Society for Medical Anthropology
Volunteered - Oral Presentation Session
Jade Boyd (BC Centre on Substance Use)
Ryan McNeil (BC Centre on Substance Use)
BACKGROUND: British Columbia, Canada is in the midst of a fentanyl-driven overdose crisis, with 88% of fatal overdoses occurring inside. This has led to low-threshold supervised consumption sites – termed overdose prevention sites (OPS) – being integrated into select single room occupancy (SRO) housing. Although marginalized women experience vulnerability to drug-related risks markedly different than men, no research has examined how women interface with these housing-based interventions.
METHODS: From May 2017 to December 2018, ethnographic research was conducted to examine overdose risk for women who use drugs living in SROs. Data included in-depth interviews with 35 women and approximately 100 hours of observational fieldwork in SROs and surrounding areas. Data were analyzed thematically with attention to structural vulnerability, social violence, and intersectionality.
FINDINGS: Participants highlighted how everyday violence shaped their negotiation of housing-based OPS utilization. In particular, participants characterized housing-based OPS as unsafe environments in which they were at risk of violence from residents or guests as they were uncertain who else might be using the room. The perceived risk of violence was informed by previous experiences of witnessing violence and being victimized. Despite heightened overdose risk, women often consumed in their rooms where they could minimize risk of violence, control their safety, and maintain agency in their drug use.
CONCLUSIONS: Although marginally housed women who use drugs recognized the potential for housing-based OPS to minimize overdose risk, experiences of gendered violence in SROs and the broader drug scene undermined their engagement with these interventions.