennerb,1
a

Centre for Research on Drugs and Health Behaviour, Department of Primary Care and Social Medicine, Imperial College London, The Reynolds Building, St. Dunstans Road, London W6 8RP, UK b The Department of Psychology, University College London, Gower Street, London WC1E 6BT, UK Received 2 February 2004; received in revised form 26 May 2004; accepted 28 May 2004

Abstract This paper considers the use of qualitative research in the drugs eld. Proponents have traditionally claimed that by capturing participants lived experience through language, qualitative approaches are either the antidote or the necessary complement to quantitative methods. The present paper troubles this over-simplistic dichotomy between quantitative and qualitative: both approaches often share the same ontological assumptions, rely on the same representational logic and are, in the context of applied research, subject to a will to truth born of a specic relation to policy. Poststructuralist ideas about the production of knowledge and the relationship between discourse and power are presented. Drugs research as both praxis and knowledge base may be seen as part of the machinery of advanced liberal government, which seeks to govern at a distance through the inscription of subjectivity. The drug user is produced and re-produced as a subject within research, always already positioned in relation to certain truths. We need to conceive of qualitative research and what our participants tell us differently, such that the constructive and constructed nature of knowledge and talk becomes the focus of inquiry. Discourse analysis - with its focus on construction and function within discourse - is presented as compatible with poststructuralist ideas. To illustrate the use of this approach, three interview accounts of how participants rst came to use heroin are analysed. The discourses and subject positions underpinning the peer pressure, the response to distress and the risk appraisal account are described, and we consider how these accounts might function as harm warrants for intervention. Criticisms of a poststructuralist approach and its implications for qualitative research within the broader eld of drugs research and policy are addressed. 2004 Elsevier B.V. All rights reserved.
Keywords: Accounts; Discourse analysis; Drugs; Government; Qualitative research; Poststructuralism

Introduction The production of knowledge about drug use is a growth industry. The past two decades have seen the introduction of a plethora of research programmes, academic centres, journals and books devoted specically to this topic. A good deal of research in the drugs eld and most research funding is aimed either at preventing drug use or minimising the harms associated with it. The rationality of this enterprise is taken

Corresponding author. Present address: Flat 5, 210 Deptford High Street, London SE8 3PR, UK. E-mail addresses: anthea.martin@imperial.ac.uk (A. Martin), P.Stenner@ucl.ac.uk (P. Stenner). 1 Fax: +1 207 436 4276. 0955-3959/$ see front matter 2004 Elsevier B.V. All rights reserved. doi:10.1016/j.drugpo.2004.05.005

for granted: accumulated knowledge and a better evidence base will enable us to develop more effective responses to drug-related problems. Policy-relevant research in the drugs eld is conducted within and between diverse disciplines and incorporates an array of different approaches. The primary concern of this paper is qualitative research, but we also consider the position of the broader eld in the manufacture of knowledge about drug use. We focus on qualitative research for two reasons. First, qualitative methods are gaining acceptance and becoming increasingly important in the drugs eld (Agar, 2002; Rhodes & Moore, 2001). Second, qualitative approaches are typically presented as doing something quite different to quantitative approaches, and as producing distinct research outputs.

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With these points in mind, we consider an alternative perspective on how qualitative research on drug use operates. Our title question, reecting on what we and our participants are doing in qualitative research, raises several issues that we seek to address. First, we consider the way in which qualitative and quantitative approaches are typically set up in opposition to each other, and question the usefulness of this dichotomy. Second, we position the broader drugs eld within a poststructuralist framework. Drugs research may be seen as a technology of government, and we outline the implications of this positioning for how we think about our methods of study and what our participants tell us. In this context, we introduce discourse analysis as compatible with poststructuralist thinking, and present an analysis of accounts of initiation to heroin use to illustrate the use of a discourse analysis informed by poststructuralist ideas. Finally, we address some of the key criticisms directed at a poststructuralist approach and discuss its implications for qualitative research within the broader eld of drugs research and policy.

as entertainment). The nasty guy backs the target into a corner of the interview room and demands just the facts maam and simple (thin) yes or no (quantiable) answers. The nice guy offers a cup of tea and a cigarette, and empathizes with the participant, even to the extent of appearing to defend her from the blow cold operatorand draws out thick (qualitative) information. Whichever approach to interrogation is taken, the purpose is still to break down the resistance of the subject, to get them to yield a testimony to the truth. (Curt, 1994: 113) The key word here is truth. Both quantitative and qualitative approaches claim to reveal some truth about the world, about what is really going on. While the dominant traditions in the social sciences positivism and post-positivism promote very different ways of approaching reality and extracting knowledge of this from research participants, both maintain that the task of the researcher is to discover and report on something real (Robson, 2002). Whether this task is framed as explaining or understanding, whether it involves showing that observed phenomena are instances of general laws or uncovering unobservable mechanisms that link events causally, what is really going on is assumed to exist independently of our knowledge of it. Different methods and procedures are viewed as more or less transparent media through which we may capture reality via language. Emphasis is thus placed on how we may best capture what is out there, waiting to be discovered; and debate typically centres on the adequacy of our methods at the expense of epistemological and ontological questioning (Barbour, 2001). In this respect then, despite the increase in the use of qualitative methods, the drugs eld and the social sciences more generally would seem to have changed little over recent decades, remaining enchanted by the myth that the assiduous application of rigorous method will yield sound factas if empirical methodology were some form of meat grinder from which truth could be turned out like so many sausages (Gergen, 1985: 273). It is essential to be clear at this point that we do not wish to be misinterpreted as saying that methodology is unimportant. Still less do we wish to be misrepresented as nave relativists who lightly dismiss the possibility of acquiring knowledge in favour of an anything goes approach. An analogy might be useful to communicate better our intent. Traditional (qualitative and quantitative) research methodologies supply a frame within which representations of the reality of drug use can be depicted. What they do not typically see and do not typically present is that frame and the ways in which it inuences the picture it encompasses. We think that researchers need to develop ways of seeing and studying these frames as part of their research picture. If they do, the truths that they represent will transform accordingly. Just as the truth of a criminal confession depends upon the system of criminal justice that frames its meaning, so the data of social scientists is collected, interpreted and communicated in the broader institutional framework of social policy. When, as is the case

