While extensive research has examined alcohol-related harms in university residences, few studies have explored how specific drinking contexts-such as physical location, policies, and broader socio-cultural factors-shape student alcohol use. This qualitative study utilized semi-structured interviews with 25 first-year residential students and 16 staff across two Canadian universities (University of Calgary, Alberta, and Dalhousie University, Nova Scotia) to investigate how intersecting social, physical, economic, and policy environments contribute to university residences as risk and/or enabling environments. Drawing on Rhodes's risk environment framework, the analysis identified three themes: (1) Navigating tensions between policies and the physical and economic environments; (2) Shaping alcohol experiences through social influences; and (3) Co-creating cultures of care. This research highlights how student residences can reduce alcohol-related harms while fostering cultures of care, health, and well-being. These findings provide deeper insights into peer influence, the promotion of enabling environments, and integrating restorative justice as part of harm reduction strategies.

Safer supply programs (SSPs) have emerged in Canada in a response to the drug toxicity crisis and to the contaminated illicit drug supply. A form of safer supply, injectable opioid agonist treatment (iOAT) programs, provide individuals with access to regulated opioids that are generally self-administered in supervised settings. The implementation of SSPs has been controversial, and gathering additional data on their impact is necessary to inform their future. An iOAT program in New Brunswick, Canada, was evaluated from the perspectives of individuals accessing the program, to better understand program experiences, impacts, and barriers. Semistructured interviews were completed with iOAT participants (N = 21) who had been in the program for approximately six months. An Interpretive Phenomenological Analysis was used to understand the experiences of participants in the program. Participants reported positive experiences that were associated with the program's low-threshold and nonstigmatizing environment. Impacts such as improvements in mental health, increased financial stability, decreased engagement in criminal activities, and reduced use of substances from the illicit market were reported. Challenges associated with program involvement included inadequacies in the strength of available medications, negative impacts from interruptions to safer supply (e.g., from being arrested or hospitalized), and barriers to access (e.g., transportation and daily attendance). The findings from this study demonstrate the importance of SSPs as a vital option in the care of people who use drugs and identify the need for wraparound health services as well as increased continuity of care from SPPs to services available in healthcare and criminal justice settings.

Police officers have long been tasked with translating drug policies into practice; as a key public-facing side of the criminal justice system, they influence how drug policy messages are conveyed to the public through everyday enforcement practices. The government of British Columbia, Canada, received a 3-year exemption from federal drug laws to decriminalize the possession of small amounts of most illicit substances starting January 31, 2023. In this context, we explored what people who use drugs learned from drug policy as it was taken up into policing practice. We use constructs from curriculum theory as a framework to understand what policing explicitly and implicitly communicates to people who use drugs. We analyzed 40 qualitative interviews with people who use drugs in socioeconomically stable positions (housed and employed) in the first year of decriminalization in British Columbia to understand lessons gleaned from policy and policing in this policy context. Findings show that the formal curriculum of drug policy provided a sense of relief for many participants who could ease their fears of being labelled "criminals." However, the way that drug policies were applied by officers in practice, making explicit a hidden curriculum, shaped how participants saw themselves and other people who use drugs in ways that were stigmatizing. Our research shows the value of analyzing the hidden curriculum of drug policy to illuminate how it shapes the way in which people who use drugs construct and position themselves.

The work of sociologist Howard Becker has been used extensively to study and theorize the experience of using cannabis for recreational purposes and more recently, the experience of using cannabis for medical purposes. Building on recent research that uses Becker's work to study and theorize the process of becoming a medical cannabis use r, we extracted and analyzed interview data from a larger qualitative case study of low-threshold access points (i.e., medical dispensaries and cannabis clubs) in British Columbia (Canada). The majority of participants were 50 years or older, had an annual income of less than $30,000, listed disability assistance as their primary source of income, and were renting a room or an apartment. Educational level was distributed across the sample and gender representation was close to balanced with seven cisgender women and five cisgender men. All of the participants identified as White (European descent). In terms of cannabis consumption, the majority of participants reported using daily and indicated a preference for ingesting cannabis, followed by smoking and applying topically. Our theory-informed analysis suggests that becoming a medical cannabis user is a process that requires low-threshold access to community, medicine, and space-three domains across which learning unfolds, in relationships (with staff and peers) and in response to health and social needs. Our analysis also points to three categories of learning: learning about medical cannabis, learning to medicate, and learning to substitute. Overall, our findings indicate that learning across all three categories and low-threshold access to community, medicine, and space go hand in hand in the process of becoming a medical cannabis user-thus generating new theoretical insights and empirical avenues. The findings also raise important questions about the closure of low-threshold access points in British Columbia and the impact of cannabis legalization more generally.

