Through their eyes: Listening to 2SLGBTQIA+ youth about their experiences with opioids

A Q & A with BCCSU research assistant Trevor Goodyear

Youth have unique experiences with opioids and the myriad systems of care. That’s especially true for those who identify as 2SLGBTQIA+. Listening to those youth about their experiences with opioids can help inform how programs and services are designed to better support them.

We spoke with Trevor Goodyear, a research assistant with BCCSU and PhD candidate at UBC’s School of Nursing, about a recent photovoice project documenting the experiences 2SLGBTQIA+ youth have with opioids.

Photovoice is a participatory action research method that uses photography and group dialogue as a means to deepen understanding of a community issue or concern.

  1. In your recent article, “Using photovoice to understand experiences of opioid use among sexual and gender minority youth in Vancouver, Canada”, a study was conducted with four individuals to better understand the disproportionately high rates of opioid use amongst 2SLGBTQIA+ youth. Can you tell us more about this work?

Of course. This was a qualitative study tracing 2SLGBTQIA+ youths’ trajectories of using opioids.

A key feature of this work was its use of photovoice, which involved local four 2SLGBTQIA+ youth taking photos to illustrate how, why, and in what contexts they use opioids. This centred the research on what youth felt was most important to them in the context of their opioid use, as they took photos representing issues they wanted to prioritize in research interviews.

  1. Can you tell us about the larger context that brought on the need for this work? Why do you feel that this research is important?

Unfortunately, 2SLGBTQIA+ youth continue to experience inequities related to substance use. This includes disproportionately high rates of opioid use and drug-related harms, such as overdose and criminalization. At the same time, 2SLGBTQIA+ youth have extensive histories of advocacy when it comes to harm reduction and human rights.

In this work, we wanted to draw from local knowledge to develop tailored strategies for supporting 2SLGBTQIA+ youth who use opioids. In doing so, we also aimed to unpack how social issues shape health outcomes for youth facing overlapping injustices. Targeted research such as this can help to inform responsive, equity-oriented intervention.

  1. What did you learn from this research? What do you feel we could all take away from this work?

In this research, opioid use featured as a source of both healing and harm.

Interviewed youth shared sentiments of internalized shame and queer/transphobia, alongside past experiences of “feeling trapped” and “wanting to feel free.” These realities could partly explain disparities in substance use in this group. Importantly, opioid use was also connected to mental health, with youth using opioids to cope with social stress and maintain wellbeing. Often, youths’ experiences of distress were made worse by drug-related harms stemming from contexts of opioid use. These contexts involved vulnerability as a result of poverty, criminalization, stigma, violence, and drug policy inaction.

These insights signal the need for integrated substance use and mental health supports for 2SLGBTQIA+ youth, alongside structural policy interventions.

  1. How does this work inform us on the broader context of substance use amongst 2SLGBTQIA+ individuals? In what ways is it connected to your previous work that yourself and other researchers at the BCCSU have explored together?

Our study enhances understandings of the complexity of opioid use and associated inequities among 2SLGBTQIA+ youth. Intersectional insights, such as those we surfaced are critical to contextualizing health research and practice with 2SLGBTQIA+ people (and others).

This work also builds on our team’s ongoing research with 2SLGBTQIA+ youth who use drugs, led by Dr. Rod Knight. As with our previous work, youth in this study called for support beyond individual interventions to meaningfully protect and promote their health. They called for youth-inclusive decriminalization, safer supply, enhanced income and housing supports, and continued action to address societal inequities impacting 2SLGBTQIA+ communities.

  1. The article mentions that 2SLGBTQIA+ youth within the context of opioid use are fairly under-researched. What are the outcomes you hope to see come from this work?

There is definitely a lack of quality research with 2SLGBTQIA+ youth who use opioids, or drugs in general for that matter. From my perspective, I would like to see more work that is youth-led and strengths-based, for which qualitative research is well suited. I’m especially keen to continue leveraging the sorts of participatory and arts-based methods used in this study.

Moving forward, there is also demand for additional intersectional work addressing overlapping social issues – inclusive of, but not limited to, gender- and sexuality-based inequities – affecting 2SLGBTQIA+ youth who use drugs. We have seen progress, yet much more work remains.

Read the full article here: