Purpose – Peer harm reduction programmes engage service users in service delivery and may help pe... more Purpose – Peer harm reduction programmes engage service users in service delivery and may help peers to develop employment skills, better health, greater stability, and new goals. Thus far, peer work has not been discussed as an intervention to promote recovery. The purpose of this paper is to provide findings related to two research questions: first,do low-threshold employment programmes have the potential to contribute to positive recovery capital, and if so, how? Second, how are such programmes designed and what challenges do they face in supporting the recovery process?
Design/methodology/approach – Using a community-based research approach, data were collected at a Toronto, Canada community health centre using in-depth interviews with peer workers (n=5), staff (n=5), and programme clients (n=4) and two focus groups with peer workers (n=12). A thematic analysis was undertaken to describe the programme model and to explore the mechanisms by which participation contributes to the development of recovery capital. Findings – The design of the Regent Park Community Health Centre peer work model demonstrates how opportunities for participation in community activities may spark cumulative growth in positive recovery capital within the community of PUDs. However, the recovery contagion of peer work may lose momentum with insufficient opportunities for new and experienced peer workers.
Originality/value – Using the concept of recovery capital, the authors demonstrate how low-threshold employment interventions have the potential to contribute to the development of positive recovery capital.
Preface: Drugs, Homelessness & Health: Homeless Youth Speak Out About Harm Reduction (2010) Youth... more Preface: Drugs, Homelessness & Health: Homeless Youth Speak Out About Harm Reduction (2010) Youth who are homeless in Toronto face many challenges, from meeting basic needs to navigating our complex service system, to finding housing and other supports to help stabilize their lives. These challenges are further complicated for youth who use alcohol or other drugs as they often face discrimination from service providers because of their substance use further marginalizing them from the very supports they need. The Shout Clinic has a long history of providing services to youth who are not well served by the rest of the service system. As part of these efforts, the Shout Clinic has conducted a comprehensive new study that provides important information about the health needs and issues of Toronto youth who are homeless and use drugs. This research reinforces the critical role of harm reduction and other health and social services in supporting youth who are homeless, and recommends str...
Community stakeholders express a range of opinions about supervised injection facilities (SIFs). ... more Community stakeholders express a range of opinions about supervised injection facilities (SIFs). We sought to identify reasons for ambivalence about SIFs amongst community stakeholders in two Canadian cities. We used purposive sampling methods to recruit various stakeholder representatives (n = 141) for key informant interviews or focus group discussions. Data were analyzed using a thematic process. We identified seven reasons for ambivalence about SIFs: lack of personal knowledge of evidence about SIFs; concern that SIF goals are too narrow and the need for a comprehensive response to drug use; uncertainty that the community drug problem is large enough to warrant a SIF(s); the need to know more about the "right" places to locate a SIF(s) to avoid damaging communities or businesses; worry that a SIF(s) will renew problems that existed prior to gentrification; concern that resources for drug use prevention and treatment efforts will be diverted to pay for a SIF(s); and concern that SIF implementation must include evaluation, community consultation, and an explicit commitment to discontinue a SIF(s) in the event of adverse outcomes. Stakeholders desire evidence about potential SIF impacts relevant to local contexts and that addresses perceived potential harms. Stakeholders would also like to see SIFs situated within a comprehensive response to drug use. Future research should determine the relative importance of these concerns and optimal approaches to address them to help guide decision-making about SIFs.
In this commentary, I describe how, through both advocacy and the generation of new knowledge, co... more In this commentary, I describe how, through both advocacy and the generation of new knowledge, community-based medical cannabis dispensaries have contributed to the broader dialogue regarding the legal and safe provision of medical cannabis in Canada. By employing an embodied health movement framework (Brown et al., 2004), this analysis highlights the role of dispensaries in creating new knowledge, challenging existing practices, and advancing their agenda to legitimise cannabis as a therapeutic substance and offer an alternative model for its provision. Although the community-based, holistic approach that dispensaries offer has not been adopted by the Canadian government, dispensaries have achieved success in being recognized as credible stakeholders and experts in the ongoing debate on the legal provision of medical cannabis in Canada.
