British Columbia Centre on Substance Use, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Int J Drug Policy. 2018 May;55:40-46. doi: 10.1016/j.drugpo.2018.02.004. Epub 2018 Mar 2.
While drug user organizations (DUO) have received public health attention as a means to potentially reduce the harms associated with drug use, there is a lack of research on the compensation and structural forces that promote or inhibit participation in DUO. Against the backdrop of structural vulnerability experienced by people who use drugs (PWUD), we examined the impact of monetary 'volunteer stipends' provided through a DUO and explore their role in providing low-threshold employment opportunities and shaping participation in DUO.
Participants were purposively sampled to reflect a range of perspectives and experiences volunteering at Vancouver Area Network of Drug Users (VANDU) and receiving stipends. Semi-structured qualitative interviews were conducted with 23 members of VANDU. Interview transcripts were coded in Atlas.ti 7 for key a priori themes and emergent categories from the data and analyzed thematically.
Stipends provided participants with symbolic and material recognition of the time, effort, and expertise they contribute to the organization, and functioned to facilitate ongoing participation. Payments that rewarded, skills, labour and drug-related knowledge reduced participant's perception of stigma against PWUD. Paid work in VANDU further provided participants with non-material benefits commonly attributed to regular employment, including social connections and a sense of purpose. Participants also identified the low level of pay as a limitation of VANDU's paid participation program. The daily demands of survival (accessing shelter, food, and drugs) posed more complex structural vulnerabilities to participate in VANDU, as small stipends were not sufficient to address these needs.
Low threshold employment opportunities within DUO may provide significant individual and public health benefits. However, these benefits are constrained by the small size of stipends. Therefore, to ensure better inclusion of PWUD, our findings recommend the development and expansion of equitable, accessible, well-paying employment programs for PWUD.
虽然毒品使用者组织（DUO）作为一种潜在的减少与吸毒相关危害的手段受到了公共卫生的关注，但对于促进或阻碍参与 DUO 的报酬和结构力量的研究却很少。在吸毒者（PWUD）所经历的结构性脆弱的背景下，我们研究了通过 DUO 提供的金钱“志愿者津贴”的影响，并探讨了它们在提供低门槛就业机会和塑造参与 DUO 方面的作用。
参与者是根据在温哥华毒品使用者网络（VANDU）做志愿者和领取津贴的不同观点和经验有目的地抽取的。对 23 名 VANDU 成员进行了半结构式定性访谈。使用 Atlas.ti 7 对访谈记录进行了编码，以便对预先确定的主题和数据中出现的类别进行分析。
津贴为参与者提供了对他们为组织贡献的时间、努力和专业知识的象征性和物质性认可，并有助于促进他们的持续参与。对技能、劳动和与毒品相关的知识的奖励性报酬降低了参与者对吸毒者的污名化的看法。VANDU 的有偿工作进一步为参与者提供了通常与正规就业相关的非物质利益，包括社交联系和目标感。参与者还指出，VANDU 的有偿参与计划的支付水平低是一个限制。获取住房、食物和毒品等生存需求给参与者参与 VANDU 带来了更多的结构性脆弱性，因为微薄的津贴不足以满足这些需求。
DUO 中的低门槛就业机会可能会给个人和公共卫生带来显著的好处。然而，这些好处受到津贴数额小的限制。因此，为了确保更好地包容吸毒者，我们的研究结果建议为吸毒者制定和扩大公平、可及、高报酬的就业计划。