Quantitative versus qualitative? In the context of the social sciences, the terms quantitative and qualitative are associated not only with particular methods and procedures but also with particular epistemologies or theories of knowledge. In the drugs eld as elsewhere, qualitative research is overwhelmingly in keeping with a realist tradition (e.g., Bourgois, 2003; Parker, Aldridge, & Measham, 1998; Taylor, 1993; see also EMCDDA, 2000), and is typically contrasted with quantitative research and the epistemology of positivism. The quantitative/qualitative debate has a long history within the social sciences (see, for example, Hammersley, 1989). Qualitative approaches have variously been presented as the antidote or, more usually in the drugs eld, the necessary complement to quantitative approaches (e.g., Bourgois, 2002; McKeganey, 1995). Advocates of both of these familiar positions hold that quantitative methodology is too narrow and too reductionist for the task of studying the social world. However, while one camp maintains that qualitative methods may reach the parts that quantitative methods cannot (e.g., Bryman, 1992), the other sees the latter as fundamentally unsuited to this task (e.g., Bryne, 1998; Pawson & Tilley, 1997). Whichever of these two positions is held, the two approaches are generally described in oppositional terms: individual/social, objective/subjective, fact/value, thin/thick and so on. These dualisms are widely promoted and serve to police and reproduce the boundaries between the two approaches (see, for example, Kitzinger, 1990; Pearce & Chen, 1989). However, if we move beyond these, the quantitative/qualitative distinction: . . . begins to resemble another melodrama of interrogationthe nice guy/nasty guy interview routine beloved of police and intelligence work (and their re-production

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with drug use, the forms of conduct under scrutiny are as important to the legal system as to the health system (and hence also of keen interest to the political system), the shaping inuence of this broader framework on the emergent ndings increases in salience and intensity. Part of the problem here is a working model of the relationship between social policy and scientic research that allocates to the latter, perhaps understandably, nothing more nor less than the role of delivering robust and objective ndings pertinent to social problems. A paradigm example might be a new and robust nding of some previously unknown harmful effects of a widely available drug. The discovery occurs thanks to the scientic system, which feeds into a social policy machine, which takes social action (e.g., a change in law, an advertising campaign, etc.). It is clear that the output of the scientic system in this framework must be robust, not just for classical reasons internal to science, but also because the ndings carry the weight of political decision over matters of public controversy. The more controversial the issue, the more importance accrues to the facticity of the data. This weight of responsibility is no less carried by social scientists, who are typically employed to produce reliable factual information of social importance. But the objects of social research are human beings and their situated conduct. This raises particular problems for social scientists, well rehearsed elsewhere (Curt, 1994; Stainton Rogers, Stenner, Gleeson, & Stainton Rogers, 1995). These include the difculty of generating truly robust (reliable and generalisable) knowledge that maintains ecological validity (and hence practical relevance). The qualitative/quantitative distinction can be seen as a means of adaptation, on the part of the social sciences, to this fundamental tension. Still today, qualitative techniques promise ecological validity at the cost of the classic scientic requirements of reproducibility and generalisability, whilst quantitative techniques promise robust ndings at the cost of diminished practical and personal relevance. One need not deny the often stormy relations that obtain between enthusiasts for one or the other camp to recognise that both are nevertheless subject to the same overarching framework: a will to truth born of a specic relation to policy. In order to become more aware of the inuence this framework has on the products of social science it is necessary to reect upon the agenda of governance that, for good or ill, pervades social science, and to recognise its inuence on the meaningful conduct of our participants. This is particularly important when the data under scrutiny are forms of communication, as is the case in qualitative research. To neglect the context of communication is to risk fundamentally misreading it. It would be a paradox indeed if a mutilated knowledge were to be produced in the name of the generation of trustworthy scientic information. We need to ask afresh what we and what our participants are doing in qualitative research. These, we stress, are not idle theoretical questions. A lack of attention to the broader framing of our research means an inability to understand our participants, and poor solutions to social problems.

Technologies of government A sophisticated perspective on the functioning of the social sciences in a broader social framework is offered by Michel Foucault and others who have adopted a poststructuralist stance. To rehearse a now familiar argument, the exercise of political power in advanced liberal democracies is seen to rely on government or: . . . any more or less calculated and rational activity, undertaken by a multiplicity of authorities and agencies, employing a variety of techniques and forms of knowledge, that seeks to shape conduct by working through our desires, aspirations, interests and beliefs, for denite but shifting ends and with a diverse set of relatively unpredictable consequences, effects and outcomes. (Dean, 1999: 11) From this perspective then, government involves guiding the possibility of conduct and putting in order the possible outcome (Foucault, 1982: 221). Individual and population management is achieved not by power being imposed directly by the state but at a distance through the diverse operations of a constellation of more or less independent institutions, agencies and experts granted authority to dene and direct human conduct. These authorities act largely (though not exclusively) not by dominating individuals but through the inculcation of norms of behaviour and subjectivity such that we govern ourselves (Rose, 1989, 1990, 1999). Paradoxically then, modern individuals are obliged to be free (ibid.) but in order to act freely must rst be shaped, guided and moulded into subjects capable of responsibly exercising that freedom through systems of domination (Dean, 1999, p. 165). The production of knowledge plays an integral role in this process. For poststructuralists, the exercise of power and the production of knowledge are inseparable. Clearly, for any domain to be governed there must rst be a way of rendering it into thought, so that it can be analysed, evaluated, its ills diagnosed and remedies prescribed (Rose, 1990, p. 105). On the other hand, knowledge presupposes power in the sense that it is produced and legitimated within a complex of power relations. Thus power and knowledge directly imply one another; . . . there is no power relation without the correlative constitution of a eld of knowledge, nor any knowledge that does not presuppose and constitute at the same time power relations (Foucault, 1991: 27). Power and knowledge are therefore less like a marriage, more like two sides of the same coin (Richer, 1992: 111). Critically, the social sciences, as the prime manufacturers of knowledge about individual and social life, are seen not to discover facts about these domains but to make new sectors of reality thinkable and practicable . . . the domains in question are realised, brought into existence, through the languages that re-present them (Rose, 1990: 105106). From this perspective, it is nave to assume that subjects, objects and processes are pre-existing entities waiting to be discovered. Instead, attention is drawn to the selectivity of

