Gilbert Quintero

Qualitative research: contributions to the study of drug use, drug abuse, and drug use(r)-related interventions.

This article describes how qualitative social science research has and can contribute to the emerging field of drug and alcohol studies. An eight-stage model of formative-reformative research is presented as a heuristic to outline the different ways in which qualitative research may be used to better understand micro and macro dimensions of drug use and distribution; more effectively design, monitor and evaluate drug use(r)-related interventions; and address the politics of drug/drug program representation. Tobacco is used as an exemplar to introduce the reader to the range of research issues that a qualitative researcher may focus upon during the initial stage of formative research. Ethnographic research on alcohol use among Native Americans is highlighted to illustrate the importance of closely examining ethnicity as well as class when investigating patterns of drug use. To familiarize the reader with qualitative research, we describe the range of methods commonly employed and the ways in which qualitative research may complement as well as contribute to quantitative research. In describing the later stages of the formative-reformative process, we consider both the use of qualitative research in the evaluation and critical assessment of drug use(r)-intervention programs, and the role of qualitative research in critically assessing the politics of prevention programs. Finally, we discuss the challenges faced by qualitative researchers when engaging in transdisciplinary research.

Rx for a party: a qualitative analysis of recreational pharmaceutical use in a collegiate setting.

Objective: Using a qualitative methodology, the author examined the sociorecreational use of pharmaceuticals in a collegiate setting. Participants: In all, 91 college students from a public, 4-year institution for higher learning in the Southwest participated in this study. Methods: The author conducted semistructured interviews between May 2004 and December 2005; they then audio recorded, transcribed, and examined the interviews for themes related to the sociorecreational use of prescription drugs. Results: A variety of prescription drugs are used for a number of purposes, including to experience pleasure, manage the duration or intensity of another drugs effects, party or socialize with friends and peers in leisure settings, facilitate sociorecreational activities, and help structure free time. Conclusions: Pharmaceuticals appear to be well integrated into the recreational drug use practices of college students, and prescription drug misuse presents a significant prevention challenge.

The lizard in the green bottle: "aging out" of problem drinking among Navajo men

The Navajo exhibit a number of indicators suggesting the extent of significant problems associated with drinking and alcohol abuse. Measures of alcohol-related mortality and morbidity provide stark testimony regarding the shape and magnitude of problem drinking among the Navajo. While these measures highlight patterns of drinking that often result in social, physical, and psychological pathology, there are other, less noted patterns of Navajo drinking. This paper describes a salient, if often overlooked, pattern of Native American drinking by examining the aging out phenomenon among Navajo men. Using narratives collected from former problem drinkers, this paper describes the factors and motivations associated with this sometimes dramatic change in drinking behavior. Several themes emerge from these narratives that help explain the aging out process. These themes include health concerns, religious involvement, living a traditional Navajo way of life, and the responsibilities and life changes associated with child rearing. This paper not only provides detail on a category of drinker and drinking phenomena that is largely ignored in accounts of Native American drinking, but also illustrates some of the values and meanings attached to drinking cessation and highlights the relation between changes in drinking behavior and stages in life course among Navajo men.

Hitting the Wall: Youth Perspectives on Boredom, Trouble, and Drug Use Dynamics in Rural New Mexico

We examine the experience of boredom and its relationship to troublemaking and drug use among rural youth in southwestern New Mexico. We draw on qualitative research with area youth to describe what they think about drug use and how they situate it within their social circumstances. We then locate youth drug use within globalized processes affecting this setting, including a local economic environment with limited educational and employment opportunities for youth. Drug use emerges as a common social practice that enables youth to ameliorate boredom, yet only some youth become known as troublemakers. Study findings offer insight into how dominant social institutions—schools and juvenile justice authorities—shape the construction of trouble from the perspectives of youth. We contend that boredom and troublemaking among rural youth are not simply age-appropriate forms of self-expression but instead represent manifestations of social position, political economic realities, and assessments of possible futures.

Substance Abuse Treatment Provider Views of “Culture”: Implications for Behavioral Health Care in Rural Settings

Mandates for culturally competent substance abuse and mental health services call for behavioral health providers to recognize and engage cultural issues. These efforts to incorporate culture typically focus on client culture, but provider views of culture can also influence the provision of services. Analysis of 42 semistructured interviews with behavioral health providers suggests that culture is considered by many to be an obstacle to help seeking and treatment of substance-abusing youth. Although some providers do not highlight cultural issues, others conceptualize culture in terms of (a) generalized Hispanic cultural attributes, (b) male-dominant gender roles, and (c) the culture of poverty. Recommendations for provider training on cultural issues focus on ways they might critically consider their ideas about culture.

