Navigating Conservative Drug Policy in Ontario's Safe Consumption Sites: A Critical Investigation of Harm Reduction Policy and Practice
Bibliographic record
Abstract
As harm reduction is increasingly integrated into social and health services and programs, it is essential to recognize the tension between healthcare provided by mainstream institutions and the values of harm reduction. Based on ten interviews with frontline staff who work at safe consumption sites in Ontario, Canada, I explore the challenges of providing harm reduction services under the 2018 Progressive Conservative Government’s Consumption Treatment Service (CTS) reform. My study interrogates the sociopolitical assumptions about drugs and drug use within the CTS policy and examines practices of micro-policy implementation by frontline staff. I characterize` harm reduction as an ontological expression rooted in the lived experience of drug use that places value on relationships and depathologizing drug use. I ask how frontline staff respond to the CTS policy if it changes their understanding and practice of harm reduction and how the policy is accommodated, refused, and disrupted? To answer these guiding questions, I turn my attention to investigating Policy Navigation Practices (PNP) which I define as the creative discretion staff use to balance policy implementation in their encounters with guests. I apply critical medical anthropology theory and methodology to analyze public health policy and services for people who use drugs. This research illuminates the gulf between the lived experience of drug use and the Ontario provincial government’s response to the overdose crisis. I prioritize how networks of care emerge in relation to and are embedded into, sociopolitical contexts that force these practices of care into existence. I situate Safe Consumption Sites (SCS) under the CTS policy as a microcosm of two conflicting worldviews about substance use, ideas of health, and forms of care. The findings advance our understanding of policy implementation practices in SCS and harm reduction as a form of care.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.021 | 0.027 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.071 | 0.095 |
| Scholarly communication | 0.015 | 0.007 |
| Open science | 0.005 | 0.011 |
| Research integrity | 0.005 | 0.008 |
| 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".