Critical Evaluation Of A Research Paper On Supervised Injection Facilities

Research Paradigm Used in the Paper

The purpose of this paper is to study the methods and analysis techniques used while conducting research on the supervised injection facilities in North America and if they can be implemented in British Columbia, Canada. A supervised injection facility is one where a person can use certain intravenous drugs, which have been pre – obtained, under supervision of medical professionals. This has been introduced to reduce drug overdose and the threats due to HIV and other related diseases which can spread through unsupervised drug intervention. The following paper studies the method of research in the journal titled, “Should North America’s first and only supervised injection facility (InSite) be expanded in British Columbia, Canada?” by Jozaghi and Andresen. This paper demonstrates how safe injection facilities have helped to reduce a negative impact on drug using population. Qualitative analysis is conducted to obtain the results.

A close reading of the journal shows that the type of research paradigm in the article is a qualitative one. A qualitative research is one that is predominantly exploratory in nature and helps in studying the underlying principles, opinions, motivations and factors behind the research (Creswell & Creswell, 2017). It provides an in depth analysis of the problems and develops a hypothesis which may pave the way for quantitative research. In addition, it can be said that an interpretivist research paradigm has been followed in the article. Such an approach to research is entirely based on human interests and takes into account the methodological and philosophical ways of conducting research (Bernard, 2017).

• Inductive: In such an inductive approach to research, data is obtained from various sources which would then be analyzed to derive a specific theory. In this journal, there is no specific pre determined theory or hypothesis in hand. As the authors mention in the article in pages 1 and 2, supervised injection facilities should be expanded into Canada because the problem of drug abuse is growing at an alarming rate in Vancouver and other places. For example, sharing of needles has been attributed as being the major cause of HIV in Canadians (Jozaghi & Andresen, 2013, p. 1).
• Use of open ended questions :The authors wanted to get the perspective of the patients at the supervised injection facilities. That is why an interview method was used, which would allow the researchers to communicate face to face with the interviewees. This is typical of a qualitative research paradigm, where the results of the research would be dependent on subjective accounts of the interviewees themselves.
• Snowball sampling method –A snowball sampling method is one where people are recruited for a survey or interview based on their acquaintances (Emerson, 2015). For example, in page 2 and 3, in the Methods section, the authors mention that participants were chosen in Surrey, Victoria and Vancouver; people who had been registered for using illicit drugs in the previous month were approached for the study. In other words, samples for the study were chosen from within familiar circles (Jozaghi & Andresen, 2013, p. 2-3).
• Purposive sampling –Purposive sampling may be defined as a method where samples for a study are selected on the basis of the population and also the objective of said research (Etikan, Musa & Alkassim, 2016). Purposive sampling may also be termed as subjective, selective or judgmental research. For example, in the first page of the article, the authors state that out of the three, Victoria, Vancouver and British Columbia, the latter would be more preferable if supervised injection facilities were to be expanded into Canada. This is because British Columbia has more provisions and resources required for effective management of supervised injection facilities.
• Constructivism– This is one of the key characteristics that make the provided journal a qualitative one. Unlike a quantitative analysis, such a qualitative approach to research would not state facts but simply interpretations of the data obtained. In the journal, the authors collect data, analyze it and then present the findings, as in page 4.
• Phenologism – In quantitative analysis, facts and statistics would be of utmost importance. However, in this case, the authors do not simply provide the facts. They are seeking a more in depth analysis of the situation, by interviewing the drug users (Jozaghi & Andresen, 2013, p.3-4). They want to get the subjective account of the situation from the drug users themselves instead of simply relying on facts.

• Statistical evidence is considered to be the benchmark as far as research methodology is concerned. However, it must be asserted that macro or mass subjectivities, which are characteristic of statistics, would not be applicable, especially in such cases. It must be understood that micro subjectivities are ever changing and thus, only qualitative polls can provide accurate, truthful results. For example in page 4, the authors state that the open ended interviews allowed them to facilitate a discussion about supervised injection facilities, the impact of supervised injection facilities on drug users’ behavior and also took into account their opinion or recommendations on how such facilities could be improved (Jozaghi & Andresen, 2013, p. 4).
• Such a qualitative approach to research increased the validity of the research article. Validity may be defined as the way a certain truth is expressed in such a way that it accurately represents a social phenomenon. In this case, to increase the validity quotient of the article, the authors have included quotes from the interviews, giving the interviewees a voice. This can be seen in page 4 of the article, in the Results section (Jozaghi & Andresen, 2013, p.4-8).
• The data obtained from the interviews were compiled and analyzed using NVivo software 9, which has been mentioned in page 4(Jozaghi & Andresen, 2013, p.4). Consequently, a thematic analysis was carried out of the data obtained, which helped the authors to throw light on the main concerns surrounding supervised injection facilities in Canada, like overdose or safety.

