在毒品供应不断变化的情况下应对被驱逐后的毒品使用问题：加拿大温哥华住房与用药过量危机重叠的空间导向定性研究。
Navigating post-eviction drug use amidst a changing drug supply: A spatially-oriented qualitative study of overlapping housing and overdose crises in Vancouver, Canada.
机构信息
General Internal Medicine, Yale School of Medicine, New Haven, CT, USA; Yale Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA; Social & Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA; Department of Anthropology, Yale University, New Haven, CT, USA.
British Columbia Centre on Substance Use, Vancouver, Canada; Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, Canada.
出版信息
Drug Alcohol Depend. 2021 May 1;222:108666. doi: 10.1016/j.drugalcdep.2021.108666. Epub 2021 Mar 18.
BACKGROUND
North American cities are experiencing intersecting housing and overdose crises as illicit drug markets become marked by the proliferation of fentanyl and methamphetamine. Despite recent research documenting associations between evictions and drug-related risks and harms, including overdose, the mechanisms through which these occur remain poorly understood. This study to examines how evictions shape the drug use practices of people who use drugs in Vancouver's Downtown Eastside - a neighbourhood with an established drug scene - as the illicit drug supply changed.
METHODS
Qualitative interviews and geo-spatial data collection were conducted with 56 recently evicted PWUD. Data were analyzed by interfacing qualitative and geo-spatial data, and interpreted focusing on how structural vulnerability shaped spatial practices and drug-related risks post-eviction.
RESULTS
Findings demonstrate how post-eviction spatial practices and routines produced risk and harm as participants navigated the uncertainties of housing vulnerability and drug supply changes. Post-eviction disruptions complicated participants' ability to engage with trusted drug sellers. Changes to spatial patterns and access to private spaces rendered public drug use inevitable, though this was mitigated to some degree by harm reduction supports. Abrupt changes to drug use patterns occurred due to post-eviction disruptions and included instrumental uses of methamphetamine to increase alertness and navigate survival amidst severe hardship.
CONCLUSIONS
Findings demonstrate how post-eviction changes to routines and spatial patterns are framed by structural vulnerability and can exacerbate drug-related harms, particularly in the context of a changing drug supply. There is an urgent need for structural interventions and harm reduction responses to mitigate harms associated with evictions.
背景
随着非法毒品市场充斥着芬太尼和冰毒，北美城市正经历着住房和过量用药危机的交织。尽管最近的研究记录了驱逐与与毒品相关的风险和危害之间的关联，包括过量用药，但这些关联发生的机制仍知之甚少。本研究考察了在温哥华市中心东区——一个拥有成熟毒品市场的社区——随着非法毒品供应的变化，驱逐是如何影响吸毒者的吸毒行为的。
方法
对 56 名最近被驱逐的吸毒者进行了定性访谈和地理空间数据收集。通过界面定性和地理空间数据进行数据分析，并重点关注结构脆弱性如何在后驱逐阶段塑造空间实践和与毒品相关的风险。
结果
研究结果表明，在后驱逐阶段，由于参与者面临住房脆弱性和毒品供应变化的不确定性，空间实践和日常生活会产生风险和危害。驱逐后的干扰使参与者难以与可信赖的毒贩打交道。空间模式的变化和私人空间的获取使公开吸毒不可避免，但这在一定程度上被减少伤害的支持所缓解。由于驱逐后的干扰，吸毒模式发生了突然变化，包括将冰毒用作工具来提高警觉性，并在极端困难中生存。
结论
研究结果表明，驱逐后日常生活和空间模式的变化受到结构脆弱性的影响，并可能加剧与毒品相关的危害，特别是在毒品供应不断变化的情况下。迫切需要进行结构性干预和减少伤害的应对措施，以减轻与驱逐相关的危害。
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