Women who use drugs: engagement in practices of harm reduction care.


Journal

Harm reduction journal
ISSN: 1477-7517
Titre abrégé: Harm Reduct J
Pays: England
ID NLM: 101153624

Informations de publication

Date de publication:
13 04 2023
Historique:
received: 16 11 2022
accepted: 28 03 2023
medline: 17 4 2023
entrez: 13 4 2023
pubmed: 14 4 2023
Statut: epublish

Résumé

Harm reduction services that employ or are operated by people who use drugs are an effective means of mitigating overdose risks and other drug-related harms. However, stereotypes portraying people who use criminalized drugs as incapable caregivers persist. This is especially true for women who use drugs, and to a greater extent racialized women, who are characterized as having diverged from traditional ideals of womanhood as a result of drug-user stigma and the intersections of gender- and class-based and racist stereotypes. In an effort to identify and understand how women who use drugs practise care through harm reduction, we explored the experiences of women accessing a low-threshold supervised consumption site exclusively for women (transgender and non-binary inclusive) in Vancouver, Canada. Data were drawn from research conducted from May 2017 to June 2018 exploring women's experiences accessing the supervised consumption site during an overdose crisis. Data included forty-five semistructured interviews with women recruited from the site, analysed thematically to explore practices of care through harm reduction. Participants reported engaging in both formal and informal care. Acts of care included interventions that both aligned with and deviated from conventional understandings of care practices, including overdose reversal and education, overdose supervision/care, and assisted injection. The boundary between formal and informal harm reduction care is fluid. Women who use drugs engage in harm reduction across these borders with acts of care that align with or fill the gaps in current harm reduction services in order to meet the needs of drug-using communities, challenging negative stereotypes of women who use drugs. However, these caregiving practices can increase risks to care providers' physical, mental, and emotional health and wellness. Increased financial, social, and institutional supports, including safer supply, assisted injection, and community resources, are needed to better support women as they continue to engage in harm reduction care.

Sections du résumé

BACKGROUND
Harm reduction services that employ or are operated by people who use drugs are an effective means of mitigating overdose risks and other drug-related harms. However, stereotypes portraying people who use criminalized drugs as incapable caregivers persist. This is especially true for women who use drugs, and to a greater extent racialized women, who are characterized as having diverged from traditional ideals of womanhood as a result of drug-user stigma and the intersections of gender- and class-based and racist stereotypes. In an effort to identify and understand how women who use drugs practise care through harm reduction, we explored the experiences of women accessing a low-threshold supervised consumption site exclusively for women (transgender and non-binary inclusive) in Vancouver, Canada.
METHODS
Data were drawn from research conducted from May 2017 to June 2018 exploring women's experiences accessing the supervised consumption site during an overdose crisis. Data included forty-five semistructured interviews with women recruited from the site, analysed thematically to explore practices of care through harm reduction.
FINDINGS
Participants reported engaging in both formal and informal care. Acts of care included interventions that both aligned with and deviated from conventional understandings of care practices, including overdose reversal and education, overdose supervision/care, and assisted injection.
CONCLUSION
The boundary between formal and informal harm reduction care is fluid. Women who use drugs engage in harm reduction across these borders with acts of care that align with or fill the gaps in current harm reduction services in order to meet the needs of drug-using communities, challenging negative stereotypes of women who use drugs. However, these caregiving practices can increase risks to care providers' physical, mental, and emotional health and wellness. Increased financial, social, and institutional supports, including safer supply, assisted injection, and community resources, are needed to better support women as they continue to engage in harm reduction care.

Identifiants

pubmed: 37055805
doi: 10.1186/s12954-023-00775-0
pii: 10.1186/s12954-023-00775-0
pmc: PMC10100181
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

49

Subventions

Organisme : CIHR
ID : PJT-155943
Pays : Canada
Organisme : CIHR
ID : 183952
Pays : Canada

Informations de copyright

© 2023. The Author(s).

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Auteurs

Tamar Austin (T)

Birth Place Lab, UBC Midwifery, Faculty of Medicine, University Boulevard, Vancouver, BC, 3302-5950, Canada.
British Columbia Centre On Substance Use, St. Paul's Hospital, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, BC, Canada.

Jennifer Lavalley (J)

British Columbia Centre On Substance Use, St. Paul's Hospital, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, BC, Canada.

Sylvia Parusel (S)

British Columbia Centre On Substance Use, St. Paul's Hospital, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.

Alexandra B Collins (AB)

Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.

Michelle Olding (M)

British Columbia Centre On Substance Use, St. Paul's Hospital, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada.
Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, BC, Canada.

Jade Boyd (J)

British Columbia Centre On Substance Use, St. Paul's Hospital, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada. jade.boyd@bccsu.ubc.ca.
Department of Medicine, University of British Columbia, St. Paul's Hospital, Burrard Street, Vancouver, BC, 608-1081, Canada. jade.boyd@bccsu.ubc.ca.

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