YWCA Hamilton’s Safer Drug Use Space (SUS) is one of only two gender-specific safe consumption spaces in Canada, and the only one integrated into an emergency drop-in program. It is widely acknowledged in both the scholarly literature and by social service and healthcare providers that women and non-binary people are vulnerable to violence and coercion when using substances around men. They also have different needs from harm reduction programs that are not always met in all-gender safe consumption sites. Furthermore, the integration of safe consumption sites in emergency shelters and drop-ins has been found to lower the number of drug poisonings in the area. This study sought to build upon this existing body of literature by speaking with service users from SUS about how they have been supported by the program in its first year of operation, and how it could be improved. Five service users were engaged in individual, qualitative interviews conducted by one of the front-line staff at SUS who is also a student at McMaster University. The “in-between” position of the researcher and previously established rapport with the participants generated nuanced insights to come out of these conversations. Four themes came out of the data: (1) the importance of positive service user/staff relationships; (2) staff knowledge and expertise; (3) SUS being considered a “safe” place and like a “home” to service users; and (4) accessibility of the space for service users being a contributor to why people return to SUS. This study revealed that aligning their harm reduction framework to include safe consumption onsite has meant SUS staff and service users develop more trusting relationships with each other. This allows them cooperate in unique ways to keep the community safe and connect service users to necessary social and healthcare supports. / Thesis / Master of Social Work (MSW)

This study explores the experiences of people who have lost loved ones due to socially stigmatized deaths. Drawing from eight individual interviews, the author argues that the stigma associated with death due to drug overdose, suicide, substance abuse, or murder can cause traumatic or prolonged grief and can complicate the way the bereaved talk about grief as a part of their healing process. With the mortality rate in the U.S. rising, there is an epidemic of disenfranchised grief affecting millions of bereaved individuals. Using Coordinated Management of Meaning and Communication Privacy Management theories, the author uncovers strategies the traumatically bereaved employ to manage interactions and relationships with others. A qualitative analysis of participant interviews revealed that social stigma, whether experienced or anticipated, affects the way the bereaved communicate and can cause self-silencing. Findings indicate a need for safe, supportive, and non-judgmental spaces for the traumatically bereaved to share their stories.

No description available.

No description available.

There is increasing concern about hepatitis C virus (HCV) and potential HIV transmission among ethnic Vietnamese injecting drug users (IDUs) in Australia. To date ethnic and cultural differences in vulnerability to blood-borne viruses (BBV) have received little attention and few studies have attempted to explore the role of cultural beliefs and values in influencing injection risk behaviour. This study aimed to systematically explore the cultural beliefs and behavioural practices that appear to place ethnic Vietnamese IDUs at increased risk of BBV infection, identify barriers to this group accessing health and preventive programs, and document antibody HIV and HCV prevalence and associated risk behaviours. The first component of the research consisted of an ethnographic study designed to explore underlying explanatory models of health and illness employed by Vietnamese IDUs and identify cultural influences on risk behaviours and vulnerability to BBVs. These data were subsequently used to inform the development of the instrument used in the second component ??? a cross-sectional survey and collection of capillary blood samples designed to assess risk behaviours and antibody HIV and antibody HCV prevalence. Analysis of data from both components indicates that cultural beliefs and practices influence risk-taking and health-seeking behaviours and suggests pathways through which this influence occurs. Relevant cultural characteristics include those pertaining to spiritual and religious beliefs, the role of the family and traditional Vietnamese family values, cultural scripts of self-control and stoicism, the importance of ???face??? and non-confrontational relationships, trust and obligation, and a reluctance to discuss problems with outsiders. Vulnerability to BBVs is influenced by these cultural characteristics, together with Vietnamese IDUs??? perceptions of risk, knowledge about HIV and HCV, and situational and environmental factors. Main factors contributing to the under-utilisation of health services include the use of self-managed care practices, ambivalence surrounding Western medicine, long waiting times, concerns in relation to confidentiality, stigmatisation of drug use, and limited knowledge of BBVs. The data indicate a need for interventions based on understanding of culturally specific meanings and contexts of health, illness and risk in order to better meet the needs of this vulnerable group.