Controlled release: a cultural analysis of collegiate polydrug use.

Abstract Social science research on polydrug use among young adult college students is scant, adopts definitions of this practice that are often devoid of sociocultural context, and emphasizes a very narrow range of use patterns. This article, based on ethnographic interviews from a study of collegiate prescription drug misuse, expands this focus by offering a cultural analysis of polydrug use. Two specific types of collegiate polydrug use, simultaneous interaction and sequential management, are examined within a cultural framework that relates these practices to the expression of two complementary values—control and release. The college experience provides young people with a culturally sanctioned “time-out” period that affords freedom from many of the roles, responsibilities, and other constraints that come to structure later adult life. At the same time, college students are expected to meet academic and social demands that require organization, initiative, and direction. Specific types of polydrug use provide young adults with a means to navigate these competing prescriptions that are characteristic of contemporary college life.

Cultural models of masculinity and drug use: “machismo,” heroin, and street survival on the U.S.-Mexico border:

This paper examines the interrelations between “machismo,” drug use, and aggression among injection drug users (IDUs) in a US-Mexico border community. Underscored is the directive force and social impact of “machismo” in the day-to-day life-worlds of Mexican male heroin addicts, or “tecatos.” This focus not only provides a broad description of the cultural model of “machismo” elucidated by this group of men, but also illuminates how ideas of masculinity are internalized and re-created through drug use and aggression in the context of life in the streets. Attention to these aspects of drug use invites consideration of several important issues, including the role structural factors play in the expression of masculinity as well as the social forces underpinning representations of Mexican men.

Ethics of Health Research in Communities: Perspectives From the Southwestern United States

PURPOSE The increasing attention paid to community-based research highlights the question of whether human research protections focused on the individual are adequate to safeguard communities. We conducted a study to explore how community members perceive low-risk health research, the adequacy of human research protection processes, and the ethical conduct of community-based research. METHODS Eighteen focus groups were conducted among rural and urban Hispanic and Native American communities in New Mexico using a semistructured guide. Group transcriptions were analyzed using iterative readings and coding, with review of the analytic summary by group members. RESULTS Although participants recognized the value of health research, many also identified several adverse effects of research in their communities, including social (community and individual labeling, stigmatization, and discrimination) and economic (community job losses, increased insurance rates, and loss of community income). A lack of community beneficence was emphasized by participants who spoke of researchers who fail to communicate results adequately or assist with follow-through. Many group members did not believe current human research and data privacy processes were adequate to protect or assist communities. CONCLUSIONS Ethical review of community-based health research should apply the Belmont principles to communities. Researchers should adopt additional approaches to community-based research by engaging communities as active partners throughout the research process, focusing on community priorities, and taking extra precautions to assure individual and community privacy. Plans for meaningful dissemination of results to communities should be part of the research design.

Risk factors for conduct disorder among Navajo Indian men and women

Objectives: To describe the risk factors for conduct disorder before age 15 among Navajo Indians. Methods. The study was based on a survey of a stratified random sample of adult Navajo Indians between the ages of 21 and 65 living on and adjacent to two different areas of the Navajo Reservation. There were 531 male and 203 female respondents. The average age (SD) of the men was 38.7 (10.5) years and of the women 35.5 (9.0) years. Conduct disorder was diagnosed retrospectively using the Diagnostic Interview Schedule first developed for the Epidemiological Catchment Area study. The responses were combined into a continuous scale. Results: Significant risk factors for increased scores on the conduct disorder scale were: histories of physical and sexual abuse in childhood; abusive maternal drinking; a small number of households per camp; younger age; and being male rather than female. Measures of social status and religion in which subjects were raised were not significant. Conclusions: Many of the risk factors that are associated with conduct disorder in other populations are also risk factors in the Navajo population. There is suggestive evidence that some of these risk factors have become more common since World War II, raising the possibility that conduct disorder has become more prevalent, as is thought to be the case nationwide.

Gender, Discord, and Illness: Navajo Philosophy and Healing in the Native American Church

Many studies of different societies throughout the world have noted how discord in prominent social relationships manifests itself as specific illnesses. This paper explores how the discord characteristic of male/female relations is related to illness in Navajo culture and how gender differences as conceptualized in Navajo cosmology are used to facilitate the healing of this discord. It will be shown that traditional Navajo philosophy recognizes discord between the sexes as a fundamental component of disease and that the reestablishment of health is accomplished through the manipulation of gendered symbolic media. In addition, a discussion of a relatively new healing tradition on the Navajo Reservation--the Native American Church--demonstrates that many of the basic cosmological principles underlying traditional Navajo ideas regarding gender are incorporated by practitioners of this healing system. This study has implications for healing, social transformation, and gender.