Seeking legitimacy for broad understandings of substance use

Substance use and meaning: transforming occupational participation and experience

“…Whereas occupational therapy literature has displayed a myopic attention to meanings deemed positive, literature in the area of substance use has been similarly narrow in focus, though in reverse, endorsing almost exclusively problematized, harmsfocused, negative meanings (Hart, 2021;Kiepek et al, 2019a;Race, 2017). Explorations and interpretations that do not conform to this negative construction are largely silenced (Walker, 2021).…”

Socially Situated Experiences of Substance Use: A Photo Elicitation Pilot Study

“…Substance use research, policy, and practice is critiqued as being predicated on assumptions of individual risk and social harm, prioritizing attention to risk, pathology, and prevention (Bacchi, 2016; Kiepek, Van de Ven et al, 2019). Neglecting to include more diverse experiences of substance use “overlooks, and effectively silences, potentially beneficial and non-problematic substance use which poses little or no risk to the individual or others and does not reflect diverse motives for or experiences of substance use” (Kiepek, Van de Ven et al, 2019, p. 59). Our findings may have implications for informing health professional education by incorporating diverse perspectives, experiences, and interpretations of substance use.…”

“…Internationally, there is very little research that examines substance use outside individualized, problemfocused epistemologies (Kiepek, Van de Ven et al, 2019). Discourses and research are shifting to recognize nonproblematic factors influencing substance use, such as pleasure (Lancaster et al, 2017;Moore, 2008;Nutt, 2012;Race, 2017;Ritter, 2014;Winstock & Nutt, 2013), performance enhancement (Enck, 2014;Kiepek, Harris et al, 2019), spirituality and ceremony (Labate, 2014;Laughlin, 2018;Tedlock & Tedlock, 1975), and enhanced lives (Evans-Brown et al, 2012).…”

“…Alongside normalization of substances to enhance health and well-being, addiction remains a dominant discourse in Canada. A predominance of research about substance use pertains to potential or actual risk for harm and/or substance use disorders (Kiepek, Van de Ven et al, 2019) and politicians and policy makers tend to construct substance use and ''problems'' in specific ways that legitimize certain perspectives, while underrepresenting the voices of those who use substances (Fraser & Ekendahl, 2018). Although Canada is regularly ranked high in terms of overall standard of living, significant pockets of marginalization and disadvantage are experienced in relation to health and substance use (Fraser & Ekendahl, 2018).…”

Performance and image enhancing drug interventions aimed at increasing knowledge among healthcare professionals (HCP): reflections on the implementation of the Dopinglinkki e-module in Europe and Australia in the HCP workforce

“…This includes the need for the inclusion of up to date evidence, organisation support to complete the e-module, the time-consuming nature of completing the module (particularly in working hours), the use of over complex language, and the modules potential to reinforce the stigmatisation of PIEDs. Reflecting on these barriers, it is important to support the design, This need for workforce development in relation to a specific substance or client group is not unique to PIEDs; as a lack of sufficient training and educational opportunities is an issue within the substance workforce more generally (van de Ven et al, 2020b;van de Ven et al, 2020c), and there are difficulties in attracting funding when it comes to PIEDs (Kiepek et al, 2019). Some of these difficulties relate to the assumption that PIED use is necessarily problematic and illicit, which reinforces stigma around substance use.…”