Area restrictions, risk, harm, and health care access among people who use drugs in Vancouver, Canada: A spatially oriented qualitative study

• Type of Material: Article
• Authors: Ryan McNeil, BC Centre for Excellence in HIV/AIDS; Hannah Cooper, Emory University; Will Small, BC Centre for Excellence in HIV/AIDS; Thomas Kerr, BC Centre for Excellence in HIV/AIDS
• Language: English
• Date: 2015-09-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 Elsevier Ltd.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.healthplace.2015.07.006
• Title of Journal or Parent Work: Health and Place
• ISSN: 1353-8292
• Volume: 35
• Start Page: 70
• End Page: 78
• Grant/Funding Information: Ryan McNeil and Will Small are supported by the Michael Smith Foundation for Health Research.; This study was supported by the US National Institutes of Health (R01DA033147, R01DA011591, and R01DA021525).
• Keywords: Policing; HIV RISK; Territorial stigmatization; Area restrictions; Harm reduction; VIOLENCE; POLICE; SOCIAL-CONTROL; DOWNTOWN EASTSIDE; STIGMA; Qualitative GIS; SPACE; Public, Environmental & Occupational Health; Science & Technology; Life Sciences & Biomedicine; PLACE
• Research Categories: Sociology, Public and Social Welfare; Health Sciences, Public Health

Abstract

Area restrictions prohibiting people from entering drug scenes or areas where they were arrested are a common socio-legal mechanism employed to regulate the spatial practices of people who use drugs (PWUD). To explore how socio-spatial patterns stemming from area restrictions shape risk, harm, and health care access, qualitative interviews and mapping exercises were conducted with 24 PWUD with area restrictions in Vancouver, Canada. Area restrictions disrupted access to health and social resources (e.g., HIV care) concentrated in drug scenes, while territorial stigma prevented PWUD from accessing supports in other neighborhoods. Rather than preventing involvement in drug-related activities, area restrictions displaced these activities to other locations and increased vulnerability to diverse risks and harms (e.g., unsafe drug use practices, violence). Given the harms stemming from area restrictions there is an urgent need to reconsider this socio-legal strategy.