Meaning and Substance in the Garden City: Talking to Street-Involved Youth about Drug Use in Victoria, BC
by
Kathleen Perkin
BA, University of Victoria, 2004 A Thesis Submitted in Partial Fulfillment
of the Requirements for the Degree of MASTER OF ARTS
in the Department of Anthropology
Kathleen Perkin, 2009 University of Victoria
All rights reserved. This thesis may not be reproduced in whole or in part, by photocopy or other means, without the permission of the author.
Supervisory Committee
Meaning and Substance in the Garden City: Talking to Street-Involved Youth about Drug Use in Victoria, BC
by
Kathleen Perkin
BA, University of Victoria, 2004
Supervisory Committee
Eric Roth (Department of Anthropology) Supervisor
Lisa Mitchell (Department of Anthropology) Departmental Member
Cecelia Benoit (Department of Sociology) Outside Member
Abstract
Supervisory Committee
Eric Roth (Department of Anthropology) Supervisor
Lisa Mitchell (Department of Anthropology) Departmental Member
Cecelia Benoit (Department of Sociology) Outside Member
Anthropologists have written about illicit drug use in the Western cultural context since the 1960s and recent years have seen an increased interest. At the same time, young people have become a significant “risk group” in public health efforts to reduce illicit drug use. In particular, youth living or spending time on the street have been the target of interventions. The following thesis describes youth connected to one such intervention in Victoria, British Columbia, Canada. Youth connected to Bridging the Gap: A Citizen Engagement Initiative in the Interests of Crystal Meth Prevention, Education and Intervention are described in terms of demographic characteristics, health and substance use. They are compared with youth from another study of street-involved youth in the area (Risky Business: Experiences of Street Youth) and a random sample of youth in Victoria (the Healthy Youth Survey). Data were collected in 39 survey-based interviews and 3 qualitative interviews.
Table of Content
Supervisory Committee ...ii
Abstract ...iii
Table of Content ...iv
List of Tables ... v
List of Figures ...vi
Acknowledgments ...vii
Chapter 1 : Introduction ... 1
Problem Definition... 1
Context ... 7
Literature Review ... 15
Chapter 2 : Materials and Methods... 40
Research Design ... 40 Ethical Considerations ... 44 Interviews... 45 Analysis ... 48 Chapter 3 : Results... 51 Socio-Demographic Characteristics... 51
Physical and Mental Health... 57
Substance Use... 65
Chapter 4 : Summary and Discussion ... 96
Summary... 96 Discussion... 97 Chapter 5: Conclusions ... 117 Bibliography... 126 Appendix A ... 136 Appendix B ... 151 Vita ... 156
List of Tables
Table 1 Timing of data collection ... 49
Table 2 Sample sizes ... 50
Table 3 Comparisons – Socio-demographic Variables ... 52
Table 4 Average age... 52
Table 5 Gender ... 53
Table 6 Parent or guardian’s educational attainment... 54
Table 7 Sexual orientation ... 54
Table 8 Ethnicity ... 55
Table 9 Parenthood... 56
Table 10 More than half of participant's friends get money from... 56
Table 11 Comparisons – Physical and Mental Health... 57
Table 12 Barriers to accessing health care ... 59
Table 13 Self-reported physical health... 59
Table 14 Do you notice that you are physically healthy? ... 60
Table 15 Physical health compared with friends’ health ... 60
Table 16 Hours of sleep per night... 62
Table 17 Self-reported mental health ... 62
Table 18 Right now, would you say that you are happy? ... 63
Table 19 Do you notice that you are generally happy? ... 63
Table 20 Would you say that you are lonely? ... 64
Table 21 Would you say that you are hopeful about the future... ... 65
Table 22 Do you notice that you feel hopeless?... 65
Table 23 Comparisons – Substance Use ... 66
Table 24 Ages at which participants first tried each drug ... 72
Table 25 Prescription drug use in the last month* ... 74
Table 26 Daily alcohol, marijuana and tobacco use ... 77
Table 27 Weekly alcohol, marijuana and tobacco use ... 77
Table 28 Alcohol, marijuana and tobacco use over longer periods of time ... 78
Table 29 Weekly heroin use ... 80
Table 30 Weekly crystal meth, speed or amphetamine use... 82
Table 31 Weekly crack or cocaine use ... 86
Table 32 Weekly mushroom, LSD or hallucinogen use ... 88
Table 33 Mushroom, LSD or hallucinogen use over longer periods of time ... 89
List of Figures
Figure 1 British Columbia (Natural Resources Canada)... 7 Figure 2 Number of Sleeping Locations in the Past Month. ... 61
Acknowledgments
I’d like to acknowledge my supervisor, Eric Roth, and all my committee members for their advice and support. I am grateful to Mikael Jansson and Cecilia Benoit and the staff of the Risky Business and Healthy Youth studies, data from which are included in this thesis. I’d like to thank the Victoria YM/YWCA and the staff of the Bridging the Gap project for their help and advice. Thank you also to my friends and family for moral support and editing, both of which were crucially important. Finally, I would especially like to acknowledge my participants: Thank you for your patience with my questions and for so generously contributing your knowledge and experiences to this research.
This thesis is dedicated to
Ron and Susan Perkin
Chapter 1: Introduction
Problem Definition
Drug and alcohol use in Western contexts (Canada, the United States, Europe, Australia and New Zealand) has lately been a topic of increasing interest to anthropologists. Over the last nine years, anthropologists and other social scientists have revealed our use of psychoactive substances to be a window on such things as personhood (Martin and Stenner 2004:400), gender (Joe 1995), enjoyment (Keane 2008), the body (McLean 2008), danger (Hunt et al. 2007) and identity (Gibson et al. 2004). Concurrent with this increased focus on drug use, drug policy and discourse in Canada continue to position youth as the main category of people in danger of drug problems. Within the broad category of youth, street-involved youth have been seen as particularly at risk. As such they have been subject to special interventions. These interventions are often street outreach projects, and typically employ a harm reduction philosophy and vocabulary.
This study looks at the participants in one such street outreach project in Victoria, British Columbia, Canada. My purpose was to bring the perspectives of street-involved youth forward and in particular to hear what they had to say on the subject of drug use. I also wanted to understand aspects of their backgrounds and how they might be similar to or different from other youth in Victoria. This
study has four main research questions:
1) What types of drugs/substances did participants use? Even though the outreach project focused on one specific drug, to what extent did participants limit themselves to any particular substance?
2) What was the pattern of drug use over time? How often did they use these substances?
3) How do youth in my study compare with youth in two other local studies in terms of health and demographic characteristics? With their “street-involved” status, participants were thought to be disadvantaged compared with other youth: at increased risk of ill-health and with lower socio-economic status. Was this the case for my participants? The small sample size in this study (39 participants) means that it is hard to tell to what degree the results might be similar to results from a larger group of participants. By comparing my results to projects in the same city with larger sample sizes, I could get an idea of how my participants fit with larger groups of youth in Victoria.