Background: Supervised consumption facilities (SCFs) aim to improve the health and well-being of ... more Background: Supervised consumption facilities (SCFs) aim to improve the health and well-being of people who use drugs by offering safer and more hygienic alternatives to the risk environments where people typically use drugs in the community. People who smoke crack cocaine may be willing to use supervised smoking facilities (SSFs), but their facility design preferences and the views of other stakeholders have not been previously investigated in detail. Methods: We consulted with people who use drugs and other stakeholders including police, fire and ambulance service personnel, other city employees and city officials, healthcare providers, residents, and business owners (N = 236) in two Canadian cities without SCFs and asked how facilities ought to be designed. All consultations were audio-recorded and transcribed. Thematic analyses were used to describe the knowledge and opinions of stakeholders. Results: People who use drugs see SSFs as offering public health and safety benefits, while other stakeholders were more sceptical about the need for SSFs. People who use drugs provided insights into how a facility might be designed to accommodate supervised injection and supervised smoking. Their strongest preference would allow both methods of drug use within the same facility with some form of physical separation between the two based on different highs, comfort regarding exposure to different methods of drug administration, and concerns about behaviours often associated with smoking crack cocaine. Other stakeholders raised a number of SSF implementation challenges worthy of consideration. Conclusion: Decision-makers in cities considering SCF or SSF implementation should consider the opinions and preferences of potential clients to ensure that facilities will attract, retain, and engage people who use drugs.
Aims: People under age 18 who inject drugs represent a population at risk of health and social ha... more Aims: People under age 18 who inject drugs represent a population at risk of health and social harms. Age restrictions at harm reduction programmes often formally exclude this population, but the reason behind such restrictions is lacking in the literature. To help fill this gap, we examine the perspectives of people who use drugs and various other stakeholders regarding whether supervised injection facilities (SIFs) should have age restrictions. Methods: Interviews and focus groups were conducted with a total of 95 people who use drugs and 141 other stakeholders (including police, fire and emergency services personnel, other city employees and officials, healthcare providers, residents and business representatives) in two Canadian cities without SIFs. Findings: We highlight the following thematic areas: mixed opinions regarding specific age restrictions; safety as a priority; different experiences and understandings of youth, agency and drug use; and ideas regarding maturity, ''help'' and other approaches. We note throughout that a familiar vulnerability-agency dichotomy often surfaced in the discussions. Conclusions: This paper contributes new empirical insights regarding youth access to SIFs. We offer considerations that may inform discussions occurring in other jurisdictions debating SIF implementation and may help remove or clarify age-related policies for harm reduction programmes.
In this commentary, I describe how, through both advocacy and the generation of new knowledge, co... more In this commentary, I describe how, through both advocacy and the generation of new knowledge, community-based medical cannabis dispensaries have contributed to the broader dialogue regarding the legal and safe provision of medical cannabis in Canada. By employing an embodied health movement framework , this analysis highlights the role of dispensaries in creating new knowledge, challenging existing practices, and advancing their agenda to legitimise cannabis as a therapeutic substance and offer an alternative model for its provision. Although the community-based, holistic approach that dispensaries offer has not been adopted by the Canadian government, dispensaries have achieved success in being recognized as credible stakeholders and experts in the ongoing debate on the legal provision of medical cannabis in Canada.
