Susan Boyd

Opportunities to learn and barriers to change: crack cocaine use in the Downtown Eastside of Vancouver

In 2004, a team comprised of researchers and service providers launched the Safer Crack Use, Outreach, Research and Education (SCORE) project in the Downtown Eastside of Vancouver, British Columbia, Canada. The project was aimed at developing a better understanding of the harms associated with crack cocaine smoking and determining the feasibility of introducing specific harm reduction strategies. Specifically, in partnership with the community, we constructed and distributed kits that contained harm reduction materials. We were particularly interested in understanding what people thought of these kits and how the kits contents were used. To obtain this information, we conducted 27 interviews with women and men who used crack cocaine and received safer crack kits. Four broad themes were generated from the data: 1) the context of crack use practices; 2) learning/transmission of harm reducon education; 3) changing practice; 4) barriers to change. This project suggests that harm reduction education is most successful when it is informed by current practices with crack use. In addition it is most effectively delivered through informal interactions with people who use crack and includes repeated demonstrations of harm reduction equipment by peers and outreach workers. This paper also suggests that barriers to harm reduction are systemic: lack of safe housing and private space shape crack use practices.

Yet they failed to do so: recommendations based on the experiences of NAOMI research survivors and a call for action

BackgroundThis article highlights the experiences of a unique group. In January 2011, Dave Murray organized a group of participants from the North American Opiate Medication Initiative (NAOMI) heroin-assisted treatment clinical trials from 2005 to 2008 in the Downtown Eastside of Vancouver (DTES), B.C., Canada. The NAOMI Patients Association (NPA) is an independent group that currently meets every Saturday in the DTES. Currently, all members of the NPA are former participants in the heroin stream of the clinical trial. The NPA offers support, education, and advocacy to its members.MethodsDrawing on brainstorming sessions and focus groups that were conducted in the summer of 2011, this paper highlights the experiences of NPA members in their own words.ResultsThe findings provide a lens to understand how becoming a research subject for the NAOMI trial impacted the lives of NPA members, both positive and negative. The NPA members discuss ethics, consent, recommendations for future HAT programs and studies, and ongoing advocacy.

Using Children: Marijuana Grow-ops, Media, and Policy

Since early 2000, media outlets in Canada have printed numerous articles about children in grow-ops. For over 15 years, the Royal Canadian Mounted Police (RCMP) and the police have used their substantial public communication resources in the form of policy directives and press releases to emphasize that marijuana grow operations are a new social problem that requires increased public awareness, law enforcement, and legal and civil regulation. Our analysis of marijuana grow operations and children emerges from analyzing 15 years (1995–2009) of newspaper articles in national, provincial, and local newspapers in British Columbia. Our analysis focuses on how social problems such as drug use and drug production are contextualized, and how systems of meaning are produced in relation to these themes. Drawing from critical and feminist perspectives, we analyze and problematize the claims made about safety, health, and risk in relation to children and grow-ops in these newspaper articles. Analyzing media reports over a designated period of time reveals how social problems emerge and how discourse develops and is acted upon. We argue that the presumed veracity of media-based claims about children and marijuana production is established by the linking of historical discourses about child saving, drugs and parenting, and racialized outsiders to emerging claims about B.C.s marijuana grow-op business.

Drug Films, Justice, and Nationhood 1

This paper examines how drug traffickers, enforcement, nationhood, and space are represented in illegal drug films. Drawing from a sample of films produced in the United States between 1916 and 2005, this paper examines several drug films in order to explore how past and contemporary films on illegal drugs reflect conventional ideologies about law and order, the nation, and imperialism. Censorship and illegal drug films that challenge and rupture conventional ideologies will also be discussed.