• Overdose – Overdose is the leading cause of death amongst drug users, which has led to widespread fear regarding the same. However, with the emergence of supervised injection facilities or InSite, it has become possible to reduce the number of deaths caused by overdose. For example, in page 4, one of the interviewees said that the availability of the supervised injection facility was a blessing for most people. Earlier, countless deaths had been reported due to overdose; people would be found behind dumpsters or in dark alleys, passed out from overdose (Jozaghi & Andresen, 2013, p.4).
• Sharing needles and HIV –It has been found that in the absence of supervised injection facilities, drug users would be inclined to sharing their needles. This can prove to be more harmful that overdose because it can aid the spread of diseases like HCV or HIV. Before the existence of supervised injection facilities, drug users would inject intravenous drugs anywhere and everywhere; as a result, hepatitis C and HIV was rampant in the area (Jozaghi & Andresen, 2013, p.5). Nevertheless, with access to supervised injection facilities, people were no longer resorting to such means.
• Safety –This is another major advantage associated with InSite facilities. People who are availing of these services find them reliable and feel safe and secured while getting their fix. In page 6, an interviewee says that she had been robbed and attacked a number of times when she headed to dark allies while getting her fix (Jozaghi & Andresen, 2013, p. 6).
• Behavioral changes –Certain behavioral changes have been noticed in the people availing of these services. Earlier people using intravenous drugs felt ashamed and embarrassed about their situation. Instead, at the InSite facilities, they felt comfortable and at home. This is because the nurses and the medical staff were caring empathetic and not judgmental (Jozaghi & Andresen, 2013, p. 7).

• Supervised injection facilities can be made part of hospital facilities. Most of these injection facilities run as independent organizations, and thus often lack the funding required for effective management (Hyshka, Bubela & Wild, 2013). Instead, if government and private hospitals were to include supervised injection facilities, it would ensure proper treatment and supervision and at the same time, provide more drug users with access to such amenities. In this case, the government or the hospital board would be entrusted with the responsibility for management and implementation of such facilities.
• Such supervised drug facilities may also be included as part of police stations. That way, more and more drug users would be discouraged from breaking the law; they would not have to sneak up to alleys in order to inject intravenous drugs. They could do so legally under medical supervision. The government would be responsible for running the operations. However, it must be remembered that some drug users might be afraid to approach such facilities because of its association with the police.

Earlier on, there was a preconceived notion that supervised injection facilities were a myth, and could not be operated in real life. This was largely due to the misconstrued notions about drug users and their practices. As a matter of fact, the condition of drug users was certainly deplorable to the extent that no provisions were being made for their mental and physical well being. As a consequence, the number of deaths caused by overdose was on the rise. To combat such issues, supervised injection facilities were introduced. These facilities would ensure that drug users can get their fix in a safe and secured environment without having to worry about being judged. Such facilities have altered conventional views in the sense that they have invited a change in the behavior of drug users along with that of the people supervising them. Such facilities also make the drug users feel embarrassed and welcomed in society.

To conclude, supervised injection facilities can be defined as safe, reliable and secured places where drug users can seek medical supervision while injecting intravenous drugs. Earlier in Canada, the mortality rate was quite high owing to drug overdose, and infectious diseases like HIV. This was a direct consequence of using shared needles and the lack of medical supervision. However, with easy access to such facilities, more and more drug users are encouraged to avail these services and use their desired drugs in medically supervised conditions so as to reduce chances of overdose and other diseases. Such facilities provide a safe environment for drug users – an environment where they can feel comfortable, away from judgmental eyes. Moreover, such supervised injection facilities should be expanded into British Columbia, so that more people can make the most of such services which are reliable and effective in controlling substance abuse.

References:

Bernard, H. R. (2017). Research methods in anthropology: Qualitative and quantitative approaches. Rowman & Littlefield.

Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.

Emerson, R. W. (2015). Convenience sampling, random sampling, and snowball sampling: How does sampling affect the validity of research?. Journal of Visual Impairment & Blindness (Online), 109(2), 164.

Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1-4.

Hyshka, E., Bubela, T., & Wild, T. C. (2013). Prospects for scaling?up supervised injection facilities in C anada: the role of evidence in legal and political decision?making. Addiction, 108(3), 468-476.

Jozaghi, E., & Andresen, M. A. (2013). Should North America’s first and only supervised injection facility (InSite) be expanded in British Columbia, Canada?. Harm reduction journal, 10(1), 1.