Navigating post-eviction drug use amidst a changing drug supply: A spatially-oriented qualitative study of overlapping housing and overdose crises in Vancouver, Canada
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Background North American cities are experiencing intersecting housing and overdose crises as illicit drug markets become marked by the proliferation of fentanyl and methamphetamine. Despite recent research documenting associations between evictions and drug-related risks and harms, including overdose, the mechanisms through which these occur remain poorly understood. This study to examines how evictions shape the drug use practices of people who use drugs in Vancouver's Downtown Eastside - a neighbourhood with an established drug scene - as the illicit drug supply changed. Methods Qualitative interviews and geo-spatial data collection were conducted with 56 recently evicted PWUD. Data were analyzed by interfacing qualitative and geo-spatial data, and interpreted focusing on how structural vulnerability shaped spatial practices and drug-related risks post-eviction. Results Findings demonstrate how post-eviction spatial practices and routines produced risk and harm as participants navigated the uncertainties of housing vulnerability and drug supply changes. Post-eviction disruptions complicated participants' ability to engage with trusted drug sellers. Changes to spatial patterns and access to private spaces rendered public drug use inevitable, though this was mitigated to some degree by harm reduction supports. Abrupt changes to drug use patterns occurred due to post-eviction disruptions and included instrumental uses of methamphetamine to increase alertness and navigate survival amidst severe hardship. Conclusions Findings demonstrate how post-eviction changes to routines and spatial patterns are framed by structural vulnerability and can exacerbate drug-related harms, particularly in the context of a changing drug supply. There is an urgent need for structural interventions and harm reduction responses to mitigate harms associated with evictions.
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Routine drug testing to screen or monitor for stimulant use in primary care and other general medical settings can degrade trust, particularly when performed without patient permission.
“it can degrade trust, particularly when such testing is performed without patient permission.173”
From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [173]
The Results discuss post-eviction stimulant use and the risks of using drugs in public; the Discussion addresses structural vulnerabilities and trusted drug sellers. Searches for clinical drug testing, patient permission, and trust found no passage about screening or monitoring in medical settings. (LLM, conf=0.76)
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- Authors
- McNeil, R., Fleming, T., Collins, A. B., Czechaczek, S., Mayer, S., & Boyd, J.
- Affiliations
- Yale University (US)
- University of British Columbia (CA)
- Brown University (US)
- British Columbia Centre on Substance Use (CA)
- Corresponding author
- McNeil, Ryan
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2021-05
- Volume
- 222
- Pages
- 108666
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC8117050
- OpenAlex
- W3136415826
- Cited by
- 30
- References
- 68
- Citations by year
- 2026: 9 · 2025: 6 · 2024: 9 · 2023: 3 · 2022: 2 · 2021: 1
- FWCI
- 2.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- eviction, drug users, drug overdose, housing crisis, spatial practices, harm reduction, fentanyl, methamphetamine, Downtown Eastside, Vancouver, structural vulnerability, public drug use, drug sellers, survival strategies
- MeSH terms
- Canada, Housing, Humans, Illicit Drugs, Substance-Related Disorders, Drug Overdose
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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