Needle exchange as a safe haven in an unsafe world

J, MacNeil; Pauly, Bernadette

doi:10.1111/j.1465-3362.2010.00188.x

Cited by 71 publications

(65 citation statements)

References 27 publications

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“…In this context, participants conceptualized SEIs as refuges from structural and everyday violence. Variously referred to as “refuges” (Fairbairn et al, 2008; Small et al, 2012a), “safe havens” (MacNeil & Pauly, 2011), and “safe spaces” (McLean, 2012; Parker et al, 2012), participants positioned these interventions as safe, regulated spaces that mitigated the dangers of the street-based drug scene.…”

Section: Resultsmentioning

confidence: 99%

‘Safer environment interventions’: A qualitative synthesis of the experiences and perceptions of people who inject drugs

McNeil

Small

2014

Social Science & Medicine

159

120

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There is growing acknowledgment that social, structural, and environmental forces produce vulnerability to health harms among people who inject drugs (PWID), and safer environment interventions (SEI) have been identified as critical to mitigating the impacts of these contextual forces on drug-related harm. To date, however, SEIs have been under-theorized in the literature, and how they minimize drug-related risks across intervention types and settings has not been adequately examined. This article presents findings from a systematic review and meta-synthesis of qualitative studies reporting PWID’s experiences with three types of SEIs (syringe exchange programmes, supervised injection facilities and peer-based harm reduction interventions) published between 1997 and 2012. This meta-synthesis seeks to develop a comprehensive understanding of SEIs informed by the experiences of PWID. Twenty-nine papers representing twenty-one unique studies that included an aggregate of more than 800 PWID were included in this meta-synthesis. This meta- synthesis found that SEIs fostered social and physical environments that mitigated drug-related harms and increased access to social and material resources. Specifically, SEIs: (1) provided refuge from street-based drug scenes; (2) enabled safer injecting by reshaping the social and environmental contexts of injection drug use; (3) mediated access to resources and health care services; and, (4) were constrained by drug prohibition and law enforcement activities. These findings indicate that it is critical to situate SEIs in relation to the lived experiences of PWID, and in particular provide broader environmental support to PWID. Given that existing drug laws limit the effectiveness of interventions, drug policy reforms are needed to enable public health, and specifically SEIs, to occupy a more prominent role in the response to injection drug use.

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Section: Resultsmentioning

confidence: 99%

‘Safer environment interventions’: A qualitative synthesis of the experiences and perceptions of people who inject drugs

McNeil

Small

2014

Social Science & Medicine

159

120

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“…to non-street peers), and feel highly alienated and marginalized (Rice et al, 2005). In addition, street youth often use drugs as a conduit to numbing the pain of and enduring the extremities and stressors of street life (MacNeil and Pauly, 2011). Therefore, drug use among street youth might be more of a structural dysfunction than a personal pathology (Karabanow and Clement, 2004).…”

Section: Discussionmentioning

confidence: 99%

Sociometric network structure and its association with methamphetamine use norms among homeless youth

Barman‐Adhikari

Begun

Rice

et al. 2016

Social Science Research

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Homeless youths' social networks are consistently linked with their substance use. Social networks influence behavior through several mechanisms, especially social norms. This study used sociometric analyses to understand whether social norms of drug use behaviors are clustered in network structures and whether these perceived norms (descriptive and injunctive) influence youths' drug use behaviors. An event-based approach was used to delineate boundaries of the two sociometric networks of homeless youth, one in Los Angeles, CA (n = 160) and the other in Santa Monica, CA (n = 130). Network characteristics included centrality (i.e., popularity) and cohesiveness (location in dense subnetworks). The primary outcome was recent methamphetamine use. Results revealed that both descriptive and injunctive norms influenced methamphetamine use. Network cohesion was found to be associated with perception of both descriptive and injunctive norms in both networks, however in opposite directions. Network interventions therefore might be effective if designed to capitalize on social influence that naturally occurs in cohesive parts of networks.

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“…L'oppression implique des jeux de pouvoir, des forces agissantes pour réprimer la personne, la diminuer, lui enlever en fait ses chances de s'émanciper socialement. Systématiquement, les personnes qui s'injectent des drogues se disent jugées, discriminées dans les services de santé et les services sociaux (Drumm, McBride, Metsch, Page, Dickerson et Jones, 2003 ;Neale, Tompkins et Sheard, 2007 ;Roy Nonn, Haley et Cox, 2007), victimes de profilage et même d'agression de la part des policiers lorsqu'elles quêtent ou s'adonnent à la prostitution et se sentent ainsi comme des citoyens de second ordre (MacNeil et Pauly, 2011 ;Rhodes et Simi'c, 2005 ;Shannon et al, 2008). De plus, des auteurs critiques de la santé publique n'hésitent pas à qualifier les interventions de réduction des méfaits de « biopouvoirs », c'est-à-dire de moyens exercés par les forces en place, dont l'État, ayant pour principale fonction de contrôler les corps, de les « rendre dociles » et conformes à une norme sociale établie (Foucault, 1975).…”

Section: La Personne Victime De Discrimination Et D'iniquités Socialesunclassified

Penser et percevoir autrement les personnes qui font usage de drogues par injection

Poliquin

2017

dss

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Cet article propose une réflexion sur les caractéristiques des personnes qui font usage de drogues par injection (UDI) pouvant mener à un élargissement de la réponse sociale qui ira au-delà des interventions biomédicales ciblant des personnes « à risques ». Ainsi, le potentiel mobilisateur et les limites de la prise en compte des personnes UDI par d’autres caractéristiques sociales seront exposés. Il s’agit de la personne vue comme étant « vulnérable », « souffrante », « victime de discrimination et d’iniquités sociales » et enfin « en devenir ». Il sera exposé que la réponse aux « problèmes » sociaux des personnes UDI dépendra de notre aptitude, en tant que société, à repenser les actions autrement que par une approche sanitaire reposant massivement sur la prévention des risques biologiques et des maladies. Plus particulièrement, la prise en compte de l’individu comme un être en devenir, avec des projets qui lui sont propres, est capital pour se déprendre des pensées institutionnelles réductrices et pour humaniser la réponse sociale. Il est notamment nécessaire, dans une société qui se veut solidaire, juste et équitable, de voir à créer les conditions sociales essentielles. Il s’agit de créer des espaces de réduction des méfaits et de soin et de rendre accessibles diverses sources d’aide dont l’insertion sociale par l’emploi et le logement, des lieux d’écoute et des mécanismes de reconnaissance des forces et des aspirations singulières de ces personnes, sans tomber dans le piège des formules d’interventions toutes faites, des préjugés ou des stéréotypes.

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Needle exchange as a safe haven in an unsafe world

Cited by 71 publications

References 27 publications

‘Safer environment interventions’: A qualitative synthesis of the experiences and perceptions of people who inject drugs

‘Safer environment interventions’: A qualitative synthesis of the experiences and perceptions of people who inject drugs

Sociometric network structure and its association with methamphetamine use norms among homeless youth

Penser et percevoir autrement les personnes qui font usage de drogues par injection

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