International Journal of Drug Policy - 2014

Volume 25 Issue 3 May 2014

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R. McNeil et al. / International Journal of Drug Policy 25 (2014) 608–615 613 obtaining food and shelter) or generate the income necessary to support continued drug use (e.g., sex work, stipended volunteer work). Many marginal men had limited involvement in the street- based economy, and their limited access to money meant that they were dependent upon these programs to obtain material resources, medical care, and social support that allowed them to survive within the context of entrenched poverty. Nearly all of the women that we interviewed engaged in sex work, and leveraged these organizations to increase their safety while working. Some women indicated that they worked primarily in close proximity to these organizations to limit their exposure to more dangerous drug scene milieus. Several women were also living in women-only housing programs that function as safer sex work environments (n.b., these programs have been described in detail elsewhere; see Krusi et al., 2012), and the availability of these supports was crucial in estab- lishing a space for them. Crossing boundaries—The need to enter drug scene milieus Among women and marginal men, there was a stark contrast between dangerous drug scene milieus characterized by gendered violence and safer areas located within their geographies of sur- vival. These areas were separated by clearly defined boundaries that were only crossed under extreme duress, primarily when unable to obtain drugs from usual sources or as necessary for income-related reasons (e.g., cashing social assistance cheques). Participants described themselves as "stressed" when they were compelled to venture into these dangerous drug scene milieus, and emphasized how these border crossings increased their vulnerabil- ity to male perpetrated violence. For example, "David", who was in is late forties, was in a motorized wheelchair due to a stroke, and had frequently been "ripped off" by men in the DTES. While David regularly exchanged prescribed oxycodone for hydromor- phone with his longstanding dealer, he was sometimes unable to obtain his preferred drug in this way. The potential for opi- ate withdrawal led him to incur considerable risk by venturing into dangerous drug scene milieus where he had experienced violence. Once I get down to that area [i.e., high traffic area in drug scene where prescription drugs are sold], I have to watch for people watching to see what I got. . .The only reason I'm there is if my regular connection [drug dealer] doesn't have pills, and I'm forced to go down there to look for pills. . .Security is one of the reasons [for avoiding this area]. . .You just never know if they're going to follow you and jump you. Mary, a twenty-something Aboriginal woman who had been entrenched in the street-based drug scene since her early teens, was frequent the target of predatory men seeking control over the resources that she generated through sex work. Mary worked primarily in the area immediately surrounding her single room occupancy hotel, which functioned as a safer sex work environ- ment (see Krusi et al., 2012), and spoke negatively of "ruthless" drug scene milieus west of Main Street. Nonetheless, there were income-related reasons why she had to occasionally cross this boundary. Everybody's so fucking ruthless and cold down there [i.e., west of Main Street]. [. . .] They'll fucking stab you if they wanted some- thing you have. . .They try their hardest to fucking bring you down 'cause they don't want to see you doing better than them. [. . .] If I go past Main [Street], it's like, "Ho, where's my fucking money?" or "give me that!" Down there it's all negativity and violence and money and bullshit. I don't want [that], don't need [that]. . .I don't go past Main [Street unless] it's for something that, like, I have to have to. Then, I will. Like, on Mondays, I go to the cheque cashing place on Main. . . [That is] the only time I go on that side of Main. Other than that, I don't even bother. As these cases demonstrate, within the situated rationality of women and marginal men, there were instances when it was nec- essary to cross boundaries and enter potentially violent drug scene milieus. Notably, none of our participants cited accessing harm reduction services as a motivation for crossing these thresholds, despite the fact that the area immediately surrounding Insite was the most commonly avoided area. It was striking that most of our participants indicated that they rarely injected at Insite because they avoided the area and approximately one third had never injected at Insite, underscoring how gendered drug scene violence was critical in constraining access to these services. For exam- ple, "Alice", a homeless woman in her late twenties engaged in sex work, had recently been attacked on the same block as Insite. Whereas she avoided the area surrounding Insite because it was perceived to be dangerous, her need to inject pushed her into other unsafe drug scene milieus. I feel very, very unsafe down by the injection site [Insite]. . . I don't go past Main [Street] anymore. . .There's some very danger- ous dealers down there. . .That's where I was robbed and beaten badly. . .This guy robbed me and beat me up. I don't go there at all [now]. [. . .] If I have to use, I'll use anywhere. I go into the alleys and I feel less safe [there]. Discussion In summary, we found that hegemonic forms of masculinity operating within the DTES perpetuated gendered violence toward women and marginal men, who restricted the geographic scope of their activities to avoid drug scene milieus where they had experienced violence. While some men attributed their geograph- ical restrictions to the need to acquire high-quality drugs, their emphasis on drug scene violence suggested that this allowed them to maintain claims to dominant forms of masculinity while enacting spatial strategies necessary to their safety. Environmental supports provided by health and social care agencies were crit- ical in enabling women and marginal men to negotiate survival within the context of gendered violence. Whereas access to harm reduction services, including Insite, was insufficient to motivate our participants to enter into "dangerous" drug scene milieus, they ventured into these areas when necessary to obtain drugs or for income-related reasons. Our findings point to the central role of hegemonic mas- culinity in subordinating marginalized men, and thus shaping how they negotiate safety and survival within a street-based drug scene. Hegemonic masculinity operated at the symbolic level, in that marginal men seemingly accepted that their lower status within the drug scene rendered them vulnerable to vio- lence. Marginal men's narratives of place in this neighbourhood were interwoven with experiences of violence that profoundly impacted their spatial practices, which were linked to the need to maintain safety from the violence of dominant men within the street-based drug scene. Whereas the hegemonic form of masculinity within the street-based drug scene was tied to the street-based drug economy, men identified violence as its defin- ing characteristic. While the concept of hegemonic masculinity has increasingly been employed to understand men's health (Canetto & Cleary, 2012; Cleary, 2012) and risk-taking (Peralta, 2007), it has received only limited attention in drug use research, where it has focused primarily on the roles occupied within street drug economies (Bourgois, 2003; Hutton, 2005) and specific

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