Exploration of a Crack Use Setting and Its Impact on Drug Users’ Risky Drug Use and Sexual Behaviors: The Case of Piaules in a Montréal Neighborhood

Abstract

From July 2011, a one-year study based on ethnographic methodology was carried out in “crack houses” in the neighborhood of Hochelaga-Maisonneuve in Montréal, Canada. The study aimed to explore the operational style of a specific indoor drug use setting and its impact on users’ risky sexual and drug use behaviors in a context of drug market change. A thematic analysis of observational and interview notes was conducted. This study stresses the importance to examine the role of environmental factors in relation to crack smoking's health-related risks and to complement individual-based interventions with structural strategies. The study's limitations are noted.

Keywords :

• crack
• crack house
• sex work
• ethnography
• risk environment
• drug use patterns
• Montréal

THE AUTHORS

Elise Roy, MD, MSc, is a public health physician, full professor at the faculty of medicine and social sciences, University of Sherbrooke. She holds a research chair, la Chaire de recherche en toxicomanie, supported by the foundation of l'Hôpital Charles-Lemoyne. In the past 20 years, she has led several studies based on quantitative and qualitative methods on risk behaviors and blood-borne infections among marginalized drug users. She is mostly involved in research on drug consumption pathways, associated social and health outcomes, and the development and evaluation of innovative interventions in this area. She is a principal investigator of a research team on mental health and HIV–HCV risky behaviors among cocaine users. She is also the co-principal co-investigator of a prospective cohort study on hepatitis C among IDUs. She is known internationally for her research work on the health of street youth and recognized as a leading expert on initiation into drug injection and R&D on interventions in the field.

Nelson Arruda, MSc, has a Master's degree in Anthropology from the Université de Montréal. He is an independent researcher whose main research interest is the risk environment of street-based drug users. He has conducted participant observation fieldwork among street-based drug injectors and crack smokers in Montréal for more than five years.