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the processes through which they are brought into being by the practices that claim to discover them and the languages taken to describe them. From this perspective then, the proper object of study shifts from reality as it is in essence to reality as it is represented. A corollary of this is that the position of the researcher shifts from an observer of reality to a secondorder observer of observers of reality (Luhmann, 1998). This double shift has led to a concern with discourse and the production of knowledge through representational practice. Discourse: . . . constructs the topic. It denes and produces the objects of our knowledge. It governs the way a topic can be meaningfully talked about and reasoned about. It also inuences how ideas are put into practice and used to regulate the conduct of others. Just as a discourse rules in certain ways of talking about a topic, dening an acceptable and intelligible way to talk, write, or conduct oneself, so also, by denition, it rules out, limits and restricts other ways of talking, of conducting ourselves in relation to the topic or constructing knowledge about it. (Hall, 1997: 44) Thus discourse, by virtue of its inherent selectivity, is constitutive of communicated reality, and plays an integral role in government by dening the parameters of thought, talk and action. Concepts such as addiction, dependence, drug problem and indeed drug use are, in a very important sense, culturally and historically specic social productions. They function via the communicative networks in which they are implicated to shape conduct and subjectivity in particular ways. Taking the poststructuralist viewpoint of a secondorder observer renders the drugs eld important not as a means by which truths about drug use may be revealed, but as a technology through which drug use is brought into existence and ordered as a domain to be governed.

Thus the practice of qualitative interviewing even before we begin the more obviously constructive work of transcribing, coding and representing our material (see, for example, Ashmore, MacMillan, & Brown, 2004; Denzin, 1990) presupposes a particular subject, a bounded sphere of thought, will, and emotion; the site of consciousness and judgment; the author of its acts and the bearer of a personal responsibility (Rose, 1989: 217). The assumption of the pre-given subject has been challenged, however, and cogent arguments have been made to the effect that the universal subject of the social sciences is constituted as uncovered by our research practices (e.g., Geertz, 1979; Henriques, Hollway, Unwin, Venn, & Walkerdine, 1984; Sampson, 1983). Thus attention turns from the subject as entity to the techniques that construct the subject; in short, to technologies of government. Clearly, the deconstruction of the unitary, autonomous subject has important implications for how we view what our participants tell us. The traditional subject of the social sciences, as the centre of experience, is taken as the source of explanation. From this viewpoint, what our participants tell us is conceived simply as more or less accurate information from which we may elucidate the workings of the world. From a poststructuralist viewpoint, however, it is discourse, not the subject, which produces knowledge. This focus on discourse: . . . implies a decentralization of the subject. The self no longer uses language to express itself; rather the language speaks through the person. The individual self becomes a medium for the culture and its language. (Kvale, 1992: 36) Thus the subject is de-centred from its position as the author of representation. Both the subject and subjectivity are brought into being through the discourses comprising the system of representation of a particular period and culture. This is not to say that our participants (or indeed we) are cultural dupes, merely relaying dominant discourses. Rather, the individual is active but not sovereign (Weedon, 1987: 41). People actively make sense of their personal and social worlds and exercise a certain agency in how they represent these, but this agency is exercised within the parameters of a nite number of discourses. Thus the poststructuralist research paradigm recognizes both the constitutive force of discourse, and in particular of discursive practices and at the same time recognizes that people are capable of exercising choice in relation to those practices (Davies & Harr , 1990: e 46).

Speaking subjects Poststructuralist ideas radically change not only what we seek to study but also how we conceptualise our methods and what our participants tell us. Our interviews and observations, as ways of knowing, cease to be mere conduits to reality; they become, as techniques, one of the means by which that reality is actively constructed. The interview, for example: . . . is an exemplary strategy of traditional humanism since such a device inscribes fundamental humanistic values (that is, liberal pluralism, unmediated knowledge, participatory democracy, consensus among free subjects) in the very practices it claims to be studying . . . The focus of the interviews (unitary, sovereign subjects) reafrm[s] the belief that people contain knowledge (they are self-present subjects) and all that one has to do to have access to that knowledge is to engage in free and unconstrained discussions . . . (Zavarzadeh & Morton, 1986/1987: 16).

Talking about drug use: discourse analysis It should be clear that a poststructuralist perspective troubles the idea that what our participants say can be straightforwardly taken as mirroring what really happened, how they really feel, what they really think, and so on. How, then, should we approach our interview material? If we take the

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poststructuralist view, that participants accounts are communicative constructions articulated in specic contexts and located within particular discursive formations, attention must turn to the limits and possibilities made available by discourse and how participants operate within these. One means of addressing such issues may be discourse analysis or discourse research. It is important to note that discourse analysis is not in itself a poststructuralist method, or even a unitary approach. Rather, discourse analysis is best seen as an umbrella term covering a wide range of different approaches and traditions, including conversation analysis, discursive psychology, Foucauldian archaeology and genealogy, critical discourse analysis and critical linguistics, interactional sociolinguistics and the ethnography of speaking, Bakhtinian literary theory, and so on (Wetherell, Taylor, & Yates, 2001a). What most obviously pulls these approaches together as a body of work is their focus on discourse. In the context of discourse analysis, discourse has a rather different meaning than it has for poststructuralists. In one sense, its meaning is broader and the term is used to refer not only to ways of knowledging the world into being but to all forms of spoken interaction, formal and informal, and written texts of all kinds (Potter & Wetherell, 1987: 7). On the other hand, its meaning in some approaches is rather narrower, and we see a focus on spoken or on spoken and written texts as opposed to representation per se. However, we also see in poststructuralist and some other work the notion of text expanded to incorporate visual images and physical texts (see, for example, Hall, 1997; Parker & the Bolton Discourse Network, 1999). What also holds this body of work together are key assumptions about the nature of discourse. Given the diversity of this work, these assumptions may best be expressed simply as two themes: construction and function. Thus discourse analysis focuses on research questions broadly related to how discourse is put together and what is achieved by these constructions. Poststructuralist versions of this approach such as Foucauldian research (e.g., Dean, 1991; Foucault, 1991, 1998) and discursive psychology (e.g., Edwards & Potter, 1992; Harr & Gillett, 1994; Potter, 1996; Potter & Wetherell, e 1987) integrate these overarching concerns with construction and function with the more specic assumptions and interests outlined above. Thus key features of poststructuralist approaches are the ontological and epistemological claims that they make. Since the orientation is towards reality as selectively constructed in discourse, the notion of a single essential reality is relegated from the status of ontological pre-commitment to the status of one amongst a variety of realities constructed in and through discourse. The expectation is that there will be multiple truths about any given state of affairs, and that relations of power will obtain between these versions. A reexive implication of this is that poststructuralist discourse analysis seeks no more than to offer plausible readings or versions of how discourse is constructed and how it works. To lay claim to denitive statements about

