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Annotated articles: Asset-based approaches

Editor’s note: This post includes clear language summaries of articles based on asset-based research approaches created for Allison Taylor’s EDST 583A: The Political Economy of Education class as part of a Community Action Project.

Brendan Dowd
Masters of Education student
University of Bristish Columbia

Two older people standing together, smiling.

Image by Tristan Le/Pexels

Boyd, S., Ivsins, A., & Murray, D. (2020). Problematizing the DSM-5 criteria for opioid use disorder: A qualitative analysis. International Journal of Drug Policy, 78, 1–10. https://doi.org/10.1016/j.drugpo.2020.102690

By incorporating the voices of members of Vancouver’s SNAP (SALOME/NAOMI Association of Patients) group, this article examines issues with the DSM-5’s criteria for diagnosing opioid use disorder. SNAP is an organization made up of individuals that participated in heroin-assisted treatment programs outside of a clinical trial and works with the Vancouver Area Network of Drug Users.  They want to establish permanent heroin-assisted treatment programs and call for drug reform in Canada. The DSM-5 is the mental health diagnosis manual used to assess if someone meets the criteria for mental illness.

The article criticizes the DSM-5 for having a narrow focus that fails to address wider societal issues that contribute to drug use and instead labels individuals as having severe neurological disorders which continues to stigmatize and demonize drug users. The DSM-5 stereotypes heroin users and reduces their experience with drugs to a few characteristics and fails to recognize a variety of different everyday life experiences that contribute to their drug habit. By labeling individuals with a disorder it takes the focus away from different political and social issues such as homelessness, poverty, violence, stigma and marginalization that all play a major role in why certain individuals develop a heroin habit. Overall, The DSM-5 fails to recognize the complex lived experiences of drug users. The article argues that their drug use should be understood as a habit that is not necessarily good or bad. This difference is important because if heroin use is understood as a habit it requires a much different approach to treatment than when treating a disorder. The article ends by arguing that given the ongoing drug overdose epidemic in Canada, there is a need for alternative ways of understanding drug use and habits that go beyond what is captured through the narrow criteria of the DSM-5.

Crabtree, A., Latham, N., Morgan, R., Pauly, B., Bungay, V., & Buxton, J. A. (2018). Perceived harms and harm reduction strategies among people who drink non-beverage alcohol: Community-based qualitative research in Vancouver, Canada. International Journal of Drug Policy, 59, 85–93. https://doi.org/10.1016/j.drugpo.2018.06.020

This article focuses on the harms faced by those in Vancouver who drink non-beverage alcohol such as mouthwash or hand-sanitizer as well as the harm reduction strategies used to help them. The article used a community based participatory research approach (CBPR)  in order to hear directly from those affected with a common goal of better supporting them in the future. The researchers conducted fourteen town hall meetings with community members and four small group meetings with specific groups. The research was also led by a committee made up of community members who used illicit substances and worked with the Vancouver Area Network of Drug Users. The town hall meetings were limited to those who occasionally drank non-beverage alcohol, so the meetings would not become dominated by drug users who drank alcohol, but instead remained focused on the marginalized community of non-beverage alcohol drinkers.

The meetings found seven main harms faced by this community. These included, unintentional injury, harms to physical health, withdrawal, violence, harms to mental health, reduced access to services and interactions with police. Through speaking with community members, examples of how non-beverage alcohol drinkers were reducing these harms were identified. These included drinking in groups instead of drinking alone, sharing alcohol with others or pooling money, limiting the amount or pace of alcohol consumption, taking care of fellow drinkers and using pharmaceuticals to manage withdrawal.

In addition to speaking about how they were trying to reduce harm, those that attended the town halls also had other suggestions for helping non-beverage alcohol drinkers. These included safe drinking spaces (similar to supervised injection sites) and a managed alcohol program that would provide users with access to alcohol to limit withdrawal. They also argued that having fellow illicit drinkers in control of these programs would help keep services relevant to the community. Finally, they argued for greater education programs run by fellow non-beverage alcohol drinkers for non-beverage alcohol drinkers as well as more education from experts for these individuals. Another suggestion was providing education for service providers delivered by non-beverage alcohol drinkers so that they could be better understood by professionals. A positive benefit of this research was the creation of the Eastside Illicit Drinkers Group for Education which advocates for much of what was outlined in the article. The group was formed when those that attended the town halls continued to meet. The article ends by discussing that the harms and harm reduction strategies of this group are similar to those faced by other drug users and can be tied to larger issues of poverty, structural violence and marginalization from society.

Crier, N., Timler, K., Keating, P., Young, P., Brown, H., & Price, R. (2021). Transformative community: Gathering the Untold Stories of Collaborative Research and Community Re-integration for Indigenous and non-Indigenous Peoples, Post-incarceration and Beyond. Turtle Island Journal of Indigenous Health, 1(2), 30–39. https://doi.org/10.33137/tijih.v1i2.36134

Written by Downtown Eastside community member Nicolas Crier, this article gives an overview of the Transformative Health and Justice Research Cluster and the work they are doing to bring together Indigenous and non-Indigenous peer leaders, academics, community advocates and student trainees to support and empower individuals that have been incarcerated in the Canadian prison system.

