Abstract
In 2004, a team comprised of researchers and service providers launched the Safer Crack Use, Outreach, Research and Education (SCORE) project in the Downtown Eastside of Vancouver, British Columbia, Canada. The project was aimed at developing a better understanding of the harms associated with crack cocaine smoking and determining the feasibility of introducing specific harm reduction strategies. Specifically, in partnership with the community, we constructed and distributed kits that contained harm reduction materials. We were particularly interested in understanding what people thought of these kits and how the kits contents were used. To obtain this information, we conducted 27 interviews with women and men who used crack cocaine and received safer crack kits. Four broad themes were generated from the data: 1) the context of crack use practices; 2) learning/transmission of harm reducon education; 3) changing practice; 4) barriers to change. This project suggests that harm reduction education is most successful when it is informed by current practices with crack use. In addition it is most effectively delivered through informal interactions with people who use crack and includes repeated demonstrations of harm reduction equipment by peers and outreach workers. This paper also suggests that barriers to harm reduction are systemic: lack of safe housing and private space shape crack use practices.
Highlights
The SCORE project was aimed at providing harm reduction services to women and men
The team worked in collaboration with the Safer Crack Use Coalition of Vancouver (SCUC), a group comprised of community outreach workers, women and men who used crack cocaine, and health care providers, as well as the SCORE's Women's Advisory Committee (SWAC), comprised of four women selected from a women's support group run by the Vancouver Area Network of Drug Users (VANDU)
Providing harm reduction education was extremely difficult given the context of people's lives in the Downtown Eastside (DTES)
Summary
The SCORE project was conducted in the DTES of Vancouver, British Columbia. It is one of the poorest neighbourhoods in Canada. Survey (VIDUS) found that crack use in a group of injection drug users in Vancouver almost doubled from 32% in 1997 to over 60% in 2004 [41]. The project drew from community-based research perspectives that aim to create social change and to give back to the community [42] This methodological approach takes into account the lives of those who are acted upon – without erasing their experiences. The team worked in collaboration with the Safer Crack Use Coalition of Vancouver (SCUC), a group comprised of community outreach workers, women and men who used crack cocaine, and health care providers, as well as the SCORE's Women's Advisory Committee (SWAC), comprised of four women selected from a women's support group run by the Vancouver Area Network of Drug Users (VANDU). Our intention was to provide an alternative model of research by including community input from the conception, to the planning, implementation, and writing about the project [25]
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