Social context matters: a focused ethnography of Talwin and Ritalin injection in Winnipeg, Manitoba

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Marshall, Shelley G
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BACKGROUND: The non-medical injection use of Talwin and Ritalin (Ts and Rs) is uniquely prevalent in urban centres of the Canadian Prairie Provinces. However, the experiences of people who inject Ts and Rs have remained largely unexplored. By positioning people who inject Ts and Rs as keepers of situated knowledge regarding local drug use trends and the social conditions for drug-related harms and benefits, this focused ethnography explored the social context surrounding the injection of Ts and Rs in Winnipeg. Drawing from the sociology of Pierre Bourdieu, attention was focused on the relations of power at the macro/structural, meso/institutional, and micro/individual levels that shape lived-experience, and conditions for drug-related harms and benefits. METHODS: Semi-structured interviews were undertaken with 36 people who inject drugs. In phase I of the research, 24 people who inject Ts and Rs were interviewed. To further explore the nature of spaces in which drugs were consumed, phase II of the research involved semi-structured interviews with 12 people who inject drugs and had no permanent residence. FINDINGS: The broad social context was shaped by racialized, classed, and gendered relations of power that manifested in institutional practices and mainstream systems of meaning. Medicalization, drug-prohibition, systemic racism, and neoliberal governance were principal influences in the social and material conditions of the local setting. Lived experiences were characterized by structurally disadvantaged social location, high institutional interactions, and elements of habitus and everyday life that influenced drug-related benefits and harms. Key factors involved in these influences included: reproduction and impacts of family separation; social, material, and symbolic aspects of drug consumption spaces; and everyday practices of harm reduction arising from community membership as a significant enabling resource. CONCLUSION: Relations of power in the social context surrounding Ts and Rs injection emerged as significant sources of everyday oppression and harm. Findings reveal the need for public health to work toward significant shifts in the distribution of power and material resources, and the decriminalization of drug use in order to mitigate social, symbolic, and material conditions for drug-related harms. Locally tailored, Indigenous and community-led, culturally safe, and gender-sensitive programs and practices are imperative.
focused ethnography, injection drug use, Talwin and Ritalin, drug use context