An Ethnographic Study of Women Who Use Intravenous Drugs, Their Subculture and Interpretation of Health: Implications for Nursing

The results portray a life that closely resembles that which is known, but also the findings enable a lens into (a) the vicious circle associated with obtaining drugs and survival, (b) the violence, both systemic and personal, that homeless, urban-living women who use intravenous drugs (WUID) in Canada endure, and (c) the importance of “being clean” that directs much of their activities and presentation. From a theoretical perspective, the study enabled a deepened understanding of the importance of the continuum of cleanliness and how it interfaces with what the women believe. In summary, WUID have received unjust opportunities to care for themselves given the current laws and stigmatization that forces them to remain hidden, perform illegal activities, avoid discrimination, and fend for themselves in a world that perpetuates the hegemony of white middle-class Western peoples. The results provide a direction for healthcare in terms of WUID. Primarily there is a need to engage WUID in establishing what would work for them and thus incorporating peers in the process of initiating and maintaining services. Clearly established is a need for drug use to be decriminalized to allow WUID to gain recognition, to avoid criminality, and to re-enter the world that belongs as much to them as any other.