4) What meaning did drugs and drug use have for youth? The majority of anti-drug policy and programming treat anti-drug use as an individual activity, involving the failing of an individual to identify and avoid a health risk. It was clear from the earliest interviews that this was far from how my participants experienced drug
use. Drugs and drug use were not only a social activity, but formed a significant part of the way participants made sense of the world around them. I collected data for the first three questions in 39 survey-based interviews covering health, drug use, and demographic information. Based on these interviews, I did three additional qualitative interviews specifically addressing the fourth question: the meaning participants saw in drugs and drug use.
Poly-drug use was the most common pattern among participants. Poly-drug use is the regular use of more than one type of drug. For example, a poly-drug user might use crystal meth every day, but also cocaine and marijuana approximately every week, and occasionally inject heroin. This term is also sometimes used to describe the simultaneous use of more than on drug. For example, mixing marijuana and cocaine and smoking them together. In this thesis, “poly-drug use” will denote the former pattern of drug use, in which multiple types of drugs are consumed regularly.
Participants not only used a great variety of illicit drugs, but had also used a wide range of legal substances in the recent past. Substances such as alcohol and cigarettes were commonly used, in addition to prescription drugs of various types, along with some plants that have thus far escaped official drug designations. In terms of substance use and health, participants are similar to participants in the Risky Business study (another study of street-involved youth in Victoria), but different from participants drawn from a random sample of youth in
the area who participated in the Healthy Youth Survey. The category of “drug”, as understood by street-involved youth in Victoria, was not delineated primarily by legality, but by the context in which the substance was used. Drug use did not occur in isolation from the rest of participants' lives, and drugs themselves were symbolically linked with participants’ ideas about nature, morality, identity, pollution and harm.
Anthropology and the Study of Drug Use
Anthropologists and other social scientists have long studied illicit drug use in Western contexts. Anthropology, however, has a unique perspective on this issue in its focus on drug users’ perspectives. Although the last nine years have seen a proliferation of drug research, the first anthropological studies of the subject were conducted in the 1960s (Agar 2002:251). Early works were true ethnographies, and mostly published as books. Agar's 1973 book, Ripping and Running: A Formal Ethnography of Urban Heroin Addicts described the activities of heroin addicts from an ethnographic perspective (Agar 1973). Other examples of ethnography include: Wheeling and Dealing: An Ethnography of an Upper Level Drug Dealing and Smuggling Community (Adler 1985), In Search of Respect, Selling Crack in El Barrio (Bourgois 1995), and The Cocaine Kids (Williams 1989). Cavan’s 1972 Hippies of the Haight, centering on a San Francisco neighbourhood, also touches on drug use. In addition to ethnographic work, anthropologists have used other qualitative methods and collaborated with researchers from other disciplines in studying drug use. This is particularly the
case for more recent work (Sterk 2003:127, Agar 2002:255).
Early work looked at heroin use (e.g. Agar 1973, Preble and Casey 1969), but the focus shifted to crack-cocaine in the 1980s and 1990s in response to the increasing popularity of this drug and fears around its effects (e.g. Bourgois 1995). In the late 1990s and early 2000s, the anthropological and social scientific study of drug use expanded to include many types of drugs, such as crystal meth (Joe 1995), “club drugs” (Sanders 2006) and solvents (MacLean 2008). More recent studies also looked at drug use in a variety of groups, not just urban drug users of modest economic means.
Anthropological studies of drug use, especially prior to 2000, have been criticized for their presentation of drug users as “isolated, passive and decontextualized individuals” (Hunt and Barker 2001:169). More recent work has addressed political economy, social context and subjectivity in relation to drug use (for example, O’Malley and Valverde 2004, Fraser 2004, Bourgois 2003). As such, current anthropological studies of drug use are characterized by attention to the emic perspective, use of ethnographic and other qualitative methods and, more recently, a critical social perspective.
There are significant overlaps between anthropological approaches to drug use and work done by researchers in other areas. Drug research in sociology, psychology, psychiatry, nursing, social work, public health and cultural studies
have significant overlaps. These include ethnographic or qualitative methods, a focus on the experience of the drug user, and a critical social approach. For example, Bungay et al.’s 2006 qualitative study of street-involved youth’s perceptions of crystal meth in Vancouver, BC was a partnership between nurses and epidemiologists.
However, the anthropological perspective is unique in that anthropological studies are characterized by attention to the emic perspective. This focus on emic perspectives is rare in drug research by other disciplines, so anthropologists have been in a position to contribute significantly to knowledge of drug use. Ideally, an anthropological approach also allows readers to better understand not only the attributes, problems and origins of the individuals of interest but also what it might be like to live the way they do. This contribution should be especially useful in the case of illicit drug users, as policy makers often have no way to relate to this kind of life experience. Despite the opportunities an anthropology of illicit drug use affords, researchers worry that such policy in North America will continue to be based primarily on ideology (Bourgois 2002: 251).
Context
Research Site
This research was conducted in Victoria, BC. This city, situated on the southern end of Vancouver Island, is the capital of British Columbia (BC), a province on the Western edge of Canada (see Fig. 1). Victoria is home to approximately 80,000 people (Government of British Columbia 2006) and the surrounding region has a population of around 350,000 as of 2006 (Capital Regional District 2006). Known as the Garden City, Victoria presents itself in tourism materials as clean, beautiful and civil.
Figure 1 British Columbia (Natural Resources Canada1)
1
Natural Resources Canada allows reproduction of this work for non-commercial purposes (see http://atlas.nrcan.gc.ca/site/english/aboutus/important_notices_old.htm).
Like most cities, Victoria also has a group of residents who, without housing or other resources, spend their time in and around the downtown area. A five-day survey of homeless people conducted by the Cool Aid Society in February of 2007 found 1,242 people in need of housing (although the Cool Aid Society’s report maintains that the real number is higher) (Cool Aid Society 2007). These disadvantaged residents are a continual topic of controversy and consternation in Victoria. They are seen to invade and pollute the city, while tainting Victoria’s reputation as a pleasant tourist destination. Far from being unnoticed by the inhabitants of the city, the local media regularly report on this problem (for example, Cleverley’s 2008 newspaper article about a proposed shelter: Neighbours skeptical of shelter plan).
Part of the perceived threat of this population relates to their association with illicit drug use, another area of concern in Victoria. In the Victoria context, homelessness and illicit drug use are not considered separate problems. Debates about medical services for people who use needles (needle exchanges, supervised injection sites) become discussions of issues related to homelessness (such as improper use of public space). Drug users are a threat in that they are viewed as the source of such undesirable and dangerous products as discarded needles, crime, disease, disorder and garbage.