these matters would be to exclude the second-order observer from their own grounding principle that reality is selectively constructed on a functional basis. Critically, the knowledge obtained through such research is presented as local and contingent, a function of concerns arising in a specic social and historical context (Wetherell, Taylor, & Yates, 2001b). It should be noted that discourse analysis, in the very broad sense of the term outlined above, has already received some attention in the drugs eld. This body of discursive work can be usefully differentiated into that which concerns itself for the most part with the relatively formal communications of institutional discourse (such as law and science) and that which is proximally concerned with the informal, everyday communication of ordinary discourse. Thus there are studies within the Foucauldian tradition that trace the development of knowledges about drug use and their power effects, and those that critically deconstruct prevailing discourses, in order to say something about how power/knowledge operates in relation to drug use in contemporary society (e.g., Bourgois, 2000; Campbell, 2000; Finer, Thur n, & Tomson, e 1998; Harding, 1988; Miller, 2001; Mugford, 1993; Sedgwick, 1992; Seltzer, 1993; Valverde, 1998; Zibbell, 2004). These studies are mainly concerned with the discourses apparent in texts available in the public domain (policy documents, journal articles, media reports and advertisements, literary works, etc.), and with the more global ideological and practical consequences of their use. This work may be contrasted with studies inuenced more by ethnomethodology and conversation analysis (e.g., Davies, 1997; Plumridge & Chetwynd, 1998, 1999), where the focus is on everyday talk in action (or at least talk as transcribed). Here, more emphasis is placed on the immediate discursive and social contexts within which selves, identities and accounts are occasioned and on their functionality within these contexts.

Accounting for heroin use Much qualitative drugs research involves asking participants to give an account of particular events in their lives. Given this, we would like to illustrate the use of a discourse analysis informed by poststructuralist ideas by offering a (rereading of interview accounts, focusing not on their explanatory value but on how they are constructed and how they work. Our approach articulates most closely with the discursive psychology developed by Jonathan Potter, Margaret Wetherell and others (see above for key references). It is important to note that our reading, like any other, is informed by particular concerns. Thus we state at the outset that our discussion of the functioning of accounts is directed more toward their global implications for intervention and policy than their immediate social functions. The accounts we consider are taken from a set of interviews with people with experience of heroin use, in which participants stories of their drug-using careers were elicited. Concepts used commonly in connection with heroin use such

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as addiction and habit featured heavily in these interviews. However, we choose not to give attention to these and the accounts in which they appear. We avoid these precisely because they seem the most obvious to focus on in relation to heroin use. Our aim is to illustrate the broad applicability of poststructuralist discourse analysis to the drugs eld rather than its application to more obviously problematic events associated with drug use. Thus we focus instead on participants accounts of how they came to start using heroin, and draw on just three examples. The rst two of these accounts are deliberately chosen for their familiarity, our purpose being to disrupt and make visible the assumptions underlying more conventional readings.

The peer pressure account Our rst extract may be described as a version of the peer pressure or peer inuence account of initiation to heroin use: Me sister, like, me sister an her- boyfriend, they, um, theyd been doin little bits, an then, er, he got some money from, er, some royalties, like, from a single they had on this album, like-, years ago, right, er-, it was in the seventies, but he got these royalties through so he decided to buy a big lump an start dealin a bit. And so an they were stayin at me Mums me Mum an me Stepdads house at the time, so it was there every day, like, an every day they kept goin, yknow, Go on, yknow, Its not- just try a bit, it wont hurt. Just try a bit, its alright. I said, No, for ages an a-, well, for months, like, yknow, I said, No, an then just one day I come back from the- Id been out somewhere, had a few drinks an that, an I came back an- they were goin, Go on. Go on, so I thought I didnt wa-Ill just do a bit t shut them up, really [interviewer laughs]. An that was it. The basic storyline narrated here is that our participant resisted inducements to use heroin for some time before nally relenting and trying the drug. The conventional social scientic reading of this account would be directed at gaining an understanding of how and why this participant rst came to use heroin. Read in this way (or for this purpose), his account would seem to offer a highly plausible explanation of this event. Why should this be so? If we think about how this account is constructed, we see that it appears as a factual report, its seeming facticity achieved through the speakers reporting of observable events. The account consists almost entirely of descriptions of behaviour, verbal and otherwise. The use of reported speech, or what Tannen (1989) refers to as constructed dialogue, works to depict the account as somehow veriable. Indeed, at the one point where our participant refers to his subjective experience to what he thought this is quickly translated into internal dialogue, again giving

