How photos used to illustrate articles about alcohol and other drugs may perpetuate stigma

Dr. Stephen Parkin writes about some of the inadvertent consequences of using photos about substance use, and makes five recommendations for authors and publishers based on his own research.

Photographs of substances (and/or of people using substances) can be used to highlight, emphasise or draw attention to written text in media reports, news articles, social media posts, and blogs, and are increasingly being featured in informal academic and scholarly articles. The source of these photos is often a catalogue of ‘stock images’ of a wide range of objects and environments, which are available to purchase, and were produced by people other than the author of the text. This method of acquiring photos can benefit the author (who can access readily available packages of specialised and bespoke photographs that are free from copyright issues), the photographer (who may derive some financial benefit), and the various muses involved in the production of images (who may stand to gain financial benefit, publicity, and/or fulfil aspirations of a modelling career).

“Those of us involved in the academic and clinical study of substance use should be especially aware and exceedingly mindful of the cultural and social implications of photo illustrations.”

Due to the range of substances, environments where substances are consumed, and methods of consuming substances, articles on drugs and alcohol present countless opportunities for illustration. Indeed, it has become almost standard and expected procedure to incorporate stock images of discarded injecting paraphernalia, people injecting substances, communal drinking scenes, drug-related litter, close-up shots of alcohol, and semi-clothed people in varying states of ecstasy and agony into articles. However, those of us involved in the academic and clinical study of substance use should be especially aware and exceedingly mindful of the cultural and social implications of photo illustrations, including their potential to send messages that stigmatise or marginalise, their potential to perpetuate negative stereotypes, and their potential to trigger substance use cravings.

Below are five suggestions of ‘what to avoid’ in photo illustrations based on my research:

1. Avoid images that identify people (especially children)

The use of any image that clearly or partially identifies people contradicts the guiding principles of ethical research to protect the confidentiality and anonymity of those who participate. Although stock images may be obtained from ‘staged’ or ‘choreographed’ photography, the person/people within the photograph may not be fully aware of how their physical image has been used by those who purchase their image, and their image may be forever attached to an article about substance use without their knowledge or consent. This is particularly relevant to young children, who I would advise are never used in a way that identifies them for illustration in articles about substance use.

2. Avoid images that identify substances

Photos of substances accompanying articles in an academic context are unnecessary as those reading the articles will understand what a needle and syringe looks like, what form heroin and crack cocaine may take, and be fully aware of the colourful designs of alcoholic products. More importantly, they can show an insensitivity towards people with substance use problems in the audience/readership, who may experience cravings as a result of seeing images of substance of choice or related paraphernalia (1 2).

3. Avoid cultural insensitivity

While photos of substances and substance use may be acceptable within the societal culture they were chosen in (often the dominant culture), they could also be insensitive to people from other cultural backgrounds. For example, the illustrator’s choice of models in certain images may reinforce cultural or racial stereotypes of particular activities, (for example stereotypes of people who engage in sex work, drug-selling, and drug use). Similarly, the actual content of the illustration may be insensitive to values within particular cultures, such as photographs of feet/toe injecting.

4. Avoid images that stigmatise drug use and/or people that use drugs

Images are very powerful media and their ability to perpetuate negative perceptions of, and attitudes towards, people who use drugs should be carefully considered in photo illustrations. This is especially relevant when featuring people taking drugs or when including injecting paraphernalia. Such images often decontextualise injecting episodes, contribute to negative reinforcements of people who inject/use drugs, and may perpetuate stigmatising attitudes or beliefs amongst those unfamiliar with concepts such as harm reduction.

5. Avoid images that sensationalise/glamourise substance use

Some photos portray drug use as an aspect of marginalised and stigmatised behaviour, while others perpetuate an image of glamour and/or a communal ‘feel good factor’. Choosing photo illustrations of joyous, celebratory social gatherings focused upon, for example, communal alcohol use may be insensitive to those who have had their health and/or social relationships severely impacted by drugs and/or alcohol.

Through my research, I have come to the conclusion that photographs can convey different meanings to different people, and in the context of alcohol and other drugs, there are a range of ways for images to inadvertently stigmatise or marginalise, perpetuate negative stereotypes, or trigger substance use cravings. I would advocate for articles to be illustrated instead with ‘neutral’ or ‘value-free’ images that connect with the content in an article in more abstract and imaginative means.

Stephen Parkin is Research Fellow at the National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London. He is author of the book ‘An Applied Visual Sociology: Picturing Harm Reduction’ which is an account of an applied photo-ethnography he employed during a study of street-based injecting drug use from 2006 to 2014.

This article was original published on The Society for the Study of Addiction. Read the full article here.