Non-profit organizations, the City of Victoria and the Vancouver Island Health Authority (VIHA) have devised various emergency shelters, walk-in clinics and
street outreach programs, mainly available in the downtown area. Many of these services have been controversial because of conflicts with neighbouring businesses and residents. They object to the increased presence of homeless people or drug users who come to access the services. For example, this conflict led to the May 2008 closure of a fixed-site needle exchange that had been operating for 20 years (Times Colonist 2008). A lawsuit by neighbours precipitated the needle exchange’s eviction from its building. This example highlights the connection between homelessness and drug use in Victoria, as the needle exchange was said to have “sparked controversy because some of the homeless addicts loiter outside” (Harnett 2007). Indeed, homeless people and people who use drugs are often presented as a problem coming from “away”, “invading” from either off the island or another neighbourhood. This attitude was exemplified in the September 2007 op-ed written by then city councilor Geoff Young. Its title was “Services for street people grow, but so do problems. Could it be that food and shelter are attracting the vulnerable?” (Young 2007). In the article, he voices an opinion that forms the subtext for much of the debate about homelessness and drug use in Victoria: that “the unconditional food and shelter and support we offer, combined with our warm weather, might be drawing the vulnerable here”.
Services for Victoria's street-involved population are usually specific to different client age groups. Anyone younger than the mid-twenties (in most cases) is called a “youth”, and anyone older, an adult. These two groups are supposed to
require both different and separate services. In 2007, the Cool Aid Society identified 108 street-involved youth and, based on other research, estimated that there were 250 to 300 youth between the ages of 14 and 24 living on the street in Victoria (Cool Aid Society 2007:27) Youth-specific services are supposed to be less intimidating than services open to anyone. Several agencies and clinics in Victoria serve only teenagers and people in their early twenties.
The Victoria YM-YWCA provides outreach and other services for “street-involved” (not necessarily homeless) youth. As part of their services, the YM-YWCA ran a program called Bridging the Gap: A Citizen Engagement Initiative in the Interests of Crystal Meth Prevention, Education and Intervention. Conceived in response to a crystal meth “epidemic” among young people, its primary goals were to ameliorate crystal meth-related harm through peer education, as well as connecting youth to appropriate medical and social services. The project employed two outreach workers.
I began this research as the evaluator for Bridging the Gap. I conducted evaluation interviews with youth connected to Bridging the Gap and at the same time collected information for a thesis, which I originally thought would be about crystal meth use by street-involved youth. Although the focus of my research shifted over time, this connection with an outreach project was very valuable. My activities as evaluator included attending evaluation meetings through which I was able to learn about outreach workers' and staff members' points of view on
drug use. This information was extremely valuable as it allowed me to acquire some of the knowledge and vocabulary of my participants before the first interview. My connection to Bridging the Gap also provided a means of recruiting participants and a space for interviewing.
Bridging the Gap and the Crystal Meth Panic
Bridging the Gap was a community-based harm reduction project in Victoria, British Columbia. In September 2005 this project was awarded $102,867 over three years by the Public Health Agency of Canada (then called Health Canada) through the Community Initiative Fund under Canada’s Drug Strategy. The project also received support from private non-profit organizations such as United Way and the Victoria Hope Society, as well as funding from the City of Victoria.
Bridging the Gap's focus was crystal meth, the most recent descendant in a long line of drugs based on the chemical “ephedrine” which occurs naturally in some plants (Gahlinger 2001: 205). Crystal meth can be made using commercially available and inconspicuous cleaning products and allergy medications. For this reason, it was fairly inexpensive compared to other illicit drugs and this contributed to its popularity. The potentially desirable effects of crystal meth are weight loss and feelings of joy, power and sexiness (Bungay et al. 2006:236). Continued use of this drug entails a wide range of unwanted side effects. Crystal meth users in Sydney Australia reported concerns such as poor appetite, heart flutters/racing heart, insomnia, fatigue, and memory problems (Hando et al.
1997:107). These users also reported psychological problems they felt were related to crystal meth such as depression, anxiety, hallucinations, panic attacks and suicidal thoughts (Hando et al. 1997:108). Street-involved youth in Vancouver, BC reported such negative side effects as appetite loss, sores on their bodies, tremors, shakiness, itchiness, chest congestion (in those who smoke crystal meth), and a lack of interest in personal hygiene (Bungay et al. 2006:243). Crystal meth can be taken many different ways, but is usually smoked in a pipe.
The list of harms and benefits in the previous paragraph is typical of the terms in which crystal meth is described in academic journals and policy documents (for example, Government of BC 2004, Hando et al. 1997:107). It does not, however, capture the very complicated set of meanings attached to the drug in popular discourse and among users. Crystal meth went from being relatively unknown to becoming very common among young drug users in a matter of a few years. This in turn inspired a zealous response in the form of media attention, government rhetoric and voluntary drug education organizations. Crystal Meth BC, a prominent volunteer-run anti-crystal meth group, was officially launched on June 8, 2005 (Crystal Meth BC Website). Their website contained a link to a “Meth Prevention Cookbook” designed to educate non-users about the dangers of crystal meth, and crystal meth users in graphic terms:
“…a METH cook/user/tweaker is an unpredictable and dangerous animal. They can go from constant chatter to deadly quiet in seconds. If they do get
silent, it is usually a sign of the paranoia kicking in, and violence is normally not far behind.” Lake and Huard n. d.:60
The crystal meth discourse created certain categories of “at risk” people who became targets of intervention. In particular, sexual orientation and age seemed to be significant risk factors. The “crystal meth epidemic” was represented as a problem belonging predominantly to young people and non-heterosexual people (for example, Halkitis et al. 2001:18). The Province (a newspaper available throughout BC) published the article “Meth ‘Ravaging’ Towns in B.C.” in 2005 (The Province 2005). The article warns that “(m)ethamphetamine is ripping through B.C. communities and across all demographics, from street kids to suburban house-wives” and that “the addiction rate may be highest among street youth but it’s by no means limited to them”.
The focus on youth as the main recipients and sources of drug-related harm extends beyond the discussions crystal meth in the media and is evident in drug policy announcements of the early and mid- 2000s. The Government of BC’s policy document on crystal meth identifies youth as the main target group for interventions (Government of B.C. 2004:5). When the federal government announced its Drug Strategy renewal in 2003, “youth” was the only category (other than “Canadians”) specifically singled out as needing anti-drug interventions. The new drug strategy would “decrease the number of people - particularly youth - who abuse drugs” and “decrease the number of young Canadians who experiment with drugs” (Ministry of Health 2003). The press
release announcing the new drug strategy states: “While we are all concerned about the use and abuse of drugs by Canadians, a special emphasis will be placed on youth” (Ministry of Health 2003). Some of this interest in illicit drug use by young people may have been due to a recent focus on youth justice at the federal level. The Young Offenders Act was replaced by the Youth Criminal Justice Act in 2002.
Bridging the Gap, with its focus on youth, was part of the response to the crystal meth crisis. The project took a harm reduction approach; its goal was to reduce the harms experienced by some youth as a result of crystal meth use. Specifically, Bridging the Gap targeted certain “at risk” groups including street-involved youth, gay and lesbian youth, pregnant youth and youth street-involved with the justice system. Bridging the Gap's main focus was the production of a small self-published magazine, a “zine”, titled Flail. The project also included a crystal meth discussion group. Youth participants produced Flail and the publication was meant to be a way for them to communicate with their peers about crystal meth. This was a form of “peer education”, an established harm reduction method (Broadhead et al. 1998:44). Submissions to the zine took the form of drawings, stories, poems and essays. A small group of participants was responsible for the design and layout and another group distributed the zines to locations where they were likely to be seen by the target audience.