the sense of an objectively available event. Thus the plausibility of this account derives from its realistic effect as a veridical report of what really happened. Plausibility is in itself a signicant discursive achievement. However, the account may be seen to accomplish far more than this. While seemingly a factual report, it works not only to explain our participants rst use of heroin but also to exonerate his conduct. Two points are important here. First, no value (positive or negative) is attached to heroin use in the account, and so in one sense at least there would seem to be nothing to excuse. However, the problematisation of heroin use within the discourses that serve to dene it (as a disease, a social problem, psychological dysfunction, etc.) call upon us to read this account as a function of . . . the conditional relevancies arising from the antecedent blame (Buttny, 1993: 45). This point relates to the poststructuralist notion that the subject is always already positioned in relation to certain truths. People with experience of heroin use cannot escape the discourses that dene what is known (or what we think we know) about their conduct; they may only position themselves and be positioned in relation to these. The second point relates to how our participants account works as an excuse. Importantly, it is not framed as such. Rather than attributing blame directly to the other characters in his account (his sister, her boyfriend and a few drinks) he simply tells it as it was, distributing agency and therefore responsibility for his rst use of heroin across this broader eld in the process. That is, he perform[s] attributional actions . . . indirectly or implicitly through providing an ostensibly disinterested factual report which allows others to follow through the upshot or implications of the report (Edwards & Potter, 1992: 158). By doing this, he neutralises prospectively the unwanted accusation that he might be making up excuses for his conduct. The use of excuses, whereby responsibility for problematised conduct is minimised, comes at a price. As we mentioned earlier, the subject of advanced liberal democracies is obliged to be free. Persons (or at least adult persons) are expected to exhibit autonomy, free will and rationality. This discourse of personhood is one of the key overarching discourses in relation to which all others are situated (Shotter, 1984). Our reading of the account thus far as an effective excuse problematises our participants position in relation to this broader discourse. By attributing responsibility to others, our participant calls into question his status as an agent with a rational and volitional self. However, we see in his account discursive work that serves to mitigate this problematic. First, as we mentioned earlier, our participant reports actively resisting inducements to use heroin for some time. This aspect of his account works to construct an agentic and rational self, and moreover a selfcapable of maintaining its agency and rationality in the face of sustained pressure. Second, his resistance only breaks down when he has a few drinks. Consumption of alcohol is accompanied by normative expectations of both cognitive functioning and conduct: [t]hat drinking is inherently

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disinhibiting. . . is held by both experts and lay persons to be an absolute truth. Disinhibition is thought to produce fuzzy thoughts as well as poor self-control (Valverde, 1998, p. 196). Thus implicit within our participants account is the idea that when he rst used heroin, his judgement and selfcontrol may have been impaired. This again works to excuse his conduct, but in such a way that his agentic and rational self remains intact: heroin use is simply a lapse brought on by the effects of alcohol.

The response to distress account Accounting for problematised conduct in terms of ones normal faculties having been impaired is common. Impairment of thought and volition may be transitory or enduring, a function of factors internal or external to the self. Consider the contrast between how impairment is constructed in the extract above and in our second extract below: Well, I just I just, er, I- I think it- at the time I was depressed an thinkin about all the things thatd happened to me in the past, an it really sort o made my defences really low or whatever, a low point, I was at a sort o low point, you know, an I- I felt that my my defences, my normal, you know, my normal, er, common-sense, wasnt so strong as it shoulda been. An, you know, I sort o relented an I- an I used it, you know, whereas maybe at another time when I felt happy about myself, or happy, I would have said, Don, you know, the common-sense in me wouldve come out an gone, Dont do that. Whatre you doin? Dont be stupid, you know. This extract is a version of the response to distress account of initiation to heroin use. It shares key features with our peer pressure account above, again offering a plausible explanation of the participants rst use of heroin and working to excuse his conduct. However, both the value of this account as an excuse and its plausibility are achieved quite differently. This participant does not implicate characters external to the self (human or otherwise) in his rst use of heroin, and therefore positions himself as the sole agent in this event. Instead, he attributes the impairment of his defences (and by implication his volition) to being depressed. Like having a few drinks, being depressed is associated with the expectation that normal functioning may be disrupted; indeed, our participant takes pains to make this point explicit, and suggests that had his defences [not been] really low, his normal common-sense would have precluded his use of heroin. Unlike having a few drinks, however, people are seen to have no control over being depressed. Thus while a degree of superordinate responsibility may be attributed to our rst participant for his use of heroin, on account of his choice to consume alcohol, no such charge may be made in relation to our second participant.

While the rst account reports a sequence of events out there in the observable world, the second focuses on subjective experience and is highly reexive. However, our second account may also be seen to achieve a realistic effect through the invocation of a cast of characters internal rather than external to the self. Depression, defences and common sense all play an important role in both lay and expert discourses about human functioning. Though these entities cannot be observed directly, and must be operationalised in order to be measured and studied, their existence is nevertheless taken for granted. Much poststructuralist work has been devoted to showing how such intrapsychic entities have been invented rather than discovered by the social sciences and by the psy disciplines in particular (e.g., Cruikshank, 1996; Rose, 1989). Moreover, not only have such entities been knowledged into existence, but as modern subjects we are assumed to have access, through introspection, to these contents of our psyches. Thus our second account achieves its realistic effect by drawing on widely used discourses about the subject and the real world that is taken to inhabit our being as humans.

The risk appraisal account Critically, both of these accounts support implicitly in the rst instance and explicitly in the second the dominant construction of heroin use as inherently problematic. Our nal account differs in so far as it challenges this idea: Um, I mean, you hear about things and, er, your mates are sayin, Oh-, what a good time they had or this how they enjoyed this or that. An then on the other side o the coin you got your parents an, like, the older people sort o sayin to you, Oh, yknow, dont, youll- youll be dead, an you dont this an that. But you think, Well how ca-yknow, how can you be dead, how can it be so bad or, yknow, how can it be like this when-, yknow, theyll admit they aint never tried it but your mates who have are out sort of enjoyin themselves. So, its a, yknow, you try it for the, er, for the experience sort of thing. And to be, er, still be sort of part o the gang, part of, yknow, your mates sort of thing. This may be described as the risk appraisal account of initiation to heroin use. Unlike the previous speakers, this participant engages with the idea that heroin use is problematic and reconstructs its status. In line with this discursive move, his account serves as a justication rather than an excuse for his rst use of heroin. What is most interesting about this account, we would argue, is the way in which this participant works hegemonic discourse, drawing on a discourse of rationality in order to discredit the widely held belief that heroin use is problematic. Our participant positions himself very much as the empiricist, presenting direct experience as the only valid source of knowledge. He juxtaposes the warnings of parents and the

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older people with the knowledge he has gained through his senses and the testimony of experienced others. Conventional wisdom is seen to lack validity because it is espoused by those who lack the experience to lend authority to their claims, and because it conicts with his observations and what has been reported to him by those who do possess the relevant experience. First heroin use is presented as following an appraisal of risk, whereby our participant weighs up the evidence and decides in favour of the evidence of his senses. He claims that he rst used heroin (at least in part) for the experience. Within the context of empiricist discourse, this not only makes sense but is rational conduct; our participant becomes a kind of nave scientist sampling the experiences that life has to offer. Moreover, by portraying rst heroin use as a choice based on rational decision-making, our participant positions himself as a fully autonomous and rational subject.

