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The process of safer crack use amongst women in Vancouver's downtown eastside Handlovsky, Ingrid Emilia

Abstract

Crack cocaine is prevalent in Vancouver’s Downtown Eastside, with evidence suggesting women use more than men. Crack cocaine poses many harms to the body, and women face unique harms due to the gendered use of crack. However, there has been little investigation into how women go about minimizing some of the harms associated with crack. Informed by harm reduction and women’s-centred philosophies, a grounded theory approach was employed to explore the process that women engage in to limit the physical, psychological and interpersonal harms associated with crack use, as well as identify the social, economic and political factors that influence the process of safer use. Data were collected via seven group interviews (n=27) that took place over a three month period with women who were actively using crack cocaine. Data illustrated women’s crack use patterns shifted over time from heavier to more intermittent use, and four central processes that enabled women to practice safer crack use were identified. At the root of these processes was a dedication to care for the self and others. The processes were identified as: establishing a safe physical space, building trusting relationships, learning about safer crack use, and accessing safer use equipment. These strategies were in turn influenced by larger contextual factors including the spatial environment (violence and police activity), economics (living with extreme financial limitations) and politics (the instability of supportive housing and lack of safe places for women). Women demonstrated proficiency to care for themselves and others in the context of crack use, but many changes within the political and health care systems are necessary to facilitate safer practices to improve health outcomes. Firstly, a political agenda that is dedicated to the development of supportive housing is essential for safer use, as is greater access to income assistance. Furthermore, harm reduction programming that focuses on women’s contributions and expertise in the realm of safer use is essential to ongoing development of a supportive community of women. Moreover, the availability of safer use equipment is quintessential for women to apply knowledge regarding safer crack use to minimize some of the harms associated with crack.

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Attribution 3.0 Unported

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