Looking beyond harm: meaning and purpose of substance use in the lives of marginalized people who use drugs

Abstract

Substance use among marginalized populations has historically been constructed as a social problem to be managed, cured, and eliminated. Much social science research concerning drug use among marginalized populations focuses on risks and harms, with little attention to positive aspects of substance use. In this paper we explore positive roles of drugs/drug use among marginalized people who use drugs. We draw on in-depth qualitative interviews conducted with 50 people who use drugs in Vancouver’s Downtown Eastside neighbourhood. Forty-three participants reported positive aspects of drug use. Participant narratives revealed four main themes regarding the role and function of drugs and drug use in their lives: (1) pain relief and management; (2) alleviating mental health issues; (3) fostering social experiences; (4) pleasurable embodied experiences. Our findings show that despite known negative consequences of substance use, in many ways drug use was beneficial for these individuals. Our study demonstrates that given the opportunity, meaningful and useful conversations that shed light on why people take drugs is possible. By understanding why marginalized individuals choose to consume the drugs they do we can begin to engage in truly helpful conversations about how to reduce drug-related harm.

Keywords:

• Drug use
• illicit drug use
• qualitative research
• pain management
• pleasure
• marginalized populations

Acknowledgements

The authors thank the study participants for their contribution to the research project. We also thank Cecilia Benoit, Karen Kobayashi, Susan Boyd and the anonymous reviewers for their insightful and constructive advice on earlier versions of this paper. We extend a heartfelt thanks to VANDU for their support and assistance.

Disclosure statement

No potential conflict of interest was reported by the authors.

Funding

This work was funded by a Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Scholarship Doctoral Award [Grant number 201110GSD-277587-173933].

Notes

1 In this paper when referring to marginalized people who use drugs, we are referring to people who are generally experiencing poverty, homelessness or unstable housing, structural and everyday violence, and who may rely on criminalized and stigmatized means of income generation.

2 Format: (Current method of drug use/Gender/Age). Methods of drug use: NIDU = non-injection drug use, IDU = injection drug use.