International Journal of Drug Policy - 2014

Volume 25 Issue 3 May 2014

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Page 144 of 153

C. Strike et al. / International Journal of Drug Policy 25 (2014) 640–649 645 You know, we have people here that have never been around street stuff, like, you have a guy in here who's like, a lawyer or something, or you know, like a real estate agent, or some- body, like, professional people that have now become ill, who don't, you know, that haven't been around stuff like this. *** "People were tying the doors up, and they were shooting up in their rooms. And they were smoking crack in the closet. There [were] clothes in there, and you're asleep and they could be burning up the closet next to you. You just don't know." Within this contextual arrangement of space, illness, and encounters, the discourse of the violent, predatory drug user was reproduced and reinforced. In keeping with Sibley and Van Hoven's (2009) study of space in a prison, participants often framed drug users as having contaminated both real and imagined spaces and places. However, descriptions of the chaotic and disruptive drug user were contrasted by some participants who talked about the 'good drug user' who is conscientious about their use and consid- erate of other's personal space: The harm reduction rule basically means. . . don't bother other people with your usage. Keep it to a minimum or at least off the property or if it's smoking, in the back. So that will keep it away from inside the house and nobody else has to put up with your situation. These 'good users' tended to use marijuana and were contrasted with crack smokers positioned as 'disruptive.' Interestingly, injec- tion drug use, while a pressing concern in terms of public health, did not emerge as a dominant issue in these interviews. Both marijuana and crack smoking were much more visible because consumption required users to leave, smoke, and come back. In their comings and goings they were likely to interact with other clients and staff: Well, I did marijuana, so I'm relatively a calm person anyhow. But there was a lot of people near the end of my stay, that were really hooked on crack. And everything they did bothered everybody. They were walking in people's rooms, or just annoy- ing in every sense. . . [they] were really obnoxious and taking advantage of everything. And they were stoned out of their head constantly, right? *** . . .most of the people that I know in the house, over the years, are aware of the medicinal benefits of marijuana, even if they don't smoke it. They understand why other people do, even if they don't. I just think it's as big a deal. I don't think marijuana tends to make people violent and agitated and jumpy and aggressive, where other drugs do. In this particular rendering, a 'good' drug user is discrete and uses common space in ways that do not cause disruption or dis- comfort for others. One participant in particular described the way he moderated his crack use, limiting it to special occa- sions and restricting the amount he bought and consumed, as well as making sure to schedule use in a way that would not interfere with medical appointments at Casey House Hospital. This differentiation between acceptable forms of use, includ- ing amongst drug users, has been reported elsewhere (Slavin, 2004). Yet, in community settings drugs users can congregate based on their drug-use preferences and patterns whereas at Casey House Hospital different kinds of users and non-users alike must share the same common, entry/exit, and outdoor spaces. Disrupted place When trying to sort through these narratives about 'deserving' clients, it became apparent that this issue surfaced most often in relation to when substance use of any kind became disruptive in the space. Drug use that negatively influenced an individual's sense of safety and comfort created the most tensions between clients. While some clients who used drugs managed their use discreetly, other participants described encountering disruptive behaviour as a result. The consequence for users and non-users from disrup- tive drug use included feeling badgered for money to help support others' drug use: Yeah, I think you expect to come here, and for me, this place is like a second home. So it was hard for me to feel comfort- able having people, that I knew were doing drugs, or under the influence of drugs, in my home. And people that aren't on drugs can have peace. . . and not worry about. . . being badgered for money and cigarettes all day, every day, over and over. While Casey House Hospital was often described to possess home like qualities or an oasis of healing, clients' health and physical limitations could make it feel claustrophobic at times. Par- ticipants described their frustration with the space when wanting to use or wanting to avoid others' use. This participant describes both sides of the issue: I was in the house for three and a half months, and it was winter. It was miserable, last winter, and cold, so you're trapped. And now you're trapped with some drug users and it was difficult. And then the other [side], their point is sort of like, 'Well, I'm stuck in the house for three and a half months. I have the right to go out and do what I want to do.' So, I don't know. And I don't have any answer really (laugh) to the problem, like the problems that sort of come up. The small physical space often combined with acute illness and limited or no mobility left few refuges from behaviours experienced as disruptive and/or threatening. As well, tolerance for disrup- tions tended to be lower when feeling sick and some participants responded by retreating into their rooms and not engaging with programs: I remember being threatened; I was threatened here, at one point. I know other [inpatients] that were threatened here. You hear about cases where nurses were abused and stuff. You don't like to hear about those things going on in the house [i.e., Casey House Hospital]. I felt at times in the house that I just wanted to keep my head down, and stay in my room and not get involved in the bigger picture, because I felt it was just too dangerous at the point where I was at. You know? The combination of Toronto winter weather, personal health limitations, and the small physical space combined to create con- flict between some clients and a sense of alienation and feeling trapped. Some participants, especially those who were not using drugs, could retreat to their rooms and avoid much of this. How- ever, for those who were using they had to leave their rooms to obtain and use illicit substances because of hospital regulations. As we discuss next, outside of the hospital they were exposed to various dangers.

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