Emma Smith, a PhD student from the School of Nursing and Midwifery, is investigating Substance misuse using 'PhotoVoice,' a technique which loans a camera to a research participant and asks them to take photographs so they may tell the stories of their community for themselves.

Substance Misuse: The current problem

Drug misuse is an international Public Health problem with the United Nations office of Drugs and Crime estimating that there are between 16 and 39 million problem drug users worldwide. It is estimated that of a population of 42 million people aged between 15 and 64 years old in the United Kingdom, 330,000 have been classified as high-risk opioid users. This has led to a rise in drug related deaths in the last ten years which sees no sign of slowing down. 

A close up shot of some tablets

Scientists are still trying to understand why some people are able to use drugs recreationally and others become addicted.  Addiction has been previously described as being a disease, a consequence of pharmaceutical companies dispensing drugs irresponsibly, the result of an individual’s predisposition (such as their genetics), or as a result of negative events which have happened in a person’s life.  The course of one person’s addiction is different for everybody and is determined by a number of individual as well as environmental factors. 

Much like addiction, the process of recovery for a person who has decided to limit the effects of drug and alcohol on their lives is also very personal and will be different for everybody.  People engaging with recovery services routinely report feelings of a stigma against them as well as changes in how they identify themselves. This happens as they transition from a person who identifies themselves as being an addict, to someone who is ‘in recovery’. Understanding how a person sees the world at different stages of the recovery process is essential for tailoring recovery services to different needs. This is why it is very important that research is done to understand the experiences of individual people and that researchers employ different and creative methods to allow people to express themselves beyond speech. Here's where 'PhotoVoice' can be useful.

So, what is 'PhotoVoice?'

'PhotoVoice' is a method of research which aims to allow people to tell their stories for themselves. During a 'PhotoVoice' project, a group of people are given cameras and asked to take pictures of their experiences and how these relate to their community. Participants take the photographs back to the researcher and the photographs are used as a catalyst for discussion during an interview to learn things about an individual’s life. There are three primary goals of 'PhotoVoice:'

  • To enable participants to record and reflect on the strengths and concerns of their community
  • To promote discussion around important community issues
  • To reach ‘stakeholders.’ Stakeholders are people who are able to create change in a participant’s community. They could be people who can change regulations, work in recovery services or are other interested parties.


A photo of two hands reaching for each other. One hand is coming out from a camera.

The photographs are generally chosen and curated by participants to create an art exhibit as a way to reach the stakeholders. This allows the stories of participants to be shared with people who might be unfamiliar with struggles in their communities as well as with people who might actively be able to create a change. The ‘Photo’ in 'PhotoVoice' stands for photography while the ‘Voice’ refers to the voice that is given to participants in sharing their world view with a researcher and with a wider audience.  It is hoped that participants find this process empowering by being in control of the research process and telling their story the way they want to tell it.

Due to its emphasis on community and participant empowerment, 'PhotoVoice' is often conducted with marginalized groups in society.  Examples of this include projects which have been done with limbless veterans, black gay men in post-apartheid South Africa, and socially isolated elderly people. As is the case in the research I hope to do, this includes people who are in recovery from drugs and alcohol use.  

What do I plan to do?

In my proposed research, I am hoping to learn about the experiences of people in recovery from drugs and alcohol using 'PhotoVoice' as the method for my research. The chronic and relapsing nature of problem drug use make it a particularly interesting group of people on which to focus a 'PhotoVoice' project. There is a high prevalence of other long-term mental and physical health issues present in people who are struggling with addiction. The marginalization and generally low socio-economic status of problem drug users align this group among some of the most disenfranchised in England who are living with long term conditions. There has also been no other research to date to attempt to understand how the use of photographs can be used as a tool to understand the experiences of people seeking support in their recovery from addiction.

I will be doing my research at a recovery organisation in Bristol with a group of 10-12 people who are in recovery from substance misuse. Over a six month period of time I will conduct a 'PhotoVoice' project with this group of participants, allowing them to have control over what they photograph and what we speak about during the interviews. It is hoped that by the end of the project we will have not only a set of photographs which accurately portray the experiences of participants, but more information as researchers regarding how the use of digital photography can effect a person’s recovery from substance misuse. 


A photo of Emma Smith a Research Student from the School of Nursing and Midwifery

Emma Smith is originally from Atlanta, Georgia and graduated with a Bachelor of Arts in Anthropology from the University of Georgia in 2014. She recently graduated with a Masters in Public Health from the University of Dundee in 2018 and began her PhD studies at the University of Worcester thereafter. She is supervised in her PhD by Dr.Melody Carter and Dr. Paul Hazell.

The School of Nursing and Midwifery offers two types of research degree programme in the School of Psychology: Master of Philosophy (MPhil) and Doctor of Philosophy (PhD) as well as undergraduate degree qualifications such as Nursing BSc and Nursing Associate FdSc.

The University of Worcester's School of Psychology offers a combination of Undergraduate, Postgraduate and Research Degrees

All views expressed in this blog are the Academic’s own and do not represent the views, policies or opinions of the University of Worcester or any of its partners.