Brock University, Department of Psychology, 1812 Sir Isaac Brock Way, St. Catharines, ON, Canada.
Brock University, Department of Psychology, 1812 Sir Isaac Brock Way, St. Catharines, ON, Canada.
Int J Drug Policy. 2024 Sep;131:104546. doi: 10.1016/j.drugpo.2024.104546. Epub 2024 Aug 22.
Substance use stigma has been positioned as a major driver of drug toxicity mortality. In response, governmental and public health organizations across Canada have invested significant resources into mass media campaigns that target stigma. Many of these campaigns feature images or stories about people who use drugs (PWUD). Although stigma and drug toxicity death disproportionately impact racially and economically marginalized PWUD, these campaigns often over-represent White, middle-class individuals. This effectively ignores intersecting roles of racism and classism in the experience of stigma and drug toxicity mortality.
To investigate how this pattern of representation might occur, we examined the development process of the British Columbia (BC) Government's "Stop Overdose" anti-stigma campaign launched in 2018. We aimed to identify strategic goals, decisions, and underlying ideas that could help explain the campaign's eventual focus on White, middle-class PWUD. Through a Freedom of Information request we obtained 320 pages of documents from the BC Government outlining the real-time development, testing, and evaluation of the first wave of the campaign. We analyzed these documents using reflexive thematic analysis.
We identified that campaign developers had a marked focus on challenging stereotypes about PWUD and humanizing PWUD, while ensuring the campaign was relevant to BC residents. To achieve these goals, campaign developers ultimately avoided images of what they deemed the inaccurately "stereotypical" marginalized drug user. Instead, they featured PWUD in more privileged social positions. By attaching labels like "co-worker" to this imagery, developers felt mainstream BC residents could relate to and have more empathy for these PWUD compared to marginalized PWUD.
In effect, these strategies perpetuated the exclusion and dehumanization of marginalized PWUD facing disproportionate harms of the drug toxicity crisis. Since anti-stigma campaigns remain a common intervention, we highlight a need for strategic approaches informed by more critical perspectives on substance use stigma.
药物使用污名已被视为导致药物毒性死亡率的主要驱动因素之一。为此，加拿大各地的政府和公共卫生组织投入了大量资源用于针对污名的大众媒体宣传活动。这些活动中的许多活动都以使用药物的人（PWUD）的图像或故事为特色。尽管污名和药物毒性死亡不成比例地影响到种族和经济边缘化的 PWUD，但这些活动往往过分强调白人、中产阶级人士。这实际上忽略了种族主义和阶级主义在污名和药物毒性死亡体验中的交叉作用。
为了调查这种代表性模式是如何产生的，我们审查了不列颠哥伦比亚省（BC）政府于 2018 年发起的“停止过量”反污名宣传活动的发展过程。我们旨在确定战略目标、决策和潜在思想，这些都有助于解释该活动最终将重点放在白人、中产阶级的 PWUD 上。我们通过信息自由请求从 BC 政府获得了 320 页的文件，这些文件概述了该活动第一波的实时发展、测试和评估。我们使用反思性主题分析对这些文件进行了分析。
我们发现，活动开发者非常关注挑战对 PWUD 的刻板印象和使 PWUD人性化，同时确保该活动与 BC 居民相关。为了实现这些目标，活动开发者最终避免了他们认为不准确的“刻板印象”边缘化吸毒者的形象。相反，他们以更具特权的社会地位来描绘 PWUD。通过将“同事”等标签附加到这些图像上，开发者认为与边缘化的 PWUD 相比，主流 BC 居民可以与这些 PWUD 产生共鸣并产生更多的同理心。
实际上，这些策略使面临不成比例的药物毒性危机危害的边缘化 PWUD 受到排斥和非人化。由于反污名宣传活动仍然是一种常见的干预措施，我们强调需要采取更具批判性的药物使用污名观点来制定战略方法。