Background: Supervised consumption facilities (SCFs) aim to improve the health and well-being of ... more Background: Supervised consumption facilities (SCFs) aim to improve the health and well-being of people who use drugs by offering safer and more hygienic alternatives to the risk environments where people typically use drugs in the community. People who smoke crack cocaine may be willing to use supervised smoking facilities (SSFs), but their facility design preferences and the views of other stakeholders have not been previously investigated in detail. Methods: We consulted with people who use drugs and other stakeholders including police, fire and ambulance service personnel, other city employees and city officials, healthcare providers, residents, and business owners (N = 236) in two Canadian cities without SCFs and asked how facilities ought to be designed. All consultations were audio-recorded and transcribed. Thematic analyses were used to describe the knowledge and opinions of stakeholders. Results: People who use drugs see SSFs as offering public health and safety benefits, while other stakeholders were more sceptical about the need for SSFs. People who use drugs provided insights into how a facility might be designed to accommodate supervised injection and supervised smoking. Their strongest preference would allow both methods of drug use within the same facility with some form of physical separation between the two based on different highs, comfort regarding exposure to different methods of drug administration, and concerns about behaviours often associated with smoking crack cocaine. Other stakeholders raised a number of SSF implementation challenges worthy of consideration. Conclusion: Decision-makers in cities considering SCF or SSF implementation should consider the opinions and preferences of potential clients to ensure that facilities will attract, retain, and engage people who use drugs.
Purpose – Peer harm reduction programmes engage service users in service delivery and may help pe... more Purpose – Peer harm reduction programmes engage service users in service delivery and may help peers to develop employment skills, better health, greater stability, and new goals. Thus far, peer work has not been discussed as an intervention to promote recovery. The purpose of this paper is to provide findings related to two research questions: first,do low-threshold employment programmes have the potential to contribute to positive recovery capital, and if so, how? Second, how are such programmes designed and what challenges do they face in supporting the recovery process?
Design/methodology/approach – Using a community-based research approach, data were collected at a Toronto, Canada community health centre using in-depth interviews with peer workers (n=5), staff (n=5), and programme clients (n=4) and two focus groups with peer workers (n=12). A thematic analysis was undertaken to describe the programme model and to explore the mechanisms by which participation contributes to the development of recovery capital. Findings – The design of the Regent Park Community Health Centre peer work model demonstrates how opportunities for participation in community activities may spark cumulative growth in positive recovery capital within the community of PUDs. However, the recovery contagion of peer work may lose momentum with insufficient opportunities for new and experienced peer workers.
Originality/value – Using the concept of recovery capital, the authors demonstrate how low-threshold employment interventions have the potential to contribute to the development of positive recovery capital.
Preface: Drugs, Homelessness & Health: Homeless Youth Speak Out About Harm Reduction (2010) Youth... more Preface: Drugs, Homelessness & Health: Homeless Youth Speak Out About Harm Reduction (2010) Youth who are homeless in Toronto face many challenges, from meeting basic needs to navigating our complex service system, to finding housing and other supports to help stabilize their lives. These challenges are further complicated for youth who use alcohol or other drugs as they often face discrimination from service providers because of their substance use further marginalizing them from the very supports they need. The Shout Clinic has a long history of providing services to youth who are not well served by the rest of the service system. As part of these efforts, the Shout Clinic has conducted a comprehensive new study that provides important information about the health needs and issues of Toronto youth who are homeless and use drugs. This research reinforces the critical role of harm reduction and other health and social services in supporting youth who are homeless, and recommends str...
Community stakeholders express a range of opinions about supervised injection facilities (SIFs). ... more Community stakeholders express a range of opinions about supervised injection facilities (SIFs). We sought to identify reasons for ambivalence about SIFs amongst community stakeholders in two Canadian cities. We used purposive sampling methods to recruit various stakeholder representatives (n = 141) for key informant interviews or focus group discussions. Data were analyzed using a thematic process. We identified seven reasons for ambivalence about SIFs: lack of personal knowledge of evidence about SIFs; concern that SIF goals are too narrow and the need for a comprehensive response to drug use; uncertainty that the community drug problem is large enough to warrant a SIF(s); the need to know more about the "right" places to locate a SIF(s) to avoid damaging communities or businesses; worry that a SIF(s) will renew problems that existed prior to gentrification; concern that resources for drug use prevention and treatment efforts will be diverted to pay for a SIF(s); and concern that SIF implementation must include evaluation, community consultation, and an explicit commitment to discontinue a SIF(s) in the event of adverse outcomes. Stakeholders desire evidence about potential SIF impacts relevant to local contexts and that addresses perceived potential harms. Stakeholders would also like to see SIFs situated within a comprehensive response to drug use. Future research should determine the relative importance of these concerns and optimal approaches to address them to help guide decision-making about SIFs.