Literature Review Harm Reduction
As the philosophical basis of Bridging the Gap and many other programs created for the benefit of street-involved youth, harm reduction deserves some further attention. There are two competing harm reduction discourses. One focuses on harm to drug users, and the other on harm to wider society as a result of drug use and the drug trade. The former type of harm reduction, which focuses on harm to drug users, is closer to harm reduction's roots as an activist movement promoting the rights of drug users. Harm reduction emerged in the 1980s as a response to the failure of prohibition to solve the “drug problem” and prevent the spread of HIV/AIDS among intravenous drug users in Europe and the United States (Erickson et al. 1997:4). In the 1990s, it expanded into an organized international movement with a conference in Liverpool, England (Erickson et al. 1997:3).
There are many ways to define harm reduction. Lenton and Single define harm reduction as “only those policies and programmes which attemp[t] to reduce the risk of harm among people who continu[e] to use drugs” (1998:215, emphasis in original). By doing so, harm reduction “attempts to assess the actual harm associated with any particular drug and then asks how these harmful effects may be minimized…within an amoral framework” (Miller 2001:167). An “amoral framework” in this case, refers to harm reduction’s professed neutrality on the moral status of drug use and drug users. This is meant to contrast with more
overtly morally judgmental approaches to drug use, such as the “just say no” approach of the Reagan era in the United States, and similar “war on drugs” policies in Canada.
The definition of harm reduction hinges on the definition of drug-related harm. In traditional definitions, it refers to the harm to drug users caused by drug use (Lenton and Single 1998:214). For example, the increased risk of contracting illnesses such as hepatitis C and HIV as a consequence of sharing needles used to inject drugs. The harm reduction response in this case would be to provide clean needles to injection drug users, along with information about how disease is spread by needle sharing.
Alternatively, some people employ a much broader, and more problematic, definition of harm. In this case, harm from drug use is taken to mean any negative consequence of drug use and drug trafficking to users, non-users and society in general (Hathaway 2002:398, Miller 2001:175, Lenton and Single 1998:215). This is problematic because it renders the term “harm reduction” meaningless. Any policy addressing drug use, or any social ill connected to drug use could be called “harm reduction”. When used in this sense “harm reduction” becomes nothing but a label useful for giving a progressive flavour to whatever initiatives governments or others propose. For example, the Government of British Columbia's 2004 policy document about crystal meth states:
affects a large proportion of the population both directly and indirectly. These harmful impacts may include loss of productivity and wages, disability and death due to overdose, as well as enforcement, social and health costs. These detrimental effects to the health and well-being of individuals, families and communities can be prevented and reduced (2004:5).
Arresting drug dealers and users may reduce drug-related harm if harm is defined as discarded needles, drug-related crime, or even reduced property values (Single 2000:1). In this way, “drug-related harm” sometimes means harm to drug users, and sometimes harm to “the community” from drug users, who are seen as the source of crime and disorder. By this definition, even the most punitive approaches to illicit drug use, as well as abstinence-based programs can be called harm reduction (Lenton and Single 1998:215). By employing this broad definition of drug-related harm, governments can frame law enforcement initiatives as “harm reduction”. For example, in a 2005 press release announcing increased penalties for crystal meth offences, then Minister of Health Dosanjh used a broader definition of harm when he said that "[t]here are significant health, social and economic harms caused by methamphetamine, not only for users, but for communities as well" (Government of Canada 2005). A clear distinction between personal and broader societal harm reduction is necessary to any discussion of this issue.
At the time of this research, the concept of harm reduction was a popular focus for action around drug use and homelessness in Victoria. Harm reduction was seen as a more humane and empowering alternative to traditional criminal justice
approaches to these issues. Recipients of harm reduction were meant to benefit from a feeling of control over their exposure to the harms of drug use. Harm reduction re-framed the “problem” so that drug use in and of itself was not the main concern. Rather, it was the ways drugs were taken, the amounts, and the unpredictable potency of illicit drugs that caused problems for users. With the problem re-framed, solutions also took on a new form. Public forums were organized and newspaper pieces written to inform everyone of the new paradigm and generate discussion and actions based on this different view of drug use. I would like to describe one such public forum as an example although this was not the only such meeting, nor does it represent all harm reduction efforts in Victoria.
On the evening of June 27, 2007 several dozen people gathered at the Central Baptist Church in downtown Victoria for the Voices of Substance community dialogue. The event was held in a large room with 12 or so round tables and a stage at the front. It was crowded, with little room left by the time I arrived. The meeting was preceded by a dinner and many people were still finishing their meals when the presentations began. The event started with opening remarks by local advocate for the homeless, Reverend Al Tysick. This was followed by a blessing from First Nations Elder May Sam. After that, Benedikt Fisher, a researcher from the Centre for Addictions Research of British Columbia, presented data from the I-Track study which looked at injection drug use in Canada. At this time Vancouver’s supervised injection site was much in the
news, and Fischer built an argument for bringing such a facility to Victoria. Fischer’s presentation started by identifying the problems of drug use: overdose deaths and the health consequences of sharing injection equipment, a lack of available treatment for those who wanted it, ineffective law enforcement, and a lack of understanding of harm reduction among police. Fischer proposed a supervised injection site as the partial solution for these problems, but identified the illegality of drugs as the ultimate source of drug-related harm.
The concept of “community” and harm to the “community” in the form of disorder and crime are often cited in drug policy documents as justifications for new more punitive illicit drug use policies. Fischer called for a mobilization of this same unit (the community) to push for policy change towards a public health approach to drug use, which would treat addiction as a health matter and protect the wellbeing of users. Turning the usual illicit drug policy discourse on its head, Fischer presented “the community” as an active agent in changing drug policy rather than a passive recipient of the ills of illicit drug use and trade. This view was well received by the audience and there followed short presentations by spokespeople from various groups covering a “gendered perspective”, an “aboriginal perspective” and a “substance user perspective”. Representatives from the Prostitutes Empowerment Resource Society and the Canadian National Coalition of Experiential Women spoke to gender issues. Two people from the Native Friendship Centre covered the aboriginal issues, and representatives from the Society of Living Intravenous Drug Users give the “substance user
perspective”. These relatively informal presentations were followed by general moderated discussion during which some audience members announced their intention to start a co-operative brothel as a way of improving working conditions for sex workers in Victoria.
According to the event program, the organization that hosted this gathering, Voices of Substance, is “a group of concerned citizens who have come together because we believe that our current drug laws and public responses to substance use are not working effectively enough to ensure the safety of all segments of our community”. The document goes on to say “we all have to work together if we are going to prevent harms in our community from substance use and ineffective drug policy”. This approach highlights structural problems as the basic cause of drug-related harm. Although there were many other harm reduction initiatives around this time, this example illustrates one way in which the ideas of harm reduction were taken up and discussed in the Victoria context.
