The “goldfish bowl” : a qualitative study of the effects of heightened surveillance on people who use drugs in a rural and coastal Canadian setting

UBC Faculty Research and Publications

The “goldfish bowl” : a qualitative study of the effects of heightened surveillance on people who use drugs in a rural and coastal Canadian setting Bardwell, Geoff; Mansoor, Manal; Van Zwietering, Ashley; Cleveland, Ellery; Snell, Dan; Kerr, Thomas

Abstract

Background: A growing body of research has focused on contextual factors that shape health and well-being of people who use drugs (PWUD). However, most of this research focuses on large cities and less is known about the efects of social and structural contexts on drug use and associated risks in rural Canadian settings. Therefore, we undertook this study to examine rural-specifc contextual factors that afect the day-to-day experiences of PWUD. Methods: Twenty-seven qualitative semi-structured interviews were conducted with PWUD in a rural and coastal setting in British Columbia, Canada. Participants had to be≥19 years old, used illegal opioids and/or stimulants regularly, and lived in the qathet region. Interview transcripts were coded based on themes identifed by the research team. Results: Participants described progressive shifts in politics and culture in the qathet region while also identifying resource scarcity, homelessness, and changes in the drug supply, where illicit drug contents have become highly toxic and unpredictable. Participants discussed the qualities of a small community where everyone knows each other and there is a lack of privacy and confdentiality around drug use, which resulted in experiences of stigma, discrimination, and surveillance. Participants also reported rural-specifc policing issues and experiences of surveillance on ferries when traveling to larger cities to purchase drugs. This led to signifcantly higher drug prices for PWUD due to the time dedication and criminalized risks associated with drug possession and trafficking. Conclusions: Our fndings illustrate the unique experiences faced by PWUD in a rural and coastal setting. The “goldfsh bowl” efect in this rural community created heightened social and structural surveillance of PWUD, which led to a variety of negative consequences. There is a clear need for interventions to address the larger contextual drivers afecting people who use drugs in rural settings, including decriminalization and peer-led anti-stigma strategies, in order to improve the lives of PWUD. [An updated version of this publication was uploaded on 2024-09-10].

Item Metadata

Title	The “goldfish bowl” : a qualitative study of the effects of heightened surveillance on people who use drugs in a rural and coastal Canadian setting
Creator	Bardwell, Geoff; Mansoor, Manal; Van Zwietering, Ashley; Cleveland, Ellery; Snell, Dan; Kerr, Thomas
Contributor	British Columbia Centre on Substance Use; St. Paul's Hospital (Vancouver, B.C.)
Publisher	BioMed Central
Date Issued	2022-12-07
Description	Background: A growing body of research has focused on contextual factors that shape health and well-being of people who use drugs (PWUD). However, most of this research focuses on large cities and less is known about the efects of social and structural contexts on drug use and associated risks in rural Canadian settings. Therefore, we undertook this study to examine rural-specifc contextual factors that afect the day-to-day experiences of PWUD. Methods: Twenty-seven qualitative semi-structured interviews were conducted with PWUD in a rural and coastal setting in British Columbia, Canada. Participants had to be≥19 years old, used illegal opioids and/or stimulants regularly, and lived in the qathet region. Interview transcripts were coded based on themes identifed by the research team. Results: Participants described progressive shifts in politics and culture in the qathet region while also identifying resource scarcity, homelessness, and changes in the drug supply, where illicit drug contents have become highly toxic and unpredictable. Participants discussed the qualities of a small community where everyone knows each other and there is a lack of privacy and confdentiality around drug use, which resulted in experiences of stigma, discrimination, and surveillance. Participants also reported rural-specifc policing issues and experiences of surveillance on ferries when traveling to larger cities to purchase drugs. This led to signifcantly higher drug prices for PWUD due to the time dedication and criminalized risks associated with drug possession and trafficking. Conclusions: Our fndings illustrate the unique experiences faced by PWUD in a rural and coastal setting. The “goldfsh bowl” efect in this rural community created heightened social and structural surveillance of PWUD, which led to a variety of negative consequences. There is a clear need for interventions to address the larger contextual drivers afecting people who use drugs in rural settings, including decriminalization and peer-led anti-stigma strategies, in order to improve the lives of PWUD. [An updated version of this publication was uploaded on 2024-09-10].
Subject	Rural Canada; People who use drugs; Goldfish bowl effect; Surveillance; Stigma; Criminalization
Genre	Article
Type	Text
Language	eng
Date Available	2023-11-20
Provider	Vancouver : University of British Columbia Library
Rights	Attribution 4.0 International (CC BY 4.0)
DOI	10.14288/1.0437782
URI	http://hdl.handle.net/2429/86628
Affiliation	Medicine, Faculty of; Non UBC; Medicine, Department of
Citation	Harm Reduction Journal. 2022 Dec 07;19(1):136
Publisher DOI	10.1186/s12954-022-00725-2
Peer Review Status	Reviewed
Scholarly Level	Faculty; Researcher; Other
Copyright Holder	The Author(s)
Rights URI	http://creativecommons.org/licenses/by/4.0/
Aggregated Source Repository	DSpace

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