The “goldfish bowl”: a qualitative study of the effects of heightened surveillance on people who use drugs in a rural and coastal Canadian setting

Harm Reduction Journal

Research

Manal Mansoor¹  Thomas Kerr²  Geoff Bardwell³  Ashley Van Zwietering⁴  Ellery Cleveland⁵  Dan Snell⁶ 

[1] British Columbia Centre on Substance Use, 400-1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada;British Columbia Centre on Substance Use, 400-1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada;Department of Medicine, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard Street, V6Z 1Y6, Vancouver, BC, Canada;School of Public Health Sciences, University of Waterloo, 200 University Avenue West, N2L 3G1, Waterloo, ON, Canada;British Columbia Centre on Substance Use, 400-1045 Howe Street, V6Z 2A9, Vancouver, BC, Canada;Department of Medicine, University of British Columbia, St. Paul’s Hospital, 608-1081 Burrard Street, V6Z 1Y6, Vancouver, BC, Canada;qathet Community Action Team, 218-6975 Alberni Street, V8A 2B8, Powell River, BC, Canada;qathet Community Action Team, 218-6975 Alberni Street, V8A 2B8, Powell River, BC, Canada;Lift Community Services of qathet Society, 218-6975 Alberni Street, V8A 2B8, Powell River, BC, Canada;qathet Community Action Team, 218-6975 Alberni Street, V8A 2B8, Powell River, BC, Canada;Lift Community Services of qathet Society, 218-6975 Alberni Street, V8A 2B8, Powell River, BC, Canada;Substance Users Society Teaching Advocacy Instead of Neglect (SUSTAIN), 218-6975 Alberni Street, V8A 2B8, Powell River, BC, Canada;

关键词: Rural Canada;    People who use drugs;    Goldfish bowl effect;    Surveillance;    Stigma;    Criminalization;   

DOI  :  10.1186/s12954-022-00725-2

 received in 2022-09-08, accepted in 2022-12-03,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundA growing body of research has focused on contextual factors that shape health and well-being of people who use drugs (PWUD). However, most of this research focuses on large cities and less is known about the effects of social and structural contexts on drug use and associated risks in rural Canadian settings. Therefore, we undertook this study to examine rural-specific contextual factors that affect the day-to-day experiences of PWUD.MethodsTwenty-seven qualitative semi-structured interviews were conducted with PWUD in a rural and coastal setting in British Columbia, Canada. Participants had to be ≥ 19 years old, used illegal opioids and/or stimulants regularly, and lived in the qathet region. Interview transcripts were coded based on themes identified by the research team.ResultsParticipants described progressive shifts in politics and culture in the qathet region while also identifying resource scarcity, homelessness, and changes in the drug supply, where illicit drug contents have become highly toxic and unpredictable. Participants discussed the qualities of a small community where everyone knows each other and there is a lack of privacy and confidentiality around drug use, which resulted in experiences of stigma, discrimination, and surveillance. Participants also reported rural-specific policing issues and experiences of surveillance on ferries when traveling to larger cities to purchase drugs. This led to significantly higher drug prices for PWUD due to the time dedication and criminalized risks associated with drug possession and trafficking.ConclusionsOur findings illustrate the unique experiences faced by PWUD in a rural and coastal setting. The “goldfish bowl” effect in this rural community created heightened social and structural surveillance of PWUD, which led to a variety of negative consequences. There is a clear need for interventions to address the larger contextual drivers affecting people who use drugs in rural settings, including decriminalization and peer-led anti-stigma strategies, in order to improve the lives of PWUD.

【 授权许可】

CC BY   
© The Author(s) 2022