Harm reduction has been enthusiastically embraced by many groups, and not without good reason, but it has also drawn critique. Although the above example demonstrates that this is not always the case, some have criticized harm reduction for its focus on an individualistic model of drug use. If harm reduction projects fail to make clear the role of government policy and other structural factors contributing to drug-related harm, they risk further marginalizing their intended beneficiaries (Bourgois et al. 1997:161, Fraser 2004: 216). Harm
reduction constructs drug users as “health-conscious citizens capable of rational decision-making, self-determination, self-regulation and risk management” (Moore and Fraser 2006:3037). That is, harm reduction messages (eg. “use a clean needle every time you inject”) often make potentially problematic assumptions about individuals consistent with a neo-liberal philosophy: that individuals are not constrained in their ability to choose one behaviour or another, have the resources and abilities necessary for the suggested harm reduction measure, wish to preserve or improve their own health and the health of others, and that preserving or improving health in the long run are of greater importance than short term gain from drug use (Fraser 2004:205). This way of looking at drug-related activities leaves out the possible constraints on how drug users can behave. For example, due to needle exchange locations and hours, intravenous drug users may have difficulty accessing clean needles in sufficient numbers to always use one when injecting. They therefore fail again, through no fault of their own, to attain that ideal of perfect self-care they were told to aspire to in harm reduction messages.
Harm reduction also does not always address the fact that drug users may consider the benefits of a problematic drug practice more significant than the harms. For example, Dwyer found that despite the immediate and painful side effects of temazepam injection, Vietnamese-Australian heroin users persisted in this practice (Dwyer 2008:370). These individuals rejected harm reduction practices, such as swallowing the temazepam capsules rather than injecting
them, citing pleasure as their motive. The danger associated with injecting temazepam, its social currency as both a shared activity and an identity marker, and the feeling of intoxication temazepam caused all combined to produce a highly valued experience (Dwyer 2008:371). Even where, as is often the case, drug users care very much about their long term health, or for other reasons would prefer to practice ideal harm reduction techniques, they may be unable to. For example, drug users (like other people) may be constrained by power relations (Bourgois et al. 1997:161), social norms (Power et al. 1996:99, Shaw et al. 2007:1631), the physical environment (Rhodes et al. 2007:582), and government policy (Fraser 2004:217). Additionally certain types of harm reduction practices would cost drug users scarce financial resources. For example, drug users are commonly discouraged from sharing drug paraphernalia, such as crack pipes. This equipment, however, is not always freely available. Crack pipes in particular tend to break, get lost or be confiscated. In order to embody ideal harm reduction practice, drug users would frequently have to purchase replacement pipes. For many crack users, this would be a significant drain on already scarce economic resources.
Drug Discourse and Neo-liberal Governmentality
In order to understand drug discourse and the thinking behind drug policy in Western countries (Canada, the U.S., Europe, New Zealand and Australia), some discussion of the philosophical backdrop of liberal democracy as it relates to health is necessary. Drug and public health policy generally in many nations
have been influenced by a philosophy of government known as “neo-liberalim”. Currently, public health strategies employ a neo-liberal approach, situating individuals as health consumers and highlighting their freedom to choose a healthy lifestyle.
Neo-liberalism, or advanced liberalism, has been a dominant philosophical trend among many Western governments since the 1980s. Neo-liberalism builds on liberalism, the preceding style of government in the West and is a philosophy of great importance in drug discourse. The liberal subject is free, rational and independent and makes decisions based on the felicity calculus (O’Malley and Valverde 2004:27). That is, rational people act to maximize pleasure and minimize pain. Liberalism, as a way of governing, seeks to regulate the freedom of rational autonomous subjects by defining acceptable behaviour and rewarding that behaviour with the rights of citizenship (Bunton 2001:224).
While liberalism views its subjects as autonomous, rational, and ideally temperate, neo-liberalism discursively produces more assertive, self-determining subjects, constructed in economic terms as consumers or “entrepreneurs of the self” (Moore and Fraser 2006:3037-3038). Neo-liberalism retains at its core the liberal notion that pain, disorder and compulsion are undesirable and can be contrasted with pleasure, order and freedom. Neo-liberal subjects are free to consume what they like and to assess and avoid risks as a way of maximizing utility in the form of enjoyment. Identifying and avoiding risks is more than a
rational choice, it is a duty (Moore and Fraser 2006:3037). If one does not qualify as a rational, free subject, (for example by failing to avoid risk, by being insane or by being under the influence of drugs) the rights of citizenship may be denied, or increased surveillance may be justified. For example, Bourgois describes methadone prescription programs in the United States as “the state’s attempt to inculcate moral discipline into the hearts, minds, and bodies of deviants who reject sobriety and economic productivity” (2000:167). In other words, drug use (and in particular, addiction), is aligned with the “pain, disorder and compulsion” category. Further, drug users have failed to avoid the risks of addiction and other health implications of drug use.
This philosophy is applied in many areas of government, but its application to public health issues has inspired a set of policies known as the “new public health”. The new public health is concerned with the social, political and economic factors that affect health (Rhodes 2002:85). This approach “can be seen as but the most recent of a series of regimes of power and knowledge that are oriented to the regulation and surveillance of individual bodies and the social body as a whole” (Petersen and Lupton 2000:3). Harm reduction is part of this broader array of neo-liberal population health strategies that see individuals primarily as consumers.
The concept of “risk” is a central feature of this approach to population health. The new public health approach involves first identifying groups of people who
can be said to be “at risk” of some health problem (for example drug addiction) or of engaging in unwanted behaviours (such as sharing needles). Castel defines risk as “the effect of a combination of abstract factors which render more or less probable the occurrence of undesirable modes of behaviour” (1991:287), but risk is more generally understood as the probability that something bad will happen (Lupton 1999:8). Government policies with regard to illicit drug use are often based on the concept of risk. For example, Jones remarks on the use of “the language of risk” in a United Kingdom drug policy document (2004:368) and Duff “looks at the place of risk and risk management in the development and implementation of drugs policies” in the Australian context (2003:286). Once “at risk” groups have been identified, various strategies to shape their behaviour are employed. As risky behaviours are not seen as a rational choice, one common strategy involves providing more information on the harmful effects of the behaviour. The hope is that users will realize that their choice is irrational and thus correct it their behaviour. This approach is often combined with increased surveillance, particularly in cases where people do not immediately see the “error of their ways”. Harm reduction fits well with this approach, as education about harmful behaviours is a common strategy for reducing harm.