In this commentary, I describe how, through both advocacy and the generation of new knowledge, co... more In this commentary, I describe how, through both advocacy and the generation of new knowledge, community-based medical cannabis dispensaries have contributed to the broader dialogue regarding the legal and safe provision of medical cannabis in Canada. By employing an embodied health movement framework (Brown et al., 2004), this analysis highlights the role of dispensaries in creating new knowledge, challenging existing practices, and advancing their agenda to legitimise cannabis as a therapeutic substance and offer an alternative model for its provision. Although the community-based, holistic approach that dispensaries offer has not been adopted by the Canadian government, dispensaries have achieved success in being recognized as credible stakeholders and experts in the ongoing debate on the legal provision of medical cannabis in Canada.
Background: Supervised consumption facilities (SCFs) aim to improve the health and well-being of ... more Background: Supervised consumption facilities (SCFs) aim to improve the health and well-being of people who use drugs by offering safer and more hygienic alternatives to the risk environments where people typically use drugs in the community. People who smoke crack cocaine may be willing to use supervised smoking facilities (SSFs), but their facility design preferences and the views of other stakeholders have not been previously investigated in detail. Methods: We consulted with people who use drugs and other stakeholders including police, fire and ambulance service personnel, other city employees and city officials, healthcare providers, residents, and business owners (N = 236) in two Canadian cities without SCFs and asked how facilities ought to be designed. All consultations were audio-recorded and transcribed. Thematic analyses were used to describe the knowledge and opinions of stakeholders. Results: People who use drugs see SSFs as offering public health and safety benefits, while other stakeholders were more sceptical about the need for SSFs. People who use drugs provided insights into how a facility might be designed to accommodate supervised injection and supervised smoking. Their strongest preference would allow both methods of drug use within the same facility with some form of physical separation between the two based on different highs, comfort regarding exposure to different methods of drug administration, and concerns about behaviours often associated with smoking crack cocaine. Other stakeholders raised a number of SSF implementation challenges worthy of consideration. Conclusion: Decision-makers in cities considering SCF or SSF implementation should consider the opinions and preferences of potential clients to ensure that facilities will attract, retain, and engage people who use drugs.
Aims: People under age 18 who inject drugs represent a population at risk of health and social ha... more Aims: People under age 18 who inject drugs represent a population at risk of health and social harms. Age restrictions at harm reduction programmes often formally exclude this population, but the reason behind such restrictions is lacking in the literature. To help fill this gap, we examine the perspectives of people who use drugs and various other stakeholders regarding whether supervised injection facilities (SIFs) should have age restrictions. Methods: Interviews and focus groups were conducted with a total of 95 people who use drugs and 141 other stakeholders (including police, fire and emergency services personnel, other city employees and officials, healthcare providers, residents and business representatives) in two Canadian cities without SIFs. Findings: We highlight the following thematic areas: mixed opinions regarding specific age restrictions; safety as a priority; different experiences and understandings of youth, agency and drug use; and ideas regarding maturity, ''help'' and other approaches. We note throughout that a familiar vulnerability-agency dichotomy often surfaced in the discussions. Conclusions: This paper contributes new empirical insights regarding youth access to SIFs. We offer considerations that may inform discussions occurring in other jurisdictions debating SIF implementation and may help remove or clarify age-related policies for harm reduction programmes.
