Annotated articles: Substance use and healthcare

Editor’s note: This post includes clear language summaries of articles on the topics of healthcare and substance use created for Allison Taylor’s EDST 583A: The Political Economy of Education class as part of a Community Action Project.

Katherine Hadley
Masters of Education student
University of Bristish Columbia

A person holds a stress ball.

Image by Matthias Zomer/Pexels.

Elkhalifa, S., Jozaghi, E., Marsh, S. et al. Combining respondent-driven sampling with a community-based participatory action study of people who smoke drugs in two cities in British Columbia, Canada. Harm Reduct J 18, 37 (2021).

This research project is about ways to help people that use drugs use them safely.. The researchers wanted to find out how people with lived experience using drugs can help others limit their use of drugs and help them to use drugs in safe ways. The research project explored information about people who smoke drugs in the Vancouver Downtown Eastside and in Abbotsford, British Columbia. It took place in these two cities because the researchers wanted to find out the differences in support with drug use that is available. Most research about this topic has been about helping people who are using drugs through needles, so this research was focused on people who use drugs by smoking them.

The study found that the two main ways that people who use drugs could be helped with using drugs safely was to have access to the needle exchange program and to have supervised places to use drugs. The researchers found out that people who use drugs in Vancouver knew of more ways to be safe when using drugs than people who use drugs in Abbotsford. For example, people who use drugs in Vancouver knew more about naloxone and First Aid while people who use drugs in Abbotsford talked about more harm related activities such as sharing or reusing crack pipes. The reason that more people in the DTES had safe drug use practices was because of their access to outreach programs and supportive housing. People living in Abbotsford were more likely to report not having a stable or safe place to live.

The researchers found that peer researchers and community peer involvement was helpful and that this type of community research should continue. They also found that more support and attention should be given to people who use drugs in Abbotsford and in other more rural areas as more help and resources on safe drug smoking practices are needed.

Jozaghi, Ehsan; Buxton, Jane A; Thomson, Erica; Marsh, Samona; Gregg, Delilah; Bouchard, Martin (2016). Building New Approaches to Risk Reduction With Social Networks and People Who Smoke Illegal Drugs From Participatory Community-Based Research.

This article looked at how including peer researchers from the communities of people who smoke drugs in the Downtown Eastside (DTES) of Vancouver and in Abbotsford could help to limit the risk of overdosing from drugs and other drug harm. The researchers from UBC hired people from the local communities of the DTES and Abbotsford and gave them paid training before having them go out into their local communities and survey people that they know who smoke drugs. The reason that the researchers had people from the local context do the surveys was because they wanted to limit the stigma that people who smoke drugs can feel. For example, the people being surveyed are likely to be more honest if they don’t feel judged for smoking drugs. This type of research was new in 2016, when this research was done, and is called Community Based Participatory Action Research (CBPAR).

The researchers found that science and research should make healthcare policy improve people’s lives and experiences. This is why they wanted to get honest information from the people that they want to reduce harm for. The research found that people living in the DTES and Abbotsford that do not have a close group of peers are more likely to experience overdose or harm connected to smoking drugs. The researchers found that putting money into training more peer researchers and finding ways to share knowledge through peer networks were practical solutions that could help to save lives and stop people from getting hurt. This study confirmed that allowing people who smoke drugs to feel included in the community and to not feel stigmatized is extremely important to keeping them safe and healthy. It showed that CBPAR is very important when researchers want to learn about a local community.

Jozaghi, E., Vandu, Maynard, R. et al. Access to oral care is a human rights issue: a community action report from the Downtown Eastside of Vancouver, Canada. Harm Reduct J 19, 42 (2022).

The research project took place in 2022 to help people who live in the Downtown Eastside of Vancouver who use drugs and do not have a dental insurance program to cover their care. The researchers explain that having a healthy mouth leads to having a healthy body, so it is important that every person has the basic right of dental care. Many more serious diseases come from having an unhealthy mouth. Making sure that people are able to go to the dentist and have access to safe drug using practices that protect their mouth is important to protecting their entire health. The Portland Community Dental Clinic has been set up in the Downtown Eastside of Vancouver and has two dentists that help 8-12 patients a day who otherwise would otherwise not be able to afford it. The Dental Clinic is also working with students from UBC’s dentist program to help them learn and gain experience. The researchers say that it is very important for Canada to create a country wide dental care program that makes going to the dentist a basic human right for everyone. They explain that if this was the case, then it would cause less people to need to go to the hospital with dental problems. In addition, often when people who use drugs do need to go to the dentist, their teeth may be extracted instead of getting help with fixing their teeth. If people have their teeth removed, it can hurt their self esteem as well as their ability to eat healthy food. Finally, many family members have experienced trauma from losing their loved ones to dental related diseases. Having support with dental care will help to keep the population of Canada and the DTES healthier.

Mendell, J., Richardson, L. Integrated knowledge translation to strengthen public policy research: a case study from experimental research on income assistance receipt among people who use drugs. BMC Public Health 21, 153 (2021).

This article is about a long-term research project based upon The Cheque Day Study that was completed over five months in the Downtown Eastside of Vancouver in 2015. The new study involved working together with people living in the Downtown Eastside, organizations supporting the Downtown Eastside and researchers. The purpose of the study was to find different ways to provide money to people who need help with their income. The problem with the current way is that all people receive the money on the same day which can cause more drug use related harm at that time. The researchers wanted to find out how policy could be changed to improve the health and wellbeing of people receiving money.

The researchers involved local community members in their research to gather their thoughts and opinions on the topic. This type of research is called Integrated Knowledge Translation or IKT for short. This means that the researchers work together for a long time with people involved with what they are studying so that the research can benefit everyone. The researchers found that this type of research that included community members was very important. Community members felt that there was a problem with the way that  income assistance money is currently given out; however, the researchers found it tricky to find specific solutions based on what community members said. There are a lot of roadblocks that happen when you are trying to change the way that the government works, such as giving out income help. The researchers ended by explaining that they found it will be important to do more IKT research in general and on this topic in the future.

Michelle Olding, Kanna Hayashi, Lindsay Pearce, Brittany Bingham, Michelle Buchholz, Delilah Gregg, Dave Hamm, Laura Shaver, Rachael McKendry, Rolando Barrios, Bohdan Nosyk, Developing a patient-reported experience questionnaire with and for people who use drugs: A community engagement process in Vancouver’s Downtown Eastside, International Journal of Drug Policy, Volume 59, 2018, Pages 16-23, ISSN 0955-3959,

This research project looked into how to create a survey  to find out how people who use drugs and live in the Downtown Eastside of Vancouver  experience getting health care. The researchers had talking circles where people could share the main problems that they have when trying to get health care. The researchers found that the participants often put off getting health care because they felt unwelcome and excluded. Often the nurses and doctors did not know how to help them manage their pain, with their addiction, and would cut them off or not fully listen to or help them. They also said that having a lot of Police around the clinics and long wait times were problems. Also, they had a hard time with having enough money to pay for medication, medical devices, and the dentist.

The people taking part in the study said that surveys that use simple, clear, and positive language to describe their needs would be most helpful. The researchers found that Indigenous peoples had the largest challenges with getting good health care because people were often racist and acted culturally unsafe toward them. For example, they might not believe how much pain they were in or not want to give them pain medication. The researchers created specific questions that were created to help Indigenous peoples. In conclusion, the researchers found that people who use drugs are often not included in giving their opinion and feedback about their experience in healthcare.


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