Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Oudshoorn, Abram

2nd Supervisor

Lloy, Wylie

Co-Supervisor

Abstract

This study's primary purpose is to critically appraise current federal and provincial policies regarding supervised consumption sites (SCS), noting intended and unintended consequences; and how these policies could impact SCS users. This study's secondary goal is to compare current policies related to SCS in Alberta, British Columbia, Ontario, and Quebec to provide critical insight and suggestions for ongoing policy development. Carol Bacchi’s (2009) “What is the Problem Represented to Be?” framework was applied to the Canadian policy document with a focus on SCS. Four themes are proposed: Public Health versus Criminality, Presumptions versus Assumptions, Policy Unaccountability, and Policy Duality. It is concluded that Canadian SCS federal policy should be more in line with provincial policy documents that framed substance use as a public health issue and the need for a continuum of care. It should encourage a more inclusive and comprehensive strategy that collaborates better with people who use drugs.

Summary for Lay Audience

The ongoing rise in substance use and related harms in Canada has been a source of concern, prompting the issue to be labelled a "public health crisis of epidemic proportions." Larger factors like public health and economic policies, socioeconomic and structural contexts like poverty, criminalization, social distress, lack of opportunity, unstable housing, substandard living and working conditions, and microenvironments like social relations, drug accessibility, drug user practice, and substance use problems all work together to contribute to the problem.

The implementation of supervised consumption sites (SCS) is one strategy for dealing with Canada's expanding substance use crisis. SCS is a legally licenced site where people can inject and smoke illegal substances under the supervision of trained staff, as part of a harm reduction policy that recognizes that complete abstinence from substance use is not always a realistic goal. The major goal of this research is to examine current federal and provincial policies on SCS, noting both intended and unforeseen implications, as well as how these regulations may affect SCS users. The secondary purpose of this research is to compare current SCS policies in Alberta, British Columbia, Ontario, and Quebec in order to provide recommendations for future policy formulation. Carol Bacchi's (2009) framework "What is the Problem Represented to Be?" was used to assess three federal and five provincial SCS policies.

The study revealed that Canada's current legal framework falls short in terms of being non-discriminatory, avoiding arbitrary decisions, and ensuring that decisions are based on facts. Canadian SCS federal policy should be more aligned with provincial policy documents that frame substance use as a public health issue and emphasize the need for a continuum of care. For the substance use problem to be successfully addressed, it should support a more inclusive and comprehensive strategy that involves those who use drugs as partners.

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