Peer Syringe Exchangers: Licit Practices Transformed in an Illicit Field

• In Event: 296 - Section on Alcohol, Drugs and Tobacco Roundtables (one-hour). Table 01. Networks and Substance Use
  In Refereed Roundtable: Table 03. Substance Use and Interventions

Abstract

Why do some injection drug users act as peer exchangers, and distribute syringes into the community? Research into peer exchange has focused on the frequency and ubiquity of the practice. Little research has explored the meanings or motivations ascribed by peer exchangers to their actions. I propose that peer syringe exchangers carry remnants of their previous exposure to legitimate institutions of work and school with them into a social structure that offers few opportunities for employment. Acting as peer exchangers allows them to transfer their habitus of legitimate work, particularly of care work, into the illegitimate field of injection drug use. For this paper, I analyzed 23 in-depth semi-structured interviews of peer exchangers. These interviews of 1 to 2 hours were conducted in San Francisco in 2013. They covered life history, demographic information, social networks, drug use, arrest, education and employment history, exchange behavior, and income generating strategies. I found that seventeen of the twenty-four peer exchangers in this preliminary study had legitimate employment or pursued higher education before they fell into drug use and poverty, and eleven of the twenty four had employment or training in the health care field. The peer exchangers distribute syringes to their friends, neighbors, loved ones, and acquaintances because they gain self-respect through their role as informal health care workers who aid their community. Further, the types of discourses they hold about their practices shape the amount of health safety information they disseminate into the injection drug users community.

Author

• Sarah Brothers, Yale University