Book Review

A nuanced discussion of drug use is no simple task. Ever-growing bodies of literature from a variety of academic disciplines continue to produce a wide range of content with regards to drug use. Nor is it easy to effectively introduce and implement research methods that both satisfy academic pursuits and hold relevance for non-academic interventions. An Applied Visual Sociology: Picturing Harm Reduction manages to not only contribute to research on injecting drug use and harm reduction through the detailed description of Stephen Parkin’s original research, but also develops a convincing defence for the usefulness of visual methods in general and applied visual sociology in particular. This is Parkin’s second book outlining different aspects of a thorough series of harm reduction-based research, the other being Habitus and Drug Using Environments: Health, Place and Lived-Experience (Parkin, 2013). Parkin has also showcased a photography exhibition on this research entitled Frontline: Photo-Ethnography of Drug Using Environments (Parkin, 2012). Clearly written, finely detailed and well-organised, Parkin writes in such a way that allows readers unfamiliar with harm reduction and visual methods to follow and understand the theoretical rational and empirical application of the research outlined in Picturing Harm Reduction. Furthermore, the book provides a suggested guide for those wishing to conduct their own study based in visual methods.

The book is divided into three parts (Review, Empiricism and An Applied Visual Sociology), which provides readers with the option to either take the book in its entirety or pick out key sections that may be of specific interest. The introduction begins with a vignette of Parkin, an exasperated audience member, challenging a presenter on the relevance of the visual data presented to their research, and the potential exploitation of the participants through the use of the data. This brief account sets up the antithesis of the book: visual methods and visual data as forms of mere illustration. Parkin claims this is “flagrant misuse of visual methods”, and argues instead for images to be used as data in and of themselves rather than as a prop for sensationalising a research topic or findings (p. 4). Parkin provides weight to this proposition throughout the book by drawing on ethnographic research he conducted in the UK from 2006 to 2011 with injecting drug users and people working in harm reduction-related professions (Parkin refers to them as “frontline workers”).

Picturing Harm Reduction uniquely combines the ethics of visual methods with original research about injecting drug use and harm reduction. Parkin emphasises throughout how the photographic data (in which he is the photographer) complement the other qualitative data in his research study (ethnographic observations and interviews) to create robust and rich findings. Academic and harm reduction-related jargon is explained throughout the book and then applied to different aspects of Parkin’s research. The book achieves the stated goal of giving suggestions on “how visual research may provide both academic and applied value to social studies” as well as indicating “how visual data may assist wider qualitative methods in approaching questions regarding health concerns” (p. 7). Rather than preaching to the converted, Picturing Harm Reduction instead introduces and explains both harm reduction and visual methods in such a clear and detailed manner that those with no previous understanding of either topic can grasp the importance of both from academic and applied stances.

Part one of the book provides an overview of various visual methods, and outlines a brief history of the development of harm reduction and the assorted approaches to applying harm reduction in practice. Of noticeable interest on pages 54–57 is a list of 68 points that serve as guidelines for safer injecting drug use from a harm reduction perspective. Parkin compiled the list from four relevant UK-based texts on the subject. As demonstrated in the following empirical section of the book, many of the points, while sensible from public health and harm reduction perspectives, are impractical and unrealistic given the contexts in which public injecting drug use takes place. As harm reduction espouses to “meet people where they’re at”, this is telling in the potential disjuncture between suggested health-based interventions and the lived realities of drug users.

Part two begins with a detailed overview of Parkin’s epistemological and methodological positionings before describing the design of the specific research study. This “full disclosure” refreshingly contrasts positivist claims of complete research objectivity and humanises both the research process and Parkin’s results, while still maintaining categorical rigour (of the photographs) through a clearly explained typography of public injecting sites and community harm reduction responses. Part two focuses on the empirical data collected from the study, and the text is rich with participant and respondent quotes, fieldnote descriptions, and of course photographs. The fieldnotes and quotes are, at times, not easy to read due to the graphic descriptions and harrowing accounts of the lived experiences and conditions in which Parkin’s participants inject drugs and clean up drug-related litter. However, the data emphasises the varying levels of sanitation, safety and protection for both drug users and frontline workers in the spaces where the injecting drug use occurred. The images displayed in the empirical chapters help demonstrate the use of Parkin’s categorisation of the places in which injecting drug use took place as both a “continuum of descending safety” (chapter five) and the various harms associated with the drug related litter left from the injecting episodes (chapter six).

Part three, as suggested by the title, focuses on the ‘applied’ nature of the research. Here, Parkin finally reveals what precisely he means by ‘applied visual sociology’ throughout the entirety of chapter nine. More concisely, according to Parkin, applied visual sociology is grounded in “Knowledge-Action-Change” (p. 240). Although the utility of applied visual sociology is demonstrated throughout the book, Parkin conveniently finishes Picturing Harm Reduction with a succession of exercises for different levels of educational competency both in and out of academia. These exercises are invaluable resources for students, educators, as well as harm reduction and other health care practitioners alike, as they provide concrete examples, tasks and questions that have relevance in a variety of ‘real life’ settings. Throughout all three parts of Picturing Harm Reduction, Parkin highlights various ethical dilemmas and issues that were either raised during his research or could arise in other qualitative studies, in general, and visual methods and/or research with drug users and frontline workers, in particular.

There is one minor point on methods that deserves some light criticism. Parkin twice states that he did not show the photographic data to participants at any time during the research. While it is unclear if any participants attended Parkin’s conference presentations or public photo exhibition containing the visual data, the research design arguably missed a beneficial opportunity to use the participants’ reactions to the images in order to further enrich the data analysis and subsequent findings. Parkin does not provide any obvious reason for deciding to withhold the images from participants during and after the fieldwork, and as such, limits one aspect of potential involvement and further reflexivity with his participants. However, this is a paltry critique, as overall the quality and rigour of the book is as thorough as it is thoughtful.

Picturing Harm Reduction is recommended for undergraduate and postgraduate students as well as for those teaching qualitative research methods, who are interested in learning more about visual methodologies, or who would like to incorporate or further develop some or all of the techniques described in the book into their current or future research. Chapter one, in particular, could be used for introductory methods courses as the text suggests a range of ethical, methodological and theoretical issues to consider if using applied visual sociology. Picturing Harm Reduction could also benefit harm reduction practitioners and other frontline workers who have available resources to conduct an evaluation of their service provisions and would like an innovative approach to document their data. Likewise, Parkin categorises public spaces where injecting drug use takes place and harm reduction responses in the empirical section of Picturing Harm Reduction (part two: chapters five, six and seven) could be of practical use to others involved in drug-related issues, such as city cleaners, police officers, and, as mentioned in the book, coroners. For those already engaged in either visual methods or harm reduction (or both, like the author of this review), Picturing Harm Reduction is a decidedly useful and relevant book which significantly enhances the understanding and application of such research and practice.

Camille Stengel

University of Kent, UK; Eötvös Loránd University Hungary E-mail: [email protected]