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UBC Theses and Dissertations

Work experiences and conditions among people who use drugs engaged in peer work : a critical examination of peer work in British Columbia, Canada Greer, Alissa Merielle


Engaging with ‘peers’, or people with lived experience of illicit substance use (past or present) who use their experiential knowledge to inform their professional work in decision-making and service provision, has been increasingly recognized as best practice within mainstream health and ham reduction institutions across British Columbia, Canada, and elsewhere. Yet, the operationalization and structure of work in peer engagement contexts have not been studied in great depth. In this research, I generate a critical and in-depth understanding of peer work conditions, the organization of peer work, and the structural factors that shape equity, inequities, and constraints in the context of the everyday work experiences of peer workers. Grounded in critical theoretical perspectives and a qualitative research design informed by interpretive descriptive methods, I conducted fifteen interviews with people engaged in peer work in British Columbia. Data coding and analysis occurred concurrent to data collection and themes were generated inductively and recursively using constant comparison techniques. Study findings indicate that peer work was demanding, oppressive, and inequitable. The emotional demands of peer workers’ day-to-day working lives were illustrated by reports of trauma and structural harms. Expressions of oppression, including powerlessness, marginalization, and exploitation, were linked to a range of interlocking, interrelated systems that structurally shaped peer work conditions and perpetuated inequity. These findings illustrated how, despite peer workers’ efforts to engage in their work, systems of oppression and inequity that were structured into the organization of peer work may enable or constrain peer workers’ agency in these settings. Inequitable access to supports appeared to make it challenging for peer workers’ roles to be effectively utilized or recognized within institutions. Collectively, study findings suggest how equity, inequity, and oppression can be shaped through the organization and operationalization of peer work. While there may be good intentions to promote the inclusion of people who use drugs in health promotion and harm reduction organizations, I provide evidence that there are potential consequences to work that is misunderstood, poorly organized, and unsupported.

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