The article begins by explaining the high level of incarceration rates among Indigenous people in Canada and says that this is because of ongoing colonial policies that affect Indigenous people in areas like poverty, employment, housing, food insecurity and education. Then, Crier explains his own background and lived experience with being in jail, homeless, and his struggles with addiction. He explains that it was empowering for him to be approached to write this article because it showed that he has an important voice and stories to share. He says that his goal is to show how now is the time for research to include community members and be accountable to the community it serves. He argues that research should work with community members in order to develop supportive programming for Indigenous and non-Indigenous people suffering from the effects of our prison system.

Next, the article explains that the Transformative Health and Justice Research Cluster is a peer and elder led group of academic and peer (community member) researchers, organizational stakeholders and community leaders/advocates who are committed to “transforming research and supporting the health, wellbeing and dignity of all people who are or have been incarcerated in Canada”. Crier then explains the way the organization is doing this starting with leadership and employment opportunities for community members affected by the prison system. Then, he explains the importance of the wisdom and leadership elders bring to the program. After, he discusses the trauma informed practices the organization uses in order to help individuals share their stories and heal. Next, Crier explains the importance of visual art and storytelling for the program. He gives an example of a writing workshop for those with experience in the prison system in order to teach them how to tell their own story and call for change. Finally, he ends by explaining the important role that students play in doing community based research and how they can help make the ideas of those in the community actually happen through meaningful collaboration.

In conclusion, this article explains the important community led work the Transformative Health and Justice Research Cluster is doing in order to make changes to the prison system in Canada and to help those affected. The group does this through peer leadership and employment, elder leadership and wisdom, trauma informed practices, visual art, storytelling and student collaboration.

Damon, W., Callon, C., Wiebe, L., Small, W., Kerr, T., & McNeil, R. (2017). Community-based participatory research in a heavily researched inner city neighbourhood: Perspectives of people who use drugs on their experiences as peer researchers. Social Science & Medicine, 176, 85–92. https://doi.org/10.1016/j.socscimed.2017.01.027

This article focuses on the experience of Downtown Eastside community members who use drugs as peer researchers in community based participatory research projects (CBPR). The article first explains what community based participatory research is and explains how it works before going through some of the positive and negative experiences of fourteen people who have been involved in these projects.

Community based research directly involves members of the community being researched throughout the process in order to ensure that information is accountable and not further stigmatizing or mis-representing a particular group. However, this can look many different ways. Sometimes, CBPR has community members serve as peer researchers where they work with university researchers as a part of the research team. Other times, community members review the final product or advise along the way. The article discusses that having community members involved as peer researchers is the best method. This article used a peer researcher from the start. They helped design the study and how information was collected as well as help interpret the data to make a conclusion. Through this study, all the people interviewed said they supported CBPR because it made sure that information was more accurate and was not taking advantage of people who use drugs or misrepresenting the neighbourhood. They said community members would be more willing to trust the research because the research was created by people that are a part of the community and not outsiders. They also supported it because as a part of the community they know what questions to ask and can make better connections with community members so the work is more authentic. Other benefits they saw were that the CBPR approach made sure that research goals were the same as the goals of the community. They also thought it led to deeper listening and could help the self-esteem of those involved. Some argued that it could also reduce drug use amongst peer researchers and help with employment.

However, they argued that not all CBPR projects are the same. Some do not truly involve the peer researchers and instead give them meaningless tasks. Sometimes, they felt judged and like they were less important than the researcher from the university. They argued that the best CBPR makes peer researchers feel like they are just as important as researchers from the university and warned that when CBPR is not done well it can be another form of exploitation like the projects that do not use this approach. In conclusion, by using a CBPR approach this article interviews former peer researchers to get their perspective on CBPR and looks at some of the positives when it is done well and the negatives when it is not.

Lavalley, J., Kastor, S., Tourangeau, M., Goodman, A., Kerr, T., & Western Aboriginal Harm Reduction Society. (2020). You just have to have other models, our DNA is different: The experiences of indigenous people who use illicit drugs and/or alcohol accessing substance use treatment. Harm Reduction Journal, 17(19), 1–10. https://doi.org/10.1186/s12954-020-00366-3

Through the direct participation of Indigenous community members, this article explores Indigenous people who use drugs or alcohol and their experiences accessing substance use treatment. The researchers partnered with the Western Aboriginal Harm Reduction Society (WAHRS) which is a part of the Vancouver Area Network of Drug Users (VANDU). Throughout the process board members of WAHRS served as community researchers and used Indigenous ways of knowing. In order to hear the experiences of the community, WAHRS led talking circles with local Indigenous people who have had personal experience with addiction treatment in the Downtown Eastside (DTES). A major theme that came from the talking circles was having limited access to substance use care facilities and a lack of support after treatment. The main reasons for having limited access included long wait times, programs that used incompatible and culturally inappropriate methods such as Christian based programs and a lack of peer led and culturally relevant treatment. Participants also expressed the expectation that they abide by program rules that were incompatible with their lifestyle and reinforced the minority status of Indigenous people while privileging non-Indigenous people.

Participants believed that Christian based programs did not recognize the lived experiences and intergenerational trauma faced by Indigenous people due to colonialism and the role Christianity played. They felt that these programs were unable to take their experiences with trauma into account which was problematic as participants shared traumatic stories that contributed to their substance use issues. The article emphasizes that the impacts of colonization are central to the experience of Indigenous people accessing substance use programs and calls for greater trauma informed care that recognizes the strengths of survivors and gives them control over their healing. Related to this, participants called for trauma informed care with an Indigenous focus that was culturally safe and peer led.

In conclusion, this article looks at key barriers to accessing substance use treatment that Indigenous people face and stresses that this is an extension of colonialism and intergenerational trauma.

 

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