Using a constructivist grounded theory design, this study explores the perception and experience of Iranian women living with drug use, identifying everyday conflicts and coping strategies that enable them to manage their situation. We conducted unstructured, in-depth interviews with abstinent drug users (11) and healthcare professionals (2) at three rehab centers in Tehran, Iran. In line with our grounded theory aspirations to explore the social meanings of women's drug use and addiction, we supplemented the interviews with a surrounding material consisting of articles published in the main national newspaper from 2015 to 2018 and a film documentary (10 parts, 3 h) entitled "Iranian Women of Addiction," (Shab boohay-e-sokhteh) (2010-2011). Our analysis resulted in two main bundles of meaning-making that we claim are permeating the everyday lives of Iranian women with drug use: the double decline in character, and self-shielding. The study reveals the simultaneous presence of two stigmatized identities: drug use and sex work (fahsha). It shows that the stigma of sex work is closely connected to a drug-related identity, irrespective of whether women are actively involved in sex work or not. The findings illustrate how societal views are biased against drug user women in the domain of drug use, diminishing their presence and voice. The interviewees tried to manage by developing a peer network, adopting a protective role, and becoming intrinsically motivated to quit drug use. The study furthers our understanding of women's alarming and complex realities in traditional Islamic and familistic patriarchal structures.

Numerous cities are experimenting with pre-booking diversion programs that allow police officers to divert community members to supportive services in instances that would otherwise result in arrest and prosecution. These programs aim to decrease harmful involvement with the criminal justice system while reducing crime and public disorder. Although previous research has explored the experiences of people receiving diversion referrals and of police officers initiating them, none have examined the perspectives of community members who can offer crucial insights into planning, evaluation, and implementation barriers. We administered a survey to 293 people living in four police districts where the Philadelphia Police Department operates a pre-booking diversion program. The survey explored residents' perspectives on the program as well as their broader views on associated issues like decriminalization of substance use, sex work, and minor theft. Bivariate χ2 tests and multivariate logistic regression examined differences in responses between subgroups. Perspectives were diverse and varied based on demographic attributes of the respondents as well as on district level attributes, like crime patterns. Most surveyed community members perceived pre-booking diversion to be a valuable tool for improving the experiences and outcomes of policing. However, residents living in areas with more crime and with more public disorder held significantly less positive perspectives. Their skepticism may reflect the possibility that pre-booking diversion and similar reforms are necessary but not sufficient to transforming individual health and public safety in some areas.

Community-based models of cannabis cultivation, distribution, and consumption-such as cannabis clubs-have been documented across Europe, North America, South America, and New Zealand since the 1990s. For the most part, these models have a history of operating outside existing legislation and regulations. Jurisdictions that have legalized cannabis have approached community-based models in opposite ways (eliminate vs. regulate). Canada legalizing cannabis has resulted in more stringent enforcement and concerted efforts to close these models despite documented health and social benefits. This paper presents a case study of the Victoria Cannabis Buyers Club (VCBC) and its consumption space-The Box. We conducted a survey of VCBC members to explore four domains: demographics, cannabis consumption, access to and use of The Box, and the impact of its temporary closure due to COVID-19. From the survey data (n = 104), descriptive statistics were generated and three conceptual avenues were identified. The majority of respondents were 40 years old and older and identified as White (European descent) cisgendered men and women. The majority reported an income of $40,000 or less and a housing status that prevented them from smoking. Close to 75% of our sample consumed cannabis multidaily for therapeutic purposes primarily, but also for a mix of recreation, social, spiritual, and traditional healing purposes. Smoking was the preferred mode of consumption. Respondents accessed The Box daily or weekly. Reasons and benefits for using The Box fell into three categories: public health, harm reduction, and wellness perspectives. Conceptually, we found that The Box acted as a therapeutic space and offered a much-needed consumption space for smokers. We also identified a need to unpack the concept of safety. Overall, the survey reinforces the need for an equity-informed approach to community-based models and cannabis consumption spaces in Canada.