In this commentary, I describe how, through both advocacy and the generation of new knowledge, co... more In this commentary, I describe how, through both advocacy and the generation of new knowledge, community-based medical cannabis dispensaries have contributed to the broader dialogue regarding the legal and safe provision of medical cannabis in Canada. By employing an embodied health movement framework , this analysis highlights the role of dispensaries in creating new knowledge, challenging existing practices, and advancing their agenda to legitimise cannabis as a therapeutic substance and offer an alternative model for its provision. Although the community-based, holistic approach that dispensaries offer has not been adopted by the Canadian government, dispensaries have achieved success in being recognized as credible stakeholders and experts in the ongoing debate on the legal provision of medical cannabis in Canada.
Background: Supervised consumption facilities (SCFs) aim to improve the health and well-being of ... more Background: Supervised consumption facilities (SCFs) aim to improve the health and well-being of people who use drugs by offering safer and more hygienic alternatives to the risk environments where people typically use drugs in the community. People who smoke crack cocaine may be willing to use supervised smoking facilities (SSFs), but their facility design preferences and the views of other stakeholders have not been previously investigated in detail. Methods: We consulted with people who use drugs and other stakeholders including police, fire and ambulance service personnel, other city employees and city officials, healthcare providers, residents, and business owners (N = 236) in two Canadian cities without SCFs and asked how facilities ought to be designed. All consultations were audio-recorded and transcribed. Thematic analyses were used to describe the knowledge and opinions of stakeholders. Results: People who use drugs see SSFs as offering public health and safety benefits, while other stakeholders were more sceptical about the need for SSFs. People who use drugs provided insights into how a facility might be designed to accommodate supervised injection and supervised smoking. Their strongest preference would allow both methods of drug use within the same facility with some form of physical separation between the two based on different highs, comfort regarding exposure to different methods of drug administration, and concerns about behaviours often associated with smoking crack cocaine. Other stakeholders raised a number of SSF implementation challenges worthy of consideration. Conclusion: Decision-makers in cities considering SCF or SSF implementation should consider the opinions and preferences of potential clients to ensure that facilities will attract, retain, and engage people who use drugs.
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Papers by Rebecca Penn
discussed as an intervention to promote recovery. The purpose of this paper is to provide findings related to two research questions: first,do low-threshold employment programmes have the potential to contribute to
positive recovery capital, and if so, how? Second, how are such programmes designed and what challenges do they face in supporting the recovery process?
Design/methodology/approach – Using a community-based research approach, data were collected at a Toronto, Canada community health centre using in-depth interviews with peer workers (n=5), staff (n=5),
and programme clients (n=4) and two focus groups with peer workers (n=12). A thematic analysis was undertaken to describe the programme model and to explore the mechanisms by which participation contributes to the development of recovery capital.
Findings – The design of the Regent Park Community Health Centre peer work model demonstrates how opportunities for participation in community activities may spark cumulative growth in positive recovery
capital within the community of PUDs. However, the recovery contagion of peer work may lose momentum with insufficient opportunities for new and experienced peer workers.
Originality/value – Using the concept of recovery capital, the authors demonstrate how low-threshold employment interventions have the potential to contribute to the development of positive recovery capital.
discussed as an intervention to promote recovery. The purpose of this paper is to provide findings related to two research questions: first,do low-threshold employment programmes have the potential to contribute to
positive recovery capital, and if so, how? Second, how are such programmes designed and what challenges do they face in supporting the recovery process?
Design/methodology/approach – Using a community-based research approach, data were collected at a Toronto, Canada community health centre using in-depth interviews with peer workers (n=5), staff (n=5),
and programme clients (n=4) and two focus groups with peer workers (n=12). A thematic analysis was undertaken to describe the programme model and to explore the mechanisms by which participation contributes to the development of recovery capital.
Findings – The design of the Regent Park Community Health Centre peer work model demonstrates how opportunities for participation in community activities may spark cumulative growth in positive recovery
capital within the community of PUDs. However, the recovery contagion of peer work may lose momentum with insufficient opportunities for new and experienced peer workers.
Originality/value – Using the concept of recovery capital, the authors demonstrate how low-threshold employment interventions have the potential to contribute to the development of positive recovery capital.