There is increasing concern about hepatitis C virus (HCV) and potential HIV transmission among ethnic Vietnamese injecting drug users (IDUs) in Australia. To date ethnic and cultural differences in vulnerability to blood-borne viruses (BBV) have received little attention and few studies have attempted to explore the role of cultural beliefs and values in influencing injection risk behaviour. This study aimed to systematically explore the cultural beliefs and behavioural practices that appear to place ethnic Vietnamese IDUs at increased risk of BBV infection, identify barriers to this group accessing health and preventive programs, and document antibody HIV and HCV prevalence and associated risk behaviours. The first component of the research consisted of an ethnographic study designed to explore underlying explanatory models of health and illness employed by Vietnamese IDUs and identify cultural influences on risk behaviours and vulnerability to BBVs. These data were subsequently used to inform the development of the instrument used in the second component ??? a cross-sectional survey and collection of capillary blood samples designed to assess risk behaviours and antibody HIV and antibody HCV prevalence. Analysis of data from both components indicates that cultural beliefs and practices influence risk-taking and health-seeking behaviours and suggests pathways through which this influence occurs. Relevant cultural characteristics include those pertaining to spiritual and religious beliefs, the role of the family and traditional Vietnamese family values, cultural scripts of self-control and stoicism, the importance of ???face??? and non-confrontational relationships, trust and obligation, and a reluctance to discuss problems with outsiders. Vulnerability to BBVs is influenced by these cultural characteristics, together with Vietnamese IDUs??? perceptions of risk, knowledge about HIV and HCV, and situational and environmental factors. Main factors contributing to the under-utilisation of health services include the use of self-managed care practices, ambivalence surrounding Western medicine, long waiting times, concerns in relation to confidentiality, stigmatisation of drug use, and limited knowledge of BBVs. The data indicate a need for interventions based on understanding of culturally specific meanings and contexts of health, illness and risk in order to better meet the needs of this vulnerable group.

Självdestruktiva handlingar innebär att medvetet tillfoga sig skada. Hos personer som avsiktligt självskadar sig är suicidtankar vanligt förekommande men syftet kan vara ångestlindring och uttryck för psykiskt illabefinnande. Mellan 2005-2014 vårdades 77371 personer inom slutenvård på grund av avsiktlig självdestruktiv handling och risken för suicid är höjd efter en självdestruktiv handling. Syftet med denna studie var att undersöka intensivvårdssjuksköterskans upplevelse av att vårda patienter som avsiktligt överdoserat läkemedel i självdestruktivt syfte. Fem kvalitativa intervjuer med semistrukturerad intervjuguide analyserades med innehållsanalys och materialet utmynnade i fem kategorier samlade under ett tema: Att vilja men inte alltid kunna. Kategorierna var: Att känna hjälplöshet i den psykiatriska omvårdnaden, Att ha kännedom om patientens sammanhang, Att prioritera bort samtal, Att attityder påverkar samarbetet med kollegor, Att ha behov av samverkan och stöd från psykiatrin. Studien visade att upplevelsen av att vårda patienter som överdoserat läkemedel i självdestruktivt syfte påverkades av patientens bakgrund, social kontext och livssituation. Bakgrund i missbruk, låg ålder och kvinnligt kön medförde att handlingen upplevdes mer impulsartad. Upplevelsen av att vårda var komplex och intensivvårdssjuksköterskan kände sympati, frustration och otillräcklighet i omvårdnaden av patienten. Samarbetet på intensivvårdsavdelningen påverkades av attityder inom personalgruppen där intensivvårdssjuksköterskan kände sig ensam ansvarig för samtal kring självdestruktivitet och mående. Det förelåg svårigheter i det multiprofessionella teamarbetet samt i förmågan att uppnå holistisk och personcentrad vård. Intensivvårdssjuksköterskorna upplevde att samarbetet med psykiatrin var bristfälligt och hade negativ påverkan på upplevelsen. Intensivvårdssjuksköterskans upplevelse var att slitas mellan sympati och frustration. Den moraliska stressen kan leda till att patienten får bristfällig omvårdnad och risken för framtida suicid kan öka.

The purpose of this study was to determine the factors that cause resistance in older adults to participation in substance abuse treatment programs.

The COVID-19 pandemic adversely affected the lives of most Americans. People with Substance Use Disorder (SUD) were particularly vulnerable to the negative effects brought on by the pandemic. This study explored the increase in deaths due to opioid overdose during the pandemic exacerbated by factors such as increased stress, decrease in treatment options due to social distancing requirements and facility closures, social isolation, and an increase in spare time. Access to treatment for opioid use disorder (OUD) was interrupted by the measures meant to mitigate the spread of COVID-19. Through a systematic review of current literature, it was demonstrated that existing patients were able to maintain access to care, while few new patients were able to initiate treatment. Telehealth proved to be a vital means of assuring PWUD were able to access life-saving treatment amid a pandemic. Further research is needed to determine whether SUD treatment measures during the COVID-19 pandemic warrants changing the policies long term.

No description available.