Social equity provisions in cannabis legislation are premised on the hope that the profit generated around adult-use cannabis can be leveraged to ameliorate the damage done by racially biased enforcement of prohibition in black and brown communities. As such, they encapsulate an attempt to reconcile the history of racism in the enforcement of cannabis law through its new future as a profit generating commodity. These programs are gaining traction, but with minimal empirical examination. The development and implementation of these programs raises a number of questions in need of study that we outline in this paper. We argue that Creary's concept of bounded justice-which critiques the inherent limitations of social justice projects that ignore structural forms of social exclusion-can provide a framework for critical understanding of the limitations of such programs, ethnographically grounded empirical research, and a framework for evaluating the justice impacts of legislation. Specifically, we argue that in order to interrogate the possibilities for social justice projects around cannabis, we must address equity at a deeper level by working with communities to investigate hyper-localized and historical factors that have influenced systems and structures.

Historically, overpolicing of some racialized and Indigenous groups in Canada has resulted in unequal application of drug laws contributing to disproportionate rates of charges and convictions in these populations. Criminal records severely and negatively impact an individual's life and can perpetuate cycles of poverty and socioeconomic disadvantage. On October 17, 2018, Canada legalized cannabis production, distribution, sale, and possession for non-medical purposes. Advocates of criminal justice reform have raised concerns that Indigenous and racialized people may not equitably benefit from legalization due to unequal police surveillance and drug enforcement. These groups are among priority populations for research on cannabis and mental health, but their views on cannabis regulation have been largely absent from research and policy-making. To address this gap, we asked self-identified members of these communities about their lived experiences and perspectives on cannabis legalization in Canada. Between September 2018 and July 2019, we conducted semistructured interviews and focus groups with 37 individuals in Québec, Ontario, Alberta and British Columbia. During this phase of early cannabis legalization, participants responded to questions about anticipated public health risks and benefits of legalization, how their jurisdiction is responding to legalization, and what community resources would be needed to address legalization impacts. We conducted a thematic analysis and identified five major themes in the data related to race and early cannabis legalization: overpolicing of racialized communities, severity of penalties in new cannabis legislation, increased police powers, and underrepresentation of racialized groups in the legal cannabis market and in cannabis research. Participants discussed opportunities to support cannabis justice, including establishing priority licenses, issuing pardons or expunging criminal records, and reinvesting cannabis revenue into impacted communities. This work begins to address the paucity of Indigenous and racialized voices in cannabis research and identifies potential solutions to injustices of cannabis prohibition.

As harm reduction programs and services proliferate, people who use drugs (PWUD) are increasingly subjected to surveillance through the collection of their personal information, systematic observation, and other means. The data generated from these practices are frequently repurposed across various institutional sites for clinical, evaluative, epidemiological, and administrative uses. Rationales provided for increased surveillance include the more effective provision of care, service optimization, risk stratification, and efficiency in resource allocation. With this in mind, our reflective essay draws on empirical analysis of work within harm reduction services and movements to reflect critically on the impacts and implications of surveillance expansion. While we argue that many surveillance practices are not inherently problematic or harmful, the unchecked expansion of surveillance under a banner of health and harm reduction may contribute to decreased uptake of services, rationing and conditionalities tied to service access, the potential deepening of health disparities amongst some PWUD, and an overlay of health and criminal-legal systems. In this context, surveillance relies on the enlistment of a range of therapeutic actors and reflects the permeable boundary between care and control. We thus call for a broader critical dialogue within harm reduction on the problems and potential impacts posed by surveillance in service settings, the end to data sharing of health information with law enforcement and other criminal legal actors, and deference to the stated need among PWUD for meaningful anonymity when accessing harm reduction and health services.

