Stories told and untold: a narrative ethnography of a hidden population of women who use drugs in Scotland

Women who use illicit drugs can be a particularly hidden and ‘invisible’ group in society, given that 
they experience greater levels of stigma and discrimination than their male counterparts (Simpson and 
McNulty, 2008). There is particular lack of representation of women who are not in contact with 
treatment agencies or the criminal justice system (McPhee, 2013). In this narrative ethnography 
(Gubrium and Holstein, 2008), I address this significant gap in the literature, using snowball sampling 
methods (Woodley and Lockard, 2016) to identify and recruit 20 women with experience of illicit drug 
use. It has been suggested (Marechal, 2009) that ‘marginal intellectuals’ who tap their ‘outsider within 
status’ can offer an alternative perspective. Through the use of auto-ethnographic vignettes, I make 
links between my life history and the research focus, utilising my own multiple marginality as a research 
tool in accessing and engaging women who use drugs. 
Trust is especially vital to the success of hidden population research and through reflexive writing I 
render visible the series of challenges encountered in the recruitment process. Guided by a feminist 
sensibility (Ettorre, 2017), the demonstrative empathy narrative interview method (DENIM) was 
developed to address the power dynamic inherent in interviews with marginalised populations. DENIM 
is an informal approach to interviewing which considers seriously the social context, positionality and
role of the researcher in co-constructing meaning, in particular the desire for social acceptability 
(Holloway and Jefferson, 2008: Esin et al, 2013).The analytic approach adopted for this study views 
narratives as forms of social code - the making of meaning - and stories as socially and dialogically 
constructed (Bakhtin, 1981: Frank, 2010: Sullivan, 2012). Dialogical narrative analysis of ambiguity 
highlights the inherent complexity of the women’s identity work. Drawing inspiration from Belotti 
(2016), significant relationships are located within the concentric circles of trust. These insider/outsider 
narratives are implicated in group boundary maintenance.
Seven small stories are presented (Smith, 2016) and these function to retrieve and restore control and 
self-empowerment, to command respect and authority and to rework and locate cultural narratives of 
risk. I argue that this cohort of socially included women have access to narrative resources which allow 
them to perform relatively socially acceptable identities in order to manage stigma. Adopting subject 
positions that give a sense of being an acceptable human being often results in a reproduction of the 
social structure (Esin et al 2014). Women’s accounts of drug use thus shape and are shaped by the 
surrounding culture of stigma, shame and prohibition.
Ettorre (2017) suggests that gender sensitive harm reduction might be achieved through paying attention 
to the neglected arena of embodiment. Forming a dialogical perspective of women’s drug talk, I suggest
the concept of narrative habitus (Frank, 2010: 2012), which links women’s narrative identity work with 
the body and social networks. A renewed focus on storytelling, particularly how stories are circulated 
and embodied, has much to add to the understanding the interplay between structure and agency in the 
lives of women who use drugs (Fleetwood, 2016).
In closing, I argue that future research might employ the ‘circles of trust’ as a tool for narrative 
elicitation and a model for the social networks in which hidden populations of women who use drugs 
are embedded. In terms of methodological advancement, the use of DENIM will assist in enhancing 
engagement with particularly stigmatised segments of the population, such as opioid using parents.