Telling our stories: heroin-assisted treatment and SNAP activism in the Downtown Eastside of Vancouver

BackgroundThis article highlights the experiences of a peer-run group, SALOME/NAOMI Association of Patients (SNAP), that meets weekly in the Downtown Eastside of Vancouver, British Columbia, Canada. SNAP is a unique independent peer- run drug user group that formed in 2011 following Canada’s first heroin-assisted treatment trial (HAT), North America Opiate Medication Initiative (NAOMI). SNAP’s members are now made up of former research participants who participated in two heroin-assisted trials in Vancouver. This article highlights SNAP members’ experiences as research subjects in Canada’s second clinical trial conducted in Vancouver, Study to Assess Longer-term Opioid Medication Effectiveness (SALOME), that began recruitment of research participants in 2011.MethodsThis paper draws on one brainstorming session, three focus groups, and field notes, with the SALOME/NAOMI Association of Patients (SNAP) in late 2013 about their experiences as research subjects in Canada’s second clinical trial, SALOME in the DTES of Vancouver, and fieldwork from a 6-year period (March 2011 to February 2017) with SNAP members. SNAP’s research draws on research principles developed by drug user groups and critical methodological frameworks on community-based research for social justice.ResultsThe results illuminate how participating in the SALOME clinical trial impacted the lives of SNAP members. In addition, the findings reveal how SNAP member’s advocacy for HAT impacts the group in positive ways. Seven major themes emerged from the analysis of the brainstorming and focus groups: life prior to SALOME, the clinic setting and routine, stability, 6-month transition, support, exiting the trial and ethics, and collective action, including their participation in a constitutional challenge in the Supreme Court of BC to continue receiving HAT once the SALOME trial ended.ConclusionsHAT benefits SNAP members. They argue that permanent HAT programs should be established in Canada because they are an effective harm reduction initiative, one that also reduces opioid overdose deaths.

Women’s activism in a drug user union in the Downtown Eastside

Marginalized women in Canada who use criminalized drugs are often defined through institutional discourses of addiction, disease, poverty, sex work, and violence. Framed by many researchers as an at risk population, the fullness of these women’s lives is often rendered invisible, and the complexity, diversity, and range of experiences of their political and community work and their movement through the city are less often a topic of interest. This gap is addressed through an exploration of how some marginalized women come to know and experience themselves politically and physically, as part of a reflection upon their movement in and through the Downtown Eastside (DTES) of Vancouver, British Columbia, Canada. Drawing from community-based research in the DTES over a four-month period with women in leadership roles at the Vancouver Area Network of Drug Users, a drug user union, this paper highlights the results from focus groups and brainstorming sessions. The participants disrupt conventional notions of addiction and criminalization through their political and community activities and their ongoing resistance to systemic discrimination.

A Canadian perspective on documentary film: Drug Addict

BACKGROUND In 1948 the first National Film Board (NFB) documentary in Canada about illegal drugs, trafficking, and addiction was produced. The documentary is titled Drug Addict, and was directed by Robert Anderson. This paper provides a socio-historical context for the documentary Drug Addict. Viewing the film through the lens of Canadian history gives readers a better context to understand the claims and representations in the film about law enforcement, people who use illegal drugs and treatment. METHODS To examine Drug Addict, a socio-historical analysis and case study were conducted. This projects qualitative methodological framework is consistent with its critical theoretical perspective, drawing from Stuart Halls perspectives on visual and textual representation and cultural criminology. RESULTS Drug Addict is a significant documentary because it provides insight into early foundational law enforcement discourses and practices about illegal drugs, addiction, and treatment, including obstacles to drug substitution and maintenance programs. It also highlights the emergence of psychiatry as a new knowledge producer in the area of drug treatment. The film also transmits ideas about the criminal nature of addicts and the need for punitive criminal justice control. CONCLUSION Drug Addict captures some past and contemporary tensions related to Canadian drug policy. The film also provides another lens to understand some of the foundational frameworks of Canadian drug policy such as the dominance of criminal justice, and its practices of knowledge production, the resistance espoused by institutions to diverse models of treatment such as drug maintenance programs, and the power of visual representation.