This paper explores Canadian professionals' engagement in licit, illicit, and pharmaceutical substance use, their perspectives on what constitutes professional misconduct and conduct unbecoming in relation to substance use, and the dilemmas they face around self-disclosure in the context of professional regulation and social expectations. The study involved semi-structured, dialogical interviews with n = 52 professionals. Key findings are: (i) professionals do indeed use and have a history of using licit, illicit, and pharmaceutical substances, (ii) there is lack of consensus about expectations for professional conduct of substance use in one's private life and an apparent lack of knowledge about legislation, jurisdiction of regulatory bodies, workplace policy, and workplace rights, and (iii) professionals use high discretion about personal disclosure of substance use to mitigate risk to public reputation and professional standing. Given the real potential for negative consequences associated with self-disclosure of substance use, professionals modify their use to be more consistent with perceived social standards and/or protect knowledge about their use from public disclosure. This can perpetuate assumptions that substance use by professionals is "unbecoming" and risks basing decisions and policies on incomplete and inadequate knowledge. Societally, classist ideologies that position professionals as distinct from non-professionals are reified.

The impact of COVID-19 itself and societal responses to it have affected people who use drugs and the illicit drug economy. This paper is part of a project investigating the health impacts of COVID-19 related control measures on people who use drugs in Scotland. It examines their roles and decisions as economically situated actors. It does this within a moral economy perspective that places economic decisions and calculations within a context of the network of social obligations and moral decisions. The paper uses a mixed methods approach, reporting on a drug trend survey and in-depth interviews with people who use drugs. It finds they were affected by restrictions in the drug consumption context and changes in the supply context, both in terms of what was supplied and changes in the relationship between sellers and buyers. Face to face selling became more fraught. Participants in more economically precarious circumstances were faced with dilemmas about whether to move into drug selling. The double impact of loss of income and reduced access to support networks were particularly difficult for them. Despite the perception that the pandemic had increased the power of sellers in relation to their customers, many full-time sellers were reported to be keeping their prices stable in order to maintain their relationships with customers, instead extending credit or adulterating their products. The effect of spatial controls on movement during the pandemic also meant that the digital divide became more apparent. People with good access to digital markets and easy drug delivery through apps were in a better position to manage disruption to drug sales contexts. We make recommendations in relation to how policy can respond to the interests of people who use drugs in a pandemic.

Social concern about sexual practices and sexual consent among young adults has increased significantly in recent years, and intoxication has often played a key role in such debates. While many studies have long suggested that alcohol plays a role in facilitating (casual) sexual encounters, intoxication has largely either been conceptualized as a risk factor, or researchers have focused on the pharmacological effects of alcohol on behaviors associated with sexual interaction and consent. To date little work has explored how young adults define and negotiate acceptable and unacceptable levels of intoxication during sexual encounters, nor the ways in which different levels of intoxication influence gendered sexual scripts and meanings of consent. This paper explores the latter two research questions using data from 145 in-depth, qualitative interviews with cisgender, heterosexual young adults ages 18-25 in the San Francisco Bay Area. In examining these interview data, by exploring the relationship between intoxication and sexual consent, and the ways in which gender plays out in notions of acceptable and unacceptable intoxicated sexual encounters, we highlight how different levels of intoxication signal different sexual scripts. Narratives about sexual encounters at low levels of intoxication highlighted the role of intoxication in achieving sexual sociability, but they also relied on the notion that intoxicated consent was dependent on the social relationship between the partners outside drinking contexts. Narratives about sexual encounters in heavy drinking situations were more explicitly gendered, often in keeping with traditionally gendered sexual scripts. In general we found that when men discussed their own levels of intoxication, their narratives were more focused on sexual performance and low status sex partners, while women's and some men's narratives about women's levels of intoxication were focused on women's consent, safety, and respectability. Finally, some participants rely on 'consent as a contract' and 'intoxication parity'- the idea that potential sexual partners should be equally intoxicated - to handle relations of power in interpersonal sexual scripts. Since these notions are sometimes deployed strategically, we suggest that they may serve to "black-box" gendered inequalities in power between the parties involved.