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Open Access Research article

'I guess my own fancy screwed me over': transitions in drug use and the context of choice among young people entrenched in an open drug scene

Danya Fast1, Will Small1, Andrea Krüsi1, Evan Wood12 and Thomas Kerr12*

Author affiliations

1 British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, Canada

2 Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada

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Citation and License

BMC Public Health 2010, 10:126  doi:10.1186/1471-2458-10-126

Published: 12 March 2010

Abstract

Background

There is growing interest in describing the broader risk trajectories experienced by young people who use drugs - that is, in describing the sequences of drug use transitions experienced by youth in relation to evolving understandings of risk and harm. This study sought to examine young people's perspectives regarding the evolution of their drug use in the context of a local drug scene in Vancouver, Canada.

Methods

Semi-structured qualitative interviews with 38 individuals recruited from a cohort of young drug users known as the At-risk Youth Study (ARYS) were supplemented by ongoing ethnographic fieldwork (e.g., observations and informal conversations with youth) conducted within the same cohort population. Interviews were transcribed verbatim and a thematic analysis was conducted.

Results

The majority of youth characterized past transition events as non-exceptional, largely 'spur-of-the-moment' decisions motivated by evolving feelings of curiosity. At the same time, participants' reflections indicated that the social, structural and material contexts of drug scene entrenchment play a powerful role in shaping these decisions and transition experiences.

Conclusions

Importantly, as young people become increasingly entrenched in the local drug scene, drug use transitions seem to constitute increasingly relevant (and even 'inevitable') choices congruent with everyday lived experience. The implications of these findings for the development of meaningful interventions for youth are discussed.