“That’s what I’m supposed to do at work”: gendered labor, self-care, and overdose risk among women who use drugs in Vancouver, Canada

ABSTRACT

Through rapid ethnography undertaken in Vancouver, Canada’s Downtown Eastside – one of Canada’s overdose epicenters – this article examines how gendered expectations of labor shape overdose risk for structurally vulnerable women and gender diverse people who use drugs. Drawing on two participant narratives, we explore how structural, symbolic, and everyday violence frame the lives of women and gender diverse people who use drugs in ways that drive their overdose risk as they balance self-care with caretaking, paid work, and basic survival. This article underscores the need for structural reform of peer overdose response work and funding for gender-attentive harm reduction and ancillary supports to better mitigate overdose risk for these populations.

KEYWORDS:

• Overdose
• women who use drugs
• social violence

Acknowledgements

This article is dedicated to Sandra Czechaczek who passed away prior to publication. We want to extend our sincerest thanks to the participants of this study for their expertise and willingness to share their insights. This work took place on the unceded territories of the xwməθkwəyə̓m (Musqueam), Skwxwú7mesh (Squamish), and selílwitulh (Tsleil-waututh) Nations.

Notes

1. Two Spirit is a fluid and non-binary umbrella (English) term coined in the 1990s that denotes Indigenous persons with both masculine and feminine spirits (Ristock et al., 2010; Robinson, 2017). While definitions continuously change, Two Spirit is often used by individuals to describe having a sexuality and/or gender that varies from others (Robinson, 2017).

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research [CBF- 362965,PJT-155943]; National Institutes of Health [R01DA044181]. ABC was supported by a Vanier Canada Graduate Scholarship. RM was supported by a CIHR New Investigator Award and a MSFHR Scholar Award. JB is supported by funding from NIH [R01DA044181].