The new public health sets up a moral system, based on liberal and neo-liberal philosophy. Ill-health, pain and compulsion are immoral and are attributed to failures of individuals to recognize and avoid risks. As Deborah Lupton put it, “‘healthiness’ has replaced ‘Godliness’ as a yardstick of accomplishment and
proper living” (1995:4). Further, the actions and states of being that can be included in the “good” category of the healthy, enjoyable and free is governed in such a way as to reproduce the status quo. This is particularly salient where the legal status of drugs is concerned (O’Malley and Valverde 2004:37). For example ignoring the possibility the illicit drugs could produce anything other than pain and dependence serves to justify their continued prohibition.
In this context, drugs become powerful substances, the use of which has profound consequences for one’s citizenship and subjectivity. Drugs are doubly condemned in neo-liberal contexts. They both produce ill-health in users and rob them of prized rationality and autonomy (Reith 2004:296). In this way, drugs threaten the personhood (and citizenship) of users at a fundamental level. There is, however, a tension where drugs and neo-liberalism are concerned. Consumerism is also important in neo-liberal discourse: the self is expressed (constructed) through consumption (Reith 2004:285). As such, drugs, like other commodities, provide an opportunity for this. Yet, the possibility that drug use could be a rational choice for consumers wishing to enact their liberal right to “the pursuit of happiness” is denied by the construction of drug use as unpleasant, un-free and irrational (O’Malley and Valverde 2004:39). The tension is solved by discursively denial of the possibilities of drugs as consumer objects, their status as a threat to rationality and autonomy takes priority.
Canadian Drug and Youth Justice Policy Context
Although Western nations have many philosophical and policy approaches to illicit drugs in common, this study was conducted in Canada and the results must be understood within the context of Canadian drug and youth justice policy. Criminal behaviour by young people and illicit drug use in general have long been concerns for Canadian society. In many ways our policy responses to these two issues followed a similar trajectory. From the moral panics of the early 1900s, to the civil rights reforms of the 1960s, to the tough-on-crime approaches of the 1980s and 90s and finally to the renewed interest in alternative approaches to drug use and youth crime in the 2000s, responses to these two social problems have run parallel to each other. The following gives some Canadian legal and historical context for a discussion of drug use by street-involved youth.
Psychoactive substances, so threatening to productive citizenship, are governed at a national level in Canada through a wide range of laws. These laws were developed over time as different substances and different categories of substance user seemed to threaten middle-class Canadian society. Alcohol was the first mood-altering substance to be controlled by Canadian law. The Canada Temperance Act of 1878 allowed municipalities or counties to control the sale of alcohol (Carstairs 2006:17). Alcohol prohibition was implemented briefly during the First World War (Carstairs 2006:17). Opiates were the next substances subjected to government control with the Anti-Opium Act of 1908 which outlawed
importing, selling or producing the drug for non-medical purposes. The possession of opium, morphine and cocaine for non-medical purposes was banned with the Opium and Drug Act of 1911 (Carstairs 2006:18). Smoking opium also became illegal at this time. These anti-opium laws were driven in no small part by anti-Asian sentiments among white Canadians in Western Canada. Most notably, a 1907 Vancouver anti-Asian riot brought the attention of Mackenzie King (then the deputy minister of labour) to concerns about opium and its supposed corrupting influence on white women and girls (Carstairs 2006:17). The laws were also passed at a time of economic difficulties when immigrant laborers were seen as a threat and blamed for the scarcity of jobs (Schissel 1993:12).
The same moral degeneracy connected with drug use was also linked to youth crime or deviance. As with drug use, however, this moral degeneracy was ascribed mainly to immigrant or marginal youth (Schissel 1993: 13). The Juvenile Delinquents Act was passed in 1908, the same year as the Anti-Opium Act. Both laws were motivated by moral outrage, declining economic conditions and a fear of non-European immigrants. The Juvenile Delinquents Act gave the state power to detain children and youth “for their own good”, often arresting them for minor infractions and detaining those from “unstable” families in disproportionate numbers (Schissel 1993:10).
rather than incarceration for drug offenses. This shifted in the 1920s. Racism against Chinese Canadians and moral panic about drug use (for which Chinese Canadians were blamed) inspired changes to Canadian drug laws characterized by an increased focus on jail time. The maximum sentences for trafficking and possession were increased in 1921 from one year to seven (Carstairs 2006:19). In 1923 marijuana and codeine were prohibited. By the mid 1920s the idea that drug use should be illegal was accepted without question in Canada (Carstairs 2006:19).
Increasing penalties for drug use and changes to immigration policies in the1920s and 1930s caused a change in how Canadians used drugs. Injection drugs became more common and the Chinese-Canadian practice of smoking opium gradually disappeared (Carstairs 2006:35). Although drug users had previously come from a variety of socio-economic backgrounds, by the 1930s people who used cocaine, opium, heroin and morphine were predominantly from the “lower classes” (Carstairs 2006:35). The depression of the 1930s made drugs difficult to find and afford. At this time many people switched to prescription narcotics that they could steal or obtain from a doctor (Carstairs 2006:55). The Second World War made narcotic drugs even more difficult to acquire. Possession of codeine became an offence under the Opium and Narcotic Drug Act in 1939 (Carstairs 2006:60). The price of narcotic drugs rose so high during the war that even non-drug users began stealing them to sell (Carstairs 2006:61). Perhaps due to the extremely high cost of narcotic drugs, some people switched
to barbiturates or amphetamines. These had previously been available over the counter, but became prescription drugs in 1941 because of concerns over recreational use (Carstairs 2006:61). However, barbiturates and amphetamines were regulated under the Food and Drugs Act, not the Opium and Narcotic Drug Act. This meant that the penalties for unlawful sale were difficult to enforce (Carstairs 2006:62).
With a rise in the prestige of medical professionals in general and psychiatrists in particular, drug users of the 1950s were increasingly seen as suffering from an illness requiring medical treatment (Carstairs 2006:124). Drug use became pathological and rehabilitation was called for. The first experiments with methadone maintenance occurred in the early 1950s, and Canada’s first methadone maintenance program was established in British Columbia in 1963 (Carstairs 2006:127).
The 1960s, which saw the introduction of socialized healthcare and the Canada Pension Plan, was a time of significant policy change towards a “philosophy of equality and help for those who had ‘fallen through the cracks’” (Alvi 2000:25). This meant increasing support for drug treatment rather than jail time, and increasing criticism of the half-century old The Juvenile Delinquents Act (Alvi 2000:24). This shift toward treatment and alternatives to incarceration, however, was not reflected in drug laws (Fischer et al. 1996:172). Despite considerable public support for treatment of drug users outside the criminal justice system, the
Narcotics Control Act was established in 1961 and reinforced a punitive approach to drug use (Carstairs 2006:155). This law spawned thousands of criminal convictions for marijuana offenses: 600,000 by the early 1990s (Fischer et al. 1996:172). Yet these convictions did not all result in prison sentences. Whereas simple possession was enough to justify jail time under the law, the surfeit of young middle-class people convicted of drug offences inspired changes to the Act in 1969 (Carstairs 2006:158). By 1971, fines were the most common type of punishment for cannabis possession, and other drug users were also treated less harshly (Carstairs 2006:158).