Participants accounts as harm warrants for intervention We have discussed how knowledge and power, discourse and conduct, are inseparable. If we take qualitative research to be thoroughly implicated in governance, a further issue to be addressed in our analysis must be how the accounts we have presented might work in this context. Thus we return to our earlier concern with the relationship between qualitative research in the drugs eld and intervention. If these accounts are presumed to contain knowledge about the real causes of initiation to heroin use or the real processes underlying this event, what action might they be taken to prescribe? That is, how might these accounts serve as harm warrants (ODell, 1993) for intervention? While conduct is always immanent within understanding (Curt, 1994: 204) the relationship between the two is not straightforward. While different understandings may converge on a singular policy programme, a single understanding may be taken to inform more than one social action discourse (Stainton Rogers & Stainton Rogers, 1986). Thus the nature of the relationship between a given reading or understanding of an account and the conduct this is taken to prescribe is an empirical question, the answer to which we need not assume to be stable. While we have not sought to explore this relationship empirically in relation to our accounts of initiation, we may nevertheless usefully extend our analysis to suggest the kinds of intervention these accounts might plausibly be taken to warrant, were they to be presented as factual claims informing a policy agenda. The rst two accounts, which work to excuse rst use of heroin, would seem to warrant some kind of intervention aimed at prevention. Both support the idea that heroin use is problematic and therefore best avoided. The peer pressure account most obviously suggests assisting people to resist pressure to use heroin. This would usually im-

ply targeting the individual with interventions such as drugs education in schools and elsewhere, perhaps incorporating techniques such as role playing risky situations. The response to distress account might also be taken to warrant individually oriented intervention. This might again involve interventions aimed at strengthening resistance to heroin use, again through education but also through more therapeutic techniques designed to alleviate psychological distress (counselling, group therapy, self-help, etc.). Critically, both accounts warrant interventions directed at the person rather than social change, locating the problem of heroin use in the bodies and minds of individuals rather than in the broader society (for discussion of the implications of this see Caplan & Nelson, 1973). It is also important to note that both accounts support implicitly the current legal status of heroin. The risk appraisal account, as we have read it, potentially warrants a very different course of action. By challenging the problematisation of heroin use and presenting it as a free and rational choice, this account would seem to advocate allowing people to go about using heroin if they so choose. This would tend to argue for the legalisation or at least the decriminalisation of the drug. However, this is clearly a contentious (if debated) proposal, and in the present political and policy climate fails to offer a pragmatic solution to the problem of heroin use. An important theme in our earlier discussion was that constraints are placed upon what is thinkable, say-able and do-able within the discursive formation of any given culture and time; and it is here that this idea becomes critical. Accounts that oppose or resist conventional knowledge tend to be treated as rhetorical, political or simply mistaken; and are therefore ignored, suppressed or, more usually, brought in line with dominant discourses. In other words, oppositional accounts are most likely to be (re-)read in such a way that they no longer pose a challenge to conventional knowledge. With this point in mind, we can see how our risk appraisal account might be read differently. While it is hard to nd fault with our participants reasoning as this is expressed, clearly his observations and the testimony of experienced others did not furnish him with the full facts. The implication here is that had our participant been aware of the real consequences of using heroin, he would have made the rational choice not to try the drug. This reading clearly warrants a different course of action to that associated with our rst reading. Our participants account would be taken to again suggest the need for prevention through education, but in this case education might be appropriate both for young people and for their parents and older people. This second reading problematises the knowledge base of adults as well as young people; adults need to be educated to supply young people with accurate information. Critically, in this reading, it is the distortion of facts that is problematised, not the facts themselves. Thus the challenge this account might pose for conventional ideas about heroin use and how we should respond to this is successfully diffused.

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Criticisms and rejoinders Our analysis has sought not to reveal facts about how people come to use heroin but to offer readings of how these accounts are put together and how they might work, both for individual speakers and as harm warrants for intervention in particular. Our purpose is to make visible the constructed and constructive nature of such accounts and to position more conventional readings within a framework of government. Critically, we emphasise that our readings of the function of the accounts we have considered are local and contingent. That is, we seek not to reveal how these accounts are really constructed or how they really operate in different contexts, but to open up alternative ways of reading and thinking about these. This in turn, as we have argued, necessitates a rethinking of qualitative material more generally. Clearly then, our purpose differs signicantly from the received work of drugs research in that we place ourselves at one step removed from the conventional aims of explaining drug use and solving related problems. We recognise that such a stance may give rise to criticisms of den[ying] the very real personal experience of pain and suffering that is imposed across . . . power-ridden categories (Bourgois, 2003: 14). However, we stress that it stems from an orientation that takes the value-based commitments of conventional research as a necessary and integral part of the subject matter for observation. To the extent that these value commitments remain unobserved and untheorised, the discursive positions occupied by our participants as strategic responses to them escape attention. The cost of this poststructuralist reorientation, as we have suggested, is that one can no longer relate to qualitative material as if it provided access to truthful descriptions and evaluations of events and experiences. It is not surprising that this stance attracts scientic, political and moral criticism. From a scientic perspective, it obviously constitutes a challenge to any scientic realism that might hope to use qualitative data as a basic for making empirical truth claims. From a moral perspective, a poststructuralist stance seems to engender a cynical, nihilistic and pessimistic political tone (Rosenau, 1992: 143). From a political perspective it is seen to validate a relativistic form of political impotence where instead of trying to change the world, the point is merely to reinterpret it (Parker, 1992: 24). Whilst we agree that any coherent political action requires an understanding of a whole range of complex factors that are not reducible to discourse (economic, political, legal, medical, etc.), we insist that nevertheless each of these factors is so thoroughly discursively mediated that any politics, morality or science grounded in a conception of a brute extradiscursive reality risks gross oversimplication. Rather than regress to one of the many forms of realism (scientic or otherwise) currently available, the challenge for poststructuralism is to engage with the full complexity of discursive mediation, including studies of the constructions of reality specic to social functions such as law, economics, medicine, science, the mass media, and so forth. Such engagement

