Authors: Arrthy Thayaparan and Negin Nia, Women’s Health Blog Coordinators | Interviewee: Dr. Jade Boyd, Ph.D., University of British Columbia
Published: October 29th, 2021
News of the opioid epidemic is constant in Canada. But what’s discussed in the media rarely goes beyond the scope of updated death rates and the repeated calls for life-saving policy change. That’s why advocates and researchers, like Dr. Jade Boyd, are essential to change the mainstream discourse and view of the opioid crisis.
As a research scientist at the British Columbia Centre on Substance Use, Dr. Boyd has worked in Vancouver’s Downtown Eastside and across Canada at the heart of the opioid crisis. She has been observing, speaking to and learning from the very individuals affected by this crisis — trying to come up with a solution.
This month on Behind the Science, Dr. Boyd highlights the challenges faced by women and marginalized individuals in the opioid crisis, and what it’s like to work in the midst of an epidemic.
How did you get into this field?
Originally I was interested in dance, visual arts and media-based work, but was always interested in social justice issues and had a hard time kind of combining my art interest with social justice issues.
From an arts background, I moved into gender studies and knew that I had a strong interest in looking at the differences that women might experience in the world in relation to men. Also, the inequities that were coming up were always important to me, particularly for marginalized women, Black, Indigenous, women of colour, poor women, and gender diverse, transgender, and non-binary people.
During my postdoctoral studies, I was doing arts-based research with women who use drugs. There I was looking and trying to do work about resiliency, and some of the amazing things that [women] were managing to do despite all the structural barriers that they're facing in their everyday lives. And from there, I really enjoyed working with women who use drugs, and I was really lucky to work with community groups that were led by their members.
Now I've moved a bit away from the arts and more into health and medicine, and that's just because of the focus on substance use, which has become a passion of mine. It was always a topic in my family growing up and remains important to me throughout my work.
Could you highlight some of your most important findings or highlights from your research?
I think one of the basic things that's important or defines my research is that we want to have equitable, accessible health care and harm reduction that actually meets the needs of people. That's always what I'm looking to help define. Communities already know what works for them, and what doesn't. So amplifying their voices to change those policies to better meet their needs drives my research and anything that I've done.
And of course, the other biggest thing is the fact that women, men and gender diverse people experience substance use and health policies quite differently and are impacted differently. Women have to deal with criminalization and stigma, and fears around child apprehension, and racialized and gendered violence in ways that are different from cis men. Even though we already know that it seems like it continues to be siloed or under-recognized.
My work helps to maintain the importance of seeing what the needs are of those who are underserved because our health policies around harm reduction don't always take women and gender diverse peoples’ needs into account in a fulsome way. So the work that I did look at women and gender-diverse peoples’ access to overdose prevention sites and other new overdose prevention interventions, I think are some of the highlights.
What impact do you hope to see with your work 10 years from now? And what do you hope to see from policy changes regarding the opioid crisis in the future?
I want to see the end of preventable deaths, so I would hope that 10 years from now we would not be in an overdose crisis. That people have access to the supports that they need in order to live well, and experience not top-down, but community-led efforts.
I think that part of that is expanding more holistic approaches that are looking at poverty, systemic racism, and criminalization. Indigenous women have very high rates of overdose compared to non-Indigenous women — that are almost equal to men. They're also over-policed and over-surveilled. So if we don't address our prohibitionist policies and how they intersect with colonialism and misogyny, the stigma that stems from that, housing and wage inequities, or the extra surveillance of women, then we're not going to see a lower overdose death rate.
Ending the criminalization of drug use is key, as it has severe repercussions on the health of women who use drugs. While access to safe, non-toxic pharmaceutical-grade drugs is a step forward, it simply is not enough.
Why is it important to have research looking at both women's health and substance use?
Substance use and the way we deal with it, and the policies around substance use, impact women's health. Women are more likely to hide their substance use because they experience a double stigma.
Both men and women experience stigma related to substances. But women and gender diverse people experience greater stigma because they're not conforming to gender norms. So poor women who have children are going to experience heightened surveillance by social services, especially if they are Indigenous or a woman of colour. They're going to experience it by law enforcement and also if they're experiencing poverty, through housing. So that affects their health in a multitude of ways, and they may be more likely to be criminalized.
If women are more likely to hide their substance use, then they're also at heightened overdose risk, because they might be using alone without the support of someone to help them reverse an overdose. And if they're more likely to be second on the needle, because of gendered power dynamics that already exist in our society, that means that they're more at risk for transmissible diseases. All of those things negatively impact women's health.
I personally don’t think using substances is a health risk, it's the policies around it that increase risk. The way our social and structural environment impacts women who use drugs in creating negative outcomes.
Is there anything else you want to mention? Any inspirations for your work?
Our medical norms and research tend to stem from the male perspective — that's the kind of society that we live in. As I mentioned, we want to ensure equitable and accessible access to all forms of health care. That's why it's important to me to look at diverse women's needs. Because poor women's needs are different from middle-class women, and racialized women's needs are different from women who benefit from white privilege and what is going on there. What are those dynamics? And if we don't have that kind of equitable access to health care, it doesn't work if it's only serving one population.
I'm very influenced by the communities and women that I work with who use drugs. Many of them are engaged in activism if they're able to, and not everybody is, as it falls on them due to government inaction. Their expertise and knowledge, their hard work, resilience, and perseverance in the context of ongoing and constant systemic, and structural barriers that they experience — it's very inspiring.
Early on when I was doing a project with some women who use drugs, they documented what they do in their everyday lives, and all that they were doing. Many had to travel daily to obtain their drugs, on top of all the activist work they were doing while caring for people in their community, while also navigating poisoned drug supplies and income generation. They had this added work to deal with. Doing that work on resilience has been really important to me, but at the same time, many women that I've worked with over the years have passed away — it's heartbreaking. Many of these deaths were preventable because they are the result of our flawed drug policy and ongoing structural violence. And in the midst of all that, people are persevering and doing this hard work to save lives.