A more liberal attitude to drug use, particularly marijuana use, prevailed for the next decade. For example, in 1977 Prime Minister Pierre Trudeau told a group of students, “If you have a joint and you’re smoking it for private pleasure, you shouldn’t be hassled” (Erickson 1992:247). This in contrast to Minister of Health A. Anne McLellan’s comments in 2003:
“We do not want Canadians to use marijuana. We especially don't want young people to use marijuana. That is why an important part of our drug strategy will focus on strong, public education messages to inform Canadians of the negative health effects of marijuana” (Government of Canada 2003).
In 1968, there was a proposal to remove marijuana from the Criminal Code altogether and place it under the Food and Drugs Act, but despite a decade of interest the intended change never occurred (Erickson 1992:246).
and a greater focus on human rights in drug discourse, affected the way drug offences were prosecuted. The state no longer had enormous latitude with regard to searching property in drug crime cases, and the burden of evidence was shifted to the prosecution. These changes brought drug enforcement practices in line with how other crimes were investigated and prosecuted (Erickson 1992:246). Drug use also declined in the early 1980s, eroding political will for drug policy reform (Erickson 1992:248).
The year 1982 also saw the Young Offenders Act passed. This act replaced the Juvenile Delinquents Act of 1908. The same civil rights concerns and new Canadian Charter of Rights that inspired changes to drug policy influenced the new polices on youth justice. The new act contained a greater focus on rights. Whereas the old Juvenile Delinquents Act allowed the state to act in loco parentis where young people were concerned, the new laws gave youth full access the adversarial system used in adult court (Schissel 1993:vi). The Young Offenders Act was meant to combine the best from the child welfare aspects of the previous laws with a greater focus on justice. Over the next several years, the criminal justice side of the policy took over with successive changes to sentencing rules (Schissel 1993: 67).
Along with a heavier approach to youth justice, the mid 1980s saw a reduced interest in legalizing illicit drugs and a return to drug prohibition polices (Erickson 1992:244). In 1986 Prime Minister Mulroney announced a “war on drugs” in
Canada to match the Reagan administration’s popular policies in the United States. Prime Minister Mulroney stated that “drug abuse has become an epidemic that undermines our economic as well as our social fabric” (Erickson 1992:248). This shift in policy direction was so sudden, unexpected, and apparently groundless, that one official with Health and Welfare Canada remarked: “When he [the PM] made that statement, then we had to make it a problem” (Erickson 1992:248, emphasis in original). Perhaps due to the unenthusiastic response of Canadians to the proposed “war on drugs”, the 5-year national strategy for illicit drugs announced in 1987 was presented to the public as a “kinder, gentler” version of the United States style war on drugs (Jensen and Gerber 1996:459). This policy, titled ‘Canada’s Drug Strategy’ employed harm reduction language and would use 70% of its funding for “demand reduction” (education, prevention, treatment and rehabilitation) (Fischer et al. 1996:173).
The “legal backbone” for this policy would be Bill C85, an updated version of the Narcotic Control Act. The bill was criticized for not being progressive enough and failed to pass before the conservative government fell in 1993 (Fischer et al. 1996:173). A liberal government was elected and presented a new law, Bill C7, to replace Bill C85. The new bill was almost identical to the old one, and opposition to it continued (Fischer et al. 1996:173). The Canadian Government justified the harsh punishments for drug possession set out in the Bill by citing international treaties. However, the provisions in the Bill (especially with regard to marijuana) exceed the requirements of in the 1988 United Nations Convention
against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (Fischer et al. 1996:177). After some minor amendments, and re-introduction under another name (Controlled Drugs and Substances Act), the Bill eventually passed and was proclaimed in May 1997 (Fischer et al. 1996:173, Erickson 1998:264). Despite the harm reduction language in the policy, not everyone thought The Controlled Drugs and Substances Act represented a progressive approach to drug use (Fischer et al. 1996:177). The law was criticized for being a “throwback to the 1920s” based on “myths and preconceptions about illicit drugs and their evil, addictive effects on users, reinforcing the traditional policy of criminalization” and ignoring current drug research (Erickson 1998:264).
Between 1997 and 2001 changes to drug law focused on “supply reduction”. That is, organized crime offences were added to the Criminal Code (Brittain et al. 2001:7). In 2001, the Auditor General released a report on illicit substance use in Canada titled Illicit Drugs: The Federal Government’s Role (Brittain et al. 2001). The Report described the government’s efforts to control illicit drug use as disorganized, and overseen by a myriad of different agencies and departments generally concerned with either law enforcement or health (Brittain et al. 2001:14). The Report also found that the Government of Canada lacked sufficient information on the scale or nature of the “drug problem” to manage it effectively (Brittain et al. 2001:17).
justice, and in the year 2003 the Young Offenders Act was replaced by the Youth Criminal Justice Act. The new law placed greater emphasis on treatment, reserving the court system for serious offenders (Mann et al. 2007:43). It encouraged alternatives to incarceration where possible and restricted “the use of custody to meet child protection, welfare, or mental health needs” (Mann et al. 2007:43).
Canada’s Drug Strategy, first launched in 1987, was renewed in 2003. Perhaps due to the recent new approach to youth justice, youth were singled out in the policy announcement as a category of people whose drug use was particularly concerning (Government of Canada 2003). This came amid a renewed interest in cannabis policy reform, sparked in part by a report form the Special House Committee on the Non-medical Use of Drugs which recommended decriminalizing possession of small amounts for personal use. This proposal went through various incarnations as a Bill, but did not result in any changes to the criminal status of marijuana. The political will to reform marijuana policy disappeared with the Liberal government when the Conservative party was elected in 2006 (Government of Canada 2006).
In 2007 the government announced a new National Anti-Drug Strategy which would “provide $63.8 million over two years to prevent illegal drug use in young people, treat people who have drug addictions and fight illegal drug crime (sic.)” (Government of Canada 2007). Like other recent government communications
about drug policy, this announcement singled out “youth” as the group most in danger of “becoming involved with drugs”. For example, advertising campaigns were designed to educate youth and help “parents understand the dangers of drugs” (Government of Canada 2008). This focus on young people and their special vulnerability to illicit drugs continues to this day.
Street-involved youth
Young people, already susceptible to drug use, are considered particularly at risk if they are homeless or street-involved. Traditionally, the category “street child” has been defined by its members’ improper use of public space and relative lack of connections to family and other institutions (Panter-Black 2002:148). “Street youth” are similarly seen to use public space inappropriately and lack the dependence on family that usually defines children and youth. Terms like “street child” and “street youth” have been criticized for not reflecting how the individuals in questions see themselves, obscuring heterogeneity in individuals’ experiences, taking attention away from the large number of children affected by poverty who do not live on the street, and for having “pitying or pejorative connotations” (Panter-Black 2002:148). These criticisms are partly responsible for a proliferation of terms for children or youth who spend time “on the street”. Such terminology makes a big difference to how young people in trouble are viewed by society. The United Nations Convention on the Rights of the Child entered into force in 1990 and defines children as “every human being below the age of eighteen years unless under the law applicable to the child, majority is attained
earlier” (United Nations 2003). Calling someone a child or kid places them in a special category, one defined by a right to care from adults and “idealized otherness, the purity and innocence of which is to be celebrated” (Hall and Montgomery, 2000:13). Youth, on the other hand, are seen as similar to adults and cannot claim innocence and care as easily. They are assigned a greater degree of agency. Youth who live “on the street” may be feared by some members of society and therefore offered little sympathy, while “street children” are a somewhat less threatening category (Hall and Montgomery 2000:13). Street children and youth are “people out of place”, “the embodiment of dangerous natural forces, unharnessed to social ends” (Stephens 1995:13).