which must always reexively recognise its own status as discursive communication should not merely constitute a reinterpretation of reality, but a modest opening up of new alternatives for thought and action (Gergen, 1992: 27). If we consider how this aim might be achieved in practice, it should be clear that the absence of foundations requires an ethically and politically engaged approach (Fox, 1999, 2000; White, 1991). Thus Bourgois (2000) heeds Foucaults call for specic intellectuals to take political positions on the technico-scientic practical details at the interstices of public policies that discipline citizens lives (Bourgois 2000: 188; see also Foucault, 1984). Both Bourgois (2000) and Moore (2004) locate existing interventions within a framework of government and suggest alternative technologies that might produce less social suffering (Moore, 2004: 1555). In a somewhat different vein, we would position our own and other work that serves to make visible and thereby disrupt the totalising discourses and practices surrounding drug use within the genre of critical practice advocated by Keane (2003). This author argues for a style of ethical engagement that supports open-ended debate and respects the difference and freedom of others, where freedom is not an absolute ideal, nor a natural human attribute . . . [but] the capacity to actively reect on and author ones own actions, a capacity that can be enhanced or diminished by techniques of government (Keane, 2003: 232). Central to this is the recognition that in qualitative research we are dealing with complex forms of communication that both arise from and give rise to further communication. As such, our participants must be afrmed simultaneously as meaning-making beings and as beings who are made by meanings. These discursive activities are inseparable from relations of power. Our participants are whether we are aware of it or not reexively aware of the ways in which they are constructed in the communications of others, and generate their own constructions accordingly. We hope to have stressed that any policy intervention is always also an intervention into these complex dynamics of discursively mediated mutual recognition. Poststructuralist approaches afrm that these webs of mutual recognition are part of longer-term historical discourses that organise and create the objects and subjects they refer to. We are historical beings thrown into unfolding historical circumstances. If so, a crucial task for social scientists is to understand and explicate these constructions and to show their practical effects in everyday life. Courses of action which avoid this task, no matter how practical, factual and down to earth they pretend to be, lead the way to political, ethical and scientic paralysis.

Acknowledgements The interviews referred to in this paper were conducted as part of the rst authors doctoral thesis The social construction of heroin users: a discourse analysis study (in progress), Imperial College London. Our thanks to Harriette Marshall

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A. Martin, P. Stenner / International Journal of Drug Policy 15 (2004) 395405 Foucault, M. (1998). The history of sexuality, vol. 1: The will to knowledge, (trans. R. Hurley). London: Penguin Books. (This translation rst published 1978; London: Random House). Fox, N. (1999). Beyond health: Postmodernism and embodiment. London: Free Association Books. Fox, N. (2000). The ethics and politics of caring: Postmodern reections. In S. Williams, J. Gabe, & M. Calnan (Eds.), Health, medicine and society: Key theories, future agendas. London: Routledge. Geertz, C. (1979). From the natives point of view: On the nature of anthropological understanding. In P. Rabinow & W. Sullivan (Eds.), Interpretive social science: A reader. Berkeley, CA: University of California Press. Gergen, K. (1985). The social constructionist movement in modern psychology. American Psychologist, 40, 266275. Gergen, K. (1992). Toward a postmodern psychology. In S. Kvale (Ed.), Psychology and postmodernism. London: Sage. Hall, S. (1997). Representation: Cultural representations and signifying practices. London: Sage. Hammersley, M. (1989). The dilemma of qualitative method: Herbert Blumer and the Chicago tradition. London: Routledge. Harding, G. (1988). Opiate addiction, morality and medicine: From moral illness to pathological disease. Basingstoke: Macmillan. Harr , R., & Gillett, G. (1994). The discursive mind. London: Sage. e Henriques, J., Hollway, W., Unwin, C., Venn, C., & Walkerdine, V. (1984). Changing the subject: Psychology, social regulation and subjectivity. London: Methuen. Keane, H. (2003). Critiques of harm reduction, morality and the promise of human rights. International Journal of Drug Policy, 14, 227 232. Kitzinger, C. (1990). The rhetoric of pseudoscience. In I. Parker & J. Shotter (Eds.), Deconstructing social psychology. London: Routledge. Kvale, S. (1992). Postmodern psychology: A contradiction in terms? In S. Kvale (Ed.), Psychology and postmodernism. London: Sage. Luhmann, N. (1998). Observations on modernity. California: Stanford University Press. McKeganey, N. (1995). Quantitative and qualitative research in the addictions: An unhelpful divide. Addiction, 90, 749751. Miller, P. (2001). A critical review of harm minimization ideology in Australia. Critical Public Health, 11(2), 167178. Moore, D. (2004). Governing street-based injecting drug users: A critique of heroin overdose prevention in Australia. Social Science and Medicine, 59, 15471557. Mugford, S. (1993). Social change and the control of psychotropic drugs: Risk management, harm reduction and postmodernity. Drug and Alcohol Review, 12, 369375. ODell, L. (1993). The harm warrant. Paper presented to the European Association of Experimental Social Psychology General Meeting, Lisbon. Parker, H., Aldridge, J., & Measham, F. (1998). Illegal leisure: The normalization of adolescent recreational drug use. London: Routledge. Parker, I. (1992). Discourse dynamics: Critical analysis for social and individual psychology. London: Routledge. Parker, I., & the Bolton Discourse Network. (1999). Critical textwork: An introduction to varieties of discourse and analysis. Buckingham: Open University Press. Pawson, R., & Tilley, N. (1997). Realistic evaluation. London: Sage. Pearce, W., & Chen, V. (1989). Ethnography as sermonic: The rhetorics of Clifford Geertz and James Clifford. In H. Simons (Ed.), Rhetoric in the human sciences. London: Sage. Plumridge, E., & Chetwynd, J. (1998). The moral universe of injecting drug users in the era of AIDS: Sharing injecting equipment and the protection of moral standing. AIDS Care, 10, 723733. Plumridge, E., & Chetwynd, J. (1999). Identity and the social construction of risk: Injecting drug use. Sociology of Health and Illness, 21, 329343. Potter, J. (1996). Representing reality: Discourse, rhetoric and social construction. London: Sage.

(Psychology Division, Staffordshire University) from whom we borrowed the title phrase Talking about . . ., and to the Editors of IJDP and the anonymous reviewer for their helpful comments.

