Housing and harm reduction: What is the role of harm reduction in addressing homelessness?

Pauly, Bernadette; Reist, Dan; Belle-Isle, Lynne; Schactman, Chuck

doi:10.1016/j.drugpo.2013.03.008

Cited by 70 publications

(56 citation statements)

References 63 publications

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“…In order to reduce harm, in Vancouver and elsewhere, social housing with harm reduction has also been advanced (Evans & Strathdee, 2006; Pauly et al, 2013; Shannon et al, 2006). This is a significant policy directive as it is attentive to how homelessness and risk environments increase the harms of substance use (Pauly et al, 2013; Rhodes, 2002, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…Bullen, 2015; Flanagan, 2015; Knight et al, 2014; Nethercote, 2015; Powell and Flint, 2009). For example, harm reduction as a key component of social housing has been advocated to reduce risk and promote social inclusion (Pauly et al, 2013). However, some critics have questioned what supportive housing specifically entails in terms of the built environment (Evans, 2003; Kaplan & Kaplan, 2003; Knight et al, 2014; Parr, 2000).…”

Section: Introductionmentioning

confidence: 99%

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Supportive housing and surveillance

Boyd

Cunningham

Anderson

2016

International Journal of Drug Policy

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Urban centres in the US, Britain and Canada have responded to identified visible ‘social problems’ such addiction, mental health and homelessness by providing some supportive housing for the urban poor and marginalized. While some critics have questioned what supportive housing specifically entails in terms of the built environment, what remains under explored, though a growing area of concern, is the relationship between surveillance and supportive housing for urban residents identified as having addiction and mental health problems — a gap addressed in this paper. Drawing upon qualitative ethnographic observational data we examine some of the measures of control and coercion that are encroaching into social housing primarily established for poor and marginalized people with addiction and mental health problems in the urban centre of Vancouver, Canada. We witnessed three modes of regulation and control, that vary widely, among the residencies observed: physical surveillance technologies; site-specific modes of coercion; police presence and staff surveillance, which all together impact the everyday lives of residents living in low-income and supportive housing. We argue that supportive housing has the potential to provide its intended commitment— safe and secure affordable housing. However, owing to an (over)emphasis on ‘security’, the supportive housing we observed were also sites of social control.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Supportive housing and surveillance

Boyd

Cunningham

Anderson

2016

International Journal of Drug Policy

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“…It is well known that various social, structural, and environmental characteristics operating within the broader risk environment of IDU increase their vulnerability to social instability and poor health (Pauly et al, 2011; Pinkham et al, 2012; Richardson et al, 2013). A large body of evidence has documented links between unstable housing, drug addiction, and risk behaviours (Baumer et al, 1998; Deering et al, 2013; Fairbairn et al, 2007; Maher and Curtis, 1992; Palepu et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

The impact of engagement in street-based income generation activities on stimulant drug use cessation among people who inject drugs

Ti¹,

Richardson²,

DeBeck³

et al. 2014

Drug and Alcohol Dependence

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Background Despite the growing prevalence of illicit stimulant drug use internationally, and the widespread involvement of people who inject drugs (IDU) within street-based drug markets, little is known about the impact of different types of street-based income generation activities on the cessation of stimulant use among IDU. Methods Data were derived from an open prospective cohort of IDU in Vancouver, Canada. We used Kaplan-Meier methods and Cox proportional hazards regression to examine the effect of different types of street-based income generation activities (e.g., sex work, drug dealing, and scavenging) on time to cessation of stimulant use. Results Between December, 2005 and November, 2012, 887 IDU who use stimulant drugs (cocaine, crack cocaine, or crystal methamphetamine) were prospectively followed-up for a median duration of 47 months. In Kaplan-Meier analyses, compared to those who did not engage in street-based income generation activities, participants who reported sex work, drug dealing, scavenging, or more than one of these activities were significantly less likely to report stimulant drug use cessation (all p<0.001). When considered as time-updated variables and adjusted for potential confounders in a multivariable model, each type of street-based income generation activity remained significantly associated with a slower time to stimulant drug cessation (all p<0.005). Conclusions Our findings highlight the urgent need for strategies to address stimulant dependence, including novel pharmacotherapies. Also important, structural interventions, such as low-threshold employment opportunities, availability of supportive housing, legal reforms regarding drug use, and evidence-based approaches that reduce harm among IDU are urgently required.

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“…In response grassroots activists, health care specialists and policymakers have advocated for the integration of harm reduction philosophies and interventions into system-level responses to the problem of homelessness (Pauly et al, 2013). The result is a wide range of non-abstinence interventions such as low-barrier emergency shelters, Housing First (HF) programs and more recently Managed Alcohol Programs (MAPs).…”

Section: Introductionmentioning

confidence: 98%