by Carter Hemion, Staff Writer
Content warning: mentions of drug use, overdose, stereotypes against unhoused peoples, and violence against Indigenous communities
From 2003 to June 2021, a program called the Scared Straight Tour made the Downtown Eastside a living tourist attraction. Their original website and Facebook page have been taken down after recent community backlash, but they continue to offer a virtual tour targeting Indigenous youth. These tours invite people to “come and witness first hand just how devastating addiction can be!” through “tours of the worst drug-infested ghetto of North America.” While deterrence-oriented programs intend to change behaviour to lessen the drug poisoning crisis, they cause more harm than good.
Experts Dr. Alissa Greer and Dr. Jamie Livingston weigh in on issues with tactics like these, as well as alternative solutions to reduce the impact of stigma. Greer is an assistant professor at SFU’s School of Criminology, researcher, writer, and independent consultant. Livingston is an associate professor at Saint Mary’s University in the Department of Criminology and an SFU alumnus from both his MA and PhD in Criminology.
Scared Straight Tour
The tour itself is a 48-hour program visiting the Downtown Eastside. Its stated goal is to “give youth (13 and up) a reality check in terms of where they could wind up if they abuse drugs and alcohol.” The program was founded by Pierre Morais, a certified clinical counsellor, with previous lived experience of addiction. He worked as an addiction counsellor before starting the Scared Straight Tour. He believes “any drug use today is extremely dangerous,” especially with the introduction of fentanyl. The Scared Straight Tour is composed of a tour as well as webinars, an online course, videos, and more.
The online course, currently available on the tour website, targets Indigenous youth in particular. It includes videos taken of unhoused people who have used substances, sometimes recorded while people are under the influence of substances. It is unclear whether all those recorded were able to consent to being filmed.
As a whole, the online course was “gamified” for youth to earn points, badges, and places on a leaderboard, which turns the real lives of community members into a game. While Morais may advertise this program with positive intentions about reducing the likelihood of substance use disorders in youth, he presents his message in harmful and misleading ways for profit.
Both Greer and Livingston agree programs relying on fear tactics are ineffective in addressing potentially dangerous substance use behaviour. Greer said they “can be extremely stigmatizing, entrench ‘otherness’ and reinforce negative stereotypes of drug use and people who use drugs that are not rooted in the realities of drugs and drug use.” She added that particular harm comes from programs excluding people who use substances in the processes of developing or delivering the program.
Livingston said deterrence-oriented programs “promote a distorted portrait of substance use” through spreading stigmatizing stereotypes. These often spread the idea that people who use substances lead meaningless and less valuable lives than those who do not. These negative stereotypes are sometimes internalized, which can cause issues that are “detrimental to self-esteem, self-efficacy, hope, and seeking help should they need it.”
Contributing to the stigma around people who use drugs further harms the community. Greer said stigma “inevitably contributes to shame, isolation, and marginalization.” It is “a major driver in the current opioid crisis, and is deeply rooted in the criminalization of drugs.”
Livingston added that research does not support fear-based programs, like the Scared Straight Tour and D.A.R.E., as an effective strategy. He said promoting abstinence-only lifestyles does not account for the majority of people who will use substances and does not help people learn how to make healthy choices for themselves.
Deterrence-oriented programs increase stigma around and harm community members who use drugs, and structural change needs to occur in order to support people with substance use problems.
Both Greer and Livingston offered possible solutions and steps that may lessen the undue harm incurred by people who use substances. Anti-stigma programs cannot only focus on education; they also must address structural issues that create barriers to support and criminalize substance use.
When working towards awareness and comprehensive education, we must listen to and engage with people who use substances. Greer said, “Drug use and people who use drugs are extremely diverse, just like any other behaviour or group of people.” There is a wide range of experiences to listen to, and issues need to be met with empathy. Drug use can bring positive, negative, and mixed experiences. In our own lives, Greer said, “One thing we can do is to actively challenge stereotypes and have frank conversations with the people you are close with to replace negative narratives with evidence and compassion.”
When programs like the Scared Straight Tour focus on prohibition and abstinence, they can conflate substance use disorders with all substance use. Most people who use substances will not develop substance use disorders. Those who do experience problems with their substance use, to any degree, should not be vilified for it. Livingston added, “The goal of anti-stigma programs should be to create a social context in which people aren’t shamed or demonized for developing a health problem and needing help,” and they should “promote hopeful messages that people who do develop a substance use disorder can find support.”
Greer also said one piece of the work to reduce stigma is addressing the “laws and institutions that moralize drug use and say that it’s wrong or bad.” A part of this is supporting initiatives in BC that seek to reduce the stigma around substance use.
Livingston made it clear we “can’t educate our way out of this.” While education is necessary, so is structural change. This includes changing and repealing laws that criminalize and prohibit substance use. It also involves changing social institutions that disproportionately harm people who use substances. Stigma can only be addressed when these changes “rectify inequities and injustices facing people who use substances, which are disproportionately imposed on people belonging to oppressed groups (e.g., Black, Indigenous, living in poverty or with a mental illness).”
Human rights and justice for marginalized people are intertwined with substance use issues. In order to properly support people who have problems with substance use, support must be led with compassion. It cannot be a work of coercion or judgment. Greer said harm reduction needs to centre people who use drugs, and “meaningful involvement and empowerment of people who use drugs is an essential part of any drug policy, education, program, service, or study.”
With the increased risk of toxic or contaminated drugs, harm reduction can help address the drug poisoning crisis. Anyone who uses drugs that have been criminalized may be at risk, whether they develop a substance use problem or not. Harm reduction, according to Livingston, involves “developing safe supply programs for people to access pharmaceutical grade (non-toxic) grade [drugs], increasing investments in harm reduction services (including supervised consumptions sites), decriminalizing illicit substances, increasing access to services in which people can check the toxicity of their drugs, reducing barriers to Opioid Agonist Treatment (e.g., methadone), widespread distribution of naloxone, and increasing access to housing, basic income, peer support, and trauma-informed counselling.”
When any deterrence-oriented program makes a profit off of fear tactics and stigmatizing community members who use substances, it must be opposed with researched solutions. It is imperative to meet people who use substances with empathy and to ensure legislation and community resources meet their needs. Support involves deconstructing stereotypes and harmful social structures while decriminalizing substance use. Most importantly, there must be support for people who use drugs, people with substance use disorders, and unhoused people in the Downtown Eastside. They must have their needs listened to.