References
Agar, M. (2002). How the drug eld turned my beard grey. International Journal of Drug Policy, 13, 249258. Ashmore, M., MacMillan, K., & Brown, S. (2004). Its a scream: Professional hearing and tape fetishism. Journal of Pragmatics, 36, 349374. Barbour, R. (2001). Checklists for improving rigour in qualitative research: A case of the tail wagging the dog? British Medical Journal, 322, 11151117. Bourgois, P. (2000). Disciplining addictions: The bio-politics of methadone and heroin in the United States. Culture Medicine and Psychiatry, 24, 165195. Bourgois, P. (2002). Anthropology and epidemiology on drugs: The challenges of cross-methodological and theoretical dialogue. International Journal of Drug Policy, 13, 259269. Bourgois, P. (2003). In search of respect: Selling crack in El Barrio (2nd ed.). Cambridge: Cambridge University Press. Buttny, R. (1993). Social accountability in communication. London: Sage. Bryman, A. (1992). Quantitative and qualitative research: Further reections on their integration. In J. Brannen (Ed.), Mixing methods: Quantitative and qualitative research. Aldershot: Avebury. Bryne, D. (1998). Complexity theory and the social sciences: An introduction. London: Routledge. Caplan, N., & Nelson, S. (1973). On being useful: The nature and consequences of psychological research on social problems. American Psychologist, 28, 199211. Campbell, N. (2000). Using women: Gender, drug policy and social justice. London: Routledge. Cruikshank, B. (1996). Revolutions with: Self-government and selfesteem. In A. Barry, N. Rose, & T. Osborne (Eds.), Foucault and political reason: Liberalism, neo-liberalism and rationalities of government. London: Routledge. Curt, B. (1994). Textuality and tectonics: Troubling social and psychological science. Buckingham: Open University Press. Davies, B., & Harr , R. (1990). Positioning: The discursive production e of selves. Journal for the Theory of Social Behaviour, 20(1), 4365. Davies, J. B. (1997). Drugspeak: The analysis of drug discourse. Amsterdam: Harwood Academic Publishers. Dean, M. (1991). The constitution of poverty: Toward a genealogy of liberal governance. London: Routledge. Dean, M. (1999). Governmentality: Power and rule in modern society. London: Sage. Denzin, N. (1990). Harold and Agnes: A feminist narrative undoing. Sociological Theory, 8, 198216. Edwards, D., & Potter, J. (1992). Discursive psychology. London: Sage. EMCDDA (European Monitoring Centre for Drugs and Drug Addiction). (2000). Understanding and responding to drug use: The role of qualitative research. Luxembourg: Ofce for Ofcial Publications of the European Communities. Finer, D., Thur n, T., & Tomson, G. (1998). Tet offensive: Winning e hearts and minds for prevention. Social Science and Medicine, 47(1), 133145. Foucault, M. (1982). The subject and power. In H. Dreyfus & P. Rabinow (Eds.), Michel Foucault: Beyond structuralism and hermeneutics. Brighton: Harvester. Foucault, M. (1984). Truth and power. In P. Rabinow (Ed.), The Foucault reader. New York: Pantheon Books. Foucault, M. (1991). Discipline and punish: The birth of the prison, (trans. A. Sheridan). London: Penguin Books. (This translation rst published 1977; London: Allen Lane).

A. Martin, P. Stenner / International Journal of Drug Policy 15 (2004) 395405 Potter, J., & Wetherell, M. (1987). Discourse and social psychology: Beyond attitudes and behaviour. London: Sage. Rhodes, T., & Moore, D. (2001). On the qualitative in drugs research. Addiction Research and Theory, 9(4), 119. Richer, P. (1992). An introduction to deconstructionist psychology. In S. Kvale (Ed.), Psychology and postmodernism. London: Sage. Robson, C. (2002). Real world research (2nd ed.). Oxford: Blackwell. Rose, N. (1989). Governing the soul: The shaping of the private self. London: Routledge. Rose, N. (1990). Psychology as a social science. In I. Parker & J. Shotter (Eds.), Deconstructing social psychology. London: Routledge. Rose, N. (1999). Powers of freedom: Reframing political thought. Cambridge: Cambridge University Press. Rosenau, P. (1992). Postmodernism and the social sciences: Insights, inroads and intrusions. Princeton, NJ: Princeton University Press. Sampson, E. (1983). Deconstructing psychologys subject. Journal of Mind and Behaviour, 4, 136164. Sedgwick, E. (1992). Epidemics of the will. In J. Crary & S. Kwinter (Eds.), Incorporations. New York: Urzone. Seltzer, M. (1993). Serial killers (1). Differences, 5(1), 92128. Shotter, J. (1984). Social accountability and selfhood. Oxford: Blackwell. Stainton Rogers, R., & Stainton Rogers, W. (1986). What we mean by addiction and how we feel society should react. Report to the Study Participants, University of Reading.

405

Stainton Rogers, R., Stenner, P., Gleeson, K., & Stainton Rogers, W. (1995). Social psychology: A critical agenda. Cambridge: Polity. Taylor, A. (1993). Women drug users: An ethnography of a female injecting community. Oxford: Clarendon Press. Tannen, D. (1989). Talking voices: Repetition, dialogue and imagery in conversational discourse. Cambridge: Cambridge University Press. Valverde, M. (1998). Diseases of the will: Alcohol and the dilemmas of freedom. Cambridge: Cambridge University Press. Weedon, C. (1987). Feminist practice and poststructuralist theory. Oxford: Blackwell. Wetherell, M., Taylor, S., & Yates, S. (2001a). Discourse theory and practice: A reader. London: Sage. Wetherell, M., Taylor, S., & Yates, S. (2001b). Discourse as data: A guide for analysis. London: Sage. White, S. (1991). Political theory and postmodernism. Cambridge: Cambridge University Press. Zavarzadeh, M., & Morton, D. (1986/1987). Theory pedagogy politics: The crisis of the subject in the humanities. Boundary Two, 15(1/2), 121. Zibbell, J. (2004). Can the lunatics actually take over the asylum? Reconguring subjectivity and neo-liberal governance in contemporary British drug treatment. International Journal of Drug Policy, 15, 5665.