@article{ref1,
title="Having a voice and saving lives: a qualitative survey on employment impacts of people with lived experience of drug use working in harm reduction",
journal="Harm reduction journal",
year="2021",
author="Boyd, Jade and Austin, Tamar",
volume="18",
number="1",
pages="e1-e1",
abstract="BACKGROUND: Ongoing legal and social discrimination, and stigmatization of people with lived experience of drug use (PWLE) continues to contribute to overdose-related  deaths in Canada. The involvement of PWLE working in harm reduction services has  proven effective in decreasing drug-related harms among PWLE; however, there exist  unintended negative impacts. PWLE working in harm reduction services risk  overextending themselves beyond employment parameters (e.g., emotional labor) with  few systems in place (e.g., employment advocacy) for support. While meaningful  participation of PWLE in harm reduction programs is critical to addressing the  overdose crisis, their labor in Canada's overdose response commands further  investigation and recognition. This paper examines some of the benefits and negative  aspects of working in harm reduction among PWLE. <br><br>METHODS: Fifty qualitative surveys  were completed by PWLE working in harm reduction services from across Canada at the  National 2018 Stimulus conference held in Edmonton, Alberta. The surveys focused on  the benefits and negatives of 'peer' employment and recommendations for  organizational transformation through short answer written sections. Surveys were  analyzed thematically using NVivo, informed by critical perspectives on substance  use, with attention to key re-occurring themes on employment equity. <br><br>RESULTS: While  participants described multiple benefits of working in harm reduction services, such  as the valuing of their expertise by fellow 'peers,' growing skill sets, countering  stigma, and preventing overdose deaths, issues of workplace equity were  significantly identified. Stigma, tokenism, workplace discrimination, including  power and pay inequities, as well as lack of worker compensation and benefits were  identified as key factors persisting in the everyday experiences of participants. <br><br>CONCLUSION: Continued exposure to stigma, workplace discrimination, and/or power  imbalances, combined with the impact of high stakes employment (e.g., dealing with  overdose deaths), can have significant consequences for PWLE working in harm  reduction, including burn out. Policy recommendations include large-scale structural  changes that address inequities of hierarchical 'peer' employment for PWLE,  including increased leadership roles for diverse PWLE, pay equity and benefits,  unionization, as well as more supportive working environments attentive to the  intersecting social-structural factors (poverty, criminalization, racism, gendered  violence) impacting the everyday lives of PWLE working in harm reduction.<p /> <p>Language: en</p>",
language="en",
issn="1477-7517",
doi="10.1186/s12954-020-00453-5",
url="http://dx.doi.org/10.1186/s12954-020-00453-5"
}