Despite the potential problems with the term “youth”, I will refer to the young people who participated in this study as “street-involved youth”. This term is taken from Bridging the Gap documents and appears occasionally in research papers alongside terms such as “homeless youth” and “street youth”. In the context of Bridging the Gap, street-involved youth are young people who may or may not be homeless and spend some time in the social and economic world of “the street”. In this context the “street economy” mainly refers to the illegal drug economy but also could include illegal or illicit activities such as prostitution or trade in stolen items. The term “economy”, however, tends to somewhat obscure the importance of inter-personal relationships. A person “involved with the street economy” is not someone who comes downtown, buys drugs from a person they’ve never seen, and returns to where they came from. What “street-involved”
denotes is entanglement in the social world of “the street”. To be “involved” in the way that Bridging the Gap staff use the term, is to have an identifiable position within the downtown social world and to be familiar with the very specific opportunities and dangers that world offers.
For the purposes of this study, youth will be defined as persons 12 to 29 years of age. This is the official criteria for inclusion in Bridging the Gap activities, as well as the definition used by the Public Health Agency of Canada. This age-range, however, has a few potential problems. According to Bridging the Gap staff, the 12 to 29 age range does not reflect the notion of “youth” as held by the youth themselves. A younger cut-off, somewhere in the early twenties, seemed more in line with the way young people thought of themselves. In the Victoria context, being “on the street” beyond your early twenties seemed to signify a shift from being a “street youth” just going through a phase, to being a “street person” (a less desirable category to belong to) and likely to remain on the street permanently. Age is of real importance for street-involved youth, as some services are restricted, accessible depending on how old you are. For example, the Victoria Youth Clinic, which partners with the YM-YWCA in running Bridging the Gap, serves youth of ages 12 to 24. The 12 to 29 range is advantageous in that it both reflects the definition of youth used by Bridging the Gap, and is large enough to encompass the other definitions of youth used by Victoria services, the youth themselves, and the literature on street-involved youth. Baer et al. (2004), for example, define homeless youth as being of ages 13 to 19 years. Kidd (2007)
on the other hand, writing about Toronto and New York contexts, defines youth as being under 24 with no lower age limit. Kidd’s choice “reflects the street context where youths tend to group together who are in this age range, perceive one another and [are] perceived by others as ‘street youth’” (Kidd 2007:293).
The exact housing status of “street-involved” or “homeless” youth is also the source of some discussion in research papers. The term “homeless” may be misleading in the sense that it does not convey the variety of housing situations experienced by this group. For example, some youth have left a home they are free to return to, while others have been forced to leave. Some are temporarily living with friends or family, while others rely solely on shelters (Kidd 2007:293). Some of the youth I talked to changed living situations frequently, one month having an apartment or staying with friends and the next sleeping outside. For the purposes of this study, the term “street-involved” is used as it highlights involvement with the street economy and social world as the common element, rather than housing status. This also reflects the criteria Bridging the Gap staff used in deciding who to recruit for the program because they did not target people based on living arrangements.
Chapter 2: Materials and Methods
Research Design
Over the course of this project the research design has been changed and adapted a few times. These changes were in response both to the changing focus of my research and to the challenges of doing research with a highly mobile population (many of whom do not have stable housing). In the beginning, having had no previous experience talking to street-involved youth and no clear idea of what they might want to tell me, I decided to focus my research on behaviour around the use of crystal meth. This theme was of interest to me and fit with the goals of Bridging the Gap. With help from Mikael Jansson, Cecilia Benoit and Eric Roth, I designed a questionnaire that addressed both the areas of interest from the perspective of evaluating Bridging the Gap, and my own interest in the circumstances under which people use crystal meth. This survey (see Appendix A) contained mainly closed-ended questions along with some open-ended ones. Many of the questions were taken from Mikael Jansson and Cecilia Benoit’s two studies, Risky Business: Experiences of Street Youth (Benoit et al. 2008) and the Healthy Youth Survey (Jansson et al. 2006). This was done so that I would be able to compare my results to results they obtained from youth involved with the sex trade (Risky Business) and a random sample of youth in Victoria (Healthy Youth). Each interview participant received a $20 honorarium, and the interviews lasted between 30 minutes and one hour. The original design called for three waves of interviews, each with as many of the same participants
as possible. This was to measure any changes over time in participants’ answers to the survey questions, both with regard to potential impact that Bridging the Gap may have had, and to record any changes in crystal meth use among participants.
The first major change to the research design came with the realization that it was very difficult to conduct repeat interviews with youth in the study population. Due to significant turnover in the youth involved with Bridging the Gap, and problems in staying in touch with former participants, the original plan to measure change over time was replaced. A new design was conceived in which the current participants in Bridging the Gap were interviewed at three points during the project.
The second change to the research design came in response to the changing focus of my own research interests. Although many participants had tried crystal meth, very few were habitual users and none seemed very interested in my questions about crystal meth. Instead, participants often gave information related to drug use in general, such as stories or explanations, which the survey questions did not capture. In response to this, I added questions to the last wave of interviews about the social context of drug use, about risk and worry and about meanings associated with drugs. I found that participants were willing to talk about their drug use in detail, and decided to add a qualitative interview component to the research design. The qualitative component was to include
four or five interviews followed by a focus group with interview participants. Instead of crystal meth, my focus would be the social context of drug use: the various meanings attached to drug use and the place of drug use in the social lives of street-involved youth. The schedule for these interviews can be found in Appendix B.
I selected qualitative interview participants from people who previously participated in a survey-based interview. However, I had significant difficulty in contacting previous participants and in the end, was only able to complete three qualitative interviews. As previous participants were difficult to find, I tried to recruit other street-involved youth who might have knowledge about drug use, but was unable to arrange any further interviews. One of the three qualitative interview participants did not want to be involved in a focus group. I did find another person willing to be part of a focus group, but in the end not everyone was able to attend and the focus group was cancelled. Despite these logistical difficulties, I feel the qualitative interviews are a great strength of this project. Having only three to analyze meant that a more detailed analysis was possible. Also, I was glad to be able to include most of the text from the transcripts in this thesis so that readers can see for themselves the details of what three youth had to say about drug use. I believe being able to include so much from each of them brings their unique perspectives forward more than would have been possible if additional qualitative interviews were included.
