That Look That Makes You Not Really Want to be There: How Neoliberalism and the War on Drugs Compromise Nursing Care of People Who Use Substances

Abstract

Abstract
 Research conducted in 2016 explored the health care experiences of people who use illicit opioids in small Ontario urban and rural communities. Perspectives of participants who used opioids and of nurse participants were interpreted using Friere’s critical social theory framework to explore sociopolitical, economic and ideological influences. Findings describe pervasive experiences of stigma, discrimination and inappropriate care. Exploration of why such negative experiences with nursing care might be so pervasive led to a consideration of the context of health care systems and in particular of the influences of neoliberalism and the impact of the global War on Drugs. Mitigation strategies to support contextualized nursing practice are outlined. Nurses are called upon to actively resist the pressures of these political forces by advocating for policy change including decriminalization.

Learning that cannot come from a book: An evaluation of an undergraduate alcohol and other drugs subject co‐produced with experts by experience

“…Traumainformed care and harm reduction principle and practices have not only been a long-term request of PWUD (Canedo et al 2022;SAMHSA 2014), but also the practices can support AOD users' access to care and improved health outcomes, as well as their sense of moral worth and deservedness of care (Iammarino & Pauly 2020). As reported previously by Hardill (2019), this study also found that providing knowledge about the social and political context of drug use can support nurses in understanding the associated harms and advocate for the decriminalization of drugs.…”

Striving for Health Equity Through Nursing Education: A Critical Examination of Non-traditional Community Health Placements

“…As such, neoliberalism has an important impact on nurses' interactions with communities that experience marginalization and stigmatization for their "unhealthy behaviours," potentially deeming them unworthy of quality care (Hardill, 2019;Kusdemir & Oudshoorn, 2023).…”

Nurses Supporting Harm Reduction: How Take-Home Naloxone is Conceived in the Context of Neoliberalism

“…Such views might hinder the adoption of harm reduction strategies, which view addiction within a broader socio-economic context. Hardill's (2019) study is a good illustration of how these neoliberal ideologies impact nursing care. The study shows that these influences have fostered an environment of stigma, discrimination, and inappropriate care for individuals using illicit opioids.…”

“…The study shows that these influences have fostered an environment of stigma, discrimination, and inappropriate care for individuals using illicit opioids. Neoliberalism, emphasizing individual responsibility, combined with the punitive War on Drugs, has led to reluctance among nurses to provide compassionate care (Hardill, 2019). This reluctance is further exacerbated by societal biases that criminalize drug use (Hardill, 2019).…”

“…Neoliberalism, emphasizing individual responsibility, combined with the punitive War on Drugs, has led to reluctance among nurses to provide compassionate care (Hardill, 2019). This reluctance is further exacerbated by societal biases that criminalize drug use (Hardill, 2019). The research highlights the need for a shift in nursing practice and suggests for policy changes like decriminalization, to prioritize patient wellbeing over prevailing political ideologies (Hardill, 2019).…”