Resident and staff experiences of structural barriers to a housing-based overdose prevention site in Vancouver, Canada: “There is a double standard if you smoke”
Bibliographic record
Abstract
OBJECTIVES: Most overdoses in British Columbia (BC), Canada, occur within housing settings. In response, the provincial government is increasingly implementing housing-based overdose prevention sites (HOPS). Within the context of a contaminated drug supply, and changing consumption practices, there is little research examining the effectiveness of HOPS. The aim of this study was to explore qualitatively how residents and staff experience HOPS, focusing on how this intervention fits into the day-to-day operations of a low-barrier housing facility. METHODS: This study was undertaken at a non-profit housing and emergency shelter facility, with a HOPS in Vancouver, BC. We employed rapid-ethnographic methods including six weeks of non-participant observation (> 200 h), three focus groups, 20 informal interviews with residents, and 10 semi-structured interviews with staff. Data were analyzed through an inductive thematic approach. RESULTS: Our results suggest that this facility's HOPS is underutilized due to a variety of structural factors, the most prominent of these being the lack of inhalation services. This lack of service provision exacerbates overdose vulnerability and stigma. Continued drug consumption near the building and in non-monitored areas inside the building creates challenges for staff in identifying potential overdoses and exposes residents who do not consume drugs to drug use within the building. CONCLUSION: Housing provision which provides a safer consumption environment to include those who smoke drugs is urgently needed to support both individuals who smoke and those looking to transition from injecting to smoking.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.010 | 0.004 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".