School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, BC, Canada.
Int J Drug Policy. 2010 Jul;21(4):321-9. doi: 10.1016/j.drugpo.2009.12.008. Epub 2010 Feb 8.
There is increasing public health evidence that women who use crack cocaine and are street-involved experience significant health problems and are more isolated with regards to accessing harm reduction and other health-related services. Simultaneously, there is growing acknowledgement that structural and 'everyday' violence are significant factors influencing the health of women who use illegal drugs. Little research has examined how these social processes play out for women who use crack cocaine.
A critical ethnography informed by the theoretical constructs of structural and everyday violence and intersectionality was undertaken to explore women's use of crack cocaine within an inner-city neighbourhood in Western Canada. Data collection included baseline survey (n=126), participant observation and field notes, informal interviews (n=53), and in-depth interviews (n=13).
Based on thematic and theoretical analysis two interrelated themes were identified that reflected the interrelationships between women's use of crack, poverty, discrimination, racism, gendered relations of power, and legal policies and practices: (a) the context of health care; and (b) the smoking context.
Structural inequities and 'everyday' violence are perilously damaging for women who use crack. Interventions to reduce these inequities are urgently needed if we are to reduce the significant suffering of women who are street-involved and use crack cocaine.
越来越多的公共卫生证据表明，使用可卡因并流浪街头的女性会经历严重的健康问题，并且在获得减少伤害和其他健康相关服务方面更加孤立。同时，人们越来越认识到，结构性和“日常”暴力是影响使用非法药物的女性健康的重要因素。很少有研究探讨这些社会过程如何影响使用可卡因的女性。
本研究采用批判性民族志，以结构性和日常暴力以及交叉性的理论构成为指导，探索了加拿大西部一个内城区女性使用可卡因的情况。数据收集包括基线调查（n=126）、参与观察和现场记录、非正式访谈（n=53）和深入访谈（n=13）。
基于主题和理论分析，确定了两个相互关联的主题，反映了女性使用可卡因、贫困、歧视、种族主义、性别权力关系以及法律政策和实践之间的相互关系：（a）医疗保健背景；和（b）吸烟背景。
结构性不平等和“日常”暴力对使用可卡因的女性造成了严重的伤害。如果我们要减少街头流浪和使用可卡因的女性的巨大痛苦，就迫切需要采取干预措施来减少这些不平等。
