“Arrest Us or Consider Us Healthcare”: Towards Understanding The Counter-Conducts of Overdose Prevention Ottawa

Abstract

North America has seen a dramatic increase in overdose deaths since 2016. Cities across Canada have responded to the growing opioid epidemic in a myriad of ways. Safe consumption sites have been one of these interventions, however the uptake of harm reduction services and safe injection sites has been inconsistent across regions leading to a patchwork of care. In the absence of access to sanctioned services, people who use drugs and grassroots activists have developed and administered a host of harm reduction services including unsanctioned injection sites. Ottawa, Ontario was host to one such unsanctioned site run by an organization known as Overdose Prevention Ottawa (OPO). This work provides a case study on OPO, examining their direct actions and rejections of medical practices. Through seven semi-structured interviews with OPO organizers and managers of sanctioned sites, this project aimed to interrogate the contestations of practices, knowledges, and logics which govern substance use and related care. The resulting analyses pertain to the contestations of practices from outside the site, as well as within, exploring relations visibility and invisibility of drug use and public consumption, positioning of medical and experiential expertise, and how protest actions engaged external onlookers. Care practices within the site highlight non-totalizing rejection of medical logics and practices, and articulated care on the fringes of medical regimes. This positioning is explored in a comparative analysis of sanctioned and unsanctioned replacement opioid programs. Ultimately these analyses provide insight into the counter-conducts of Overdose Prevention Ottawa, suggesting alternative practices and logics of care for people who use drugs. I would like to thank Dr. William Walters for his support, feedback, and advice throughout this project. I am grateful for all the ways he has encouraged my intellectual growth through critical reflection and contributed meaningfully to my capacity to undertake this research. Further, I wish to thank Dr. Carlos Novas for his advice, support, and feedback throughout this project -from my proposal through to my completed thesis. I am grateful for his encouragement and the critical lens he has brought to my work. I would also like to extend gratitude to the Department of Sociology for allowing me the opportunity to undertake this research. The Social Sciences and Humanities Research Council has partially funded this work and I greatly appreciate this support. I express my deep gratitude, compassion, and thanks to those who have participated in this work -not only for their contributions to this project, but more fundamentally for the work they have done to shift the landscapes of harm reduction and substance use care in Ottawa. Their efforts have transformed the lives of those around them. I would like to thank those in harm reduction who have come before me, who have radicalized the means through which I care for the community. Thank you for showing me how to love unconditionally, how t...