1. RISKY BUSINESS OR
RISKY ENVIRONMENTS?
Street-Involved Youth, Crystal Methamphetamine
& Mental Health in Victoria, British Columbia
Presented By:
Alexandra Holtom
MA Student
Social Dimensions of Health
Centre for Addictions Research of
British Columbia
University of Victoria
Risky Business? Principle Investigators & Supervisors:
Dr. Cecilia Benoit - Centre for Addictions Research of British
Columbia & Department of Sociology
Dr. Mikael Jansson - Centre for Addictions Research of
British Columbia & Department of Sociology
Dr. Bernadette Pauly - Centre for Addictions Research of
British Columbia & School of Nursing
Saturday, 18 May, 13

2. OUTLINE
Introduction
Data Sets - Risky Business? & Healthy Youth Survey
Research Questions
Background & Context - Street-Involved Youth, Crystal Methamphetamine Use &
Mental Health
Risk Environment Framework
Amending the Risk Environment Framework through Meso-Level Analysis
Timeline
Feedback & Discussion
Saturday, 18 May, 13

3. INTRODUCTION
Topic: Street-involved youth, crystal methamphetamine use
& mental health
Purpose: To shed light on the social and structural changes
needed in order to reduce risk in the environments of street-
involved youth who use crystal methamphetamine and
experience simultaneous mental health struggles.
Saturday, 18 May, 13

4. DATA SETS:
RISKY BUSINESS
Project title:
Risky Business? Experiences of Street-Involvement
Project dates: 2003-2013
Study population: Non-probability sample of 185 street-involved
youth aged 14-19 (average age at first interview: 17.3)
Criteria for enrolment:
~Low level of attachment to parent or guardian
~Low level of attachment to education system
~Low level of attachment to formal economy
~High level of attachment to informal (street) economy
Saturday, 18 May, 13

5. DATA SETS:
RISKY BUSINESS
Recruitment: Work closely with community partners, posters, key
informants, peer-recruitment using respondent-drive sampling
technique
Mixed methods: Closed ended and open ended questions, body
mapping
Panel data: Individuals interviewed in-person repeatedly over time,
following them into early adulthood
Comparison group: Compared street involved youth to random sample
of youth in the same geographical region (Healthy Youth Survey)
Saturday, 18 May, 13

6. DATA SETS:
HEALTHY YOUTH SURVEY
Wave 1: 2003
~Random sampling through phone calls in Victoria
Metropolitan Area
~9,500 homes called, 1,036 eligible
~Youth at home between the ages of 12-18
~852 (82%) parents agreed
~664 (78%) of youth agreed
Wave 2: 2005 (longitudinal follow-up)
Wave 3: 2007 (longitudinal follow-up)
Saturday, 18 May, 13

7. DATA SETS:
COMPARATIVE STATISTICS
Gender (F/M): 54% Risky Business Youth
53% Healthy Youth Survey
Average Age: 17.3 Risky Business Youth
17.7 Healthy Youth Survey
Aboriginal: 33% Risky Business Youth
2.4% Healthy Youth Survey
Heterosexual: 64% Risky Business Youth
89% Healthy Youth Survey
Foster care (ever): 28% Risky Business Youth
<1% Healthy Youth Survey
0%
25.0%
50.0%
75.0%
100.0%
14-15 16-17 18-19 20-21
HYS
RB
Users of marijuana in last 12 months (HYS)
or last 6 months (RB)
Saturday, 18 May, 13

8. RESEARCH QUESTIONS
How can we alter the environments of street-
involved youth who use crystal methamphetamine
to decrease risk factors and increase protective
factors?
What social and structural changes are needed to
improve the environments of street-involved youth
who use crystal methamphetamine?
Saturday, 18 May, 13

9. STREET-INVOLVED YOUTH
Lack of agreed upon definition & numbers are very difficult to
estimate
Include not only youth who live mainly on the street, but also
“couch surfers” who share shelter with intimate partners or
friends, youth who are in and out of government care, and youth
who frequent shelters for people who are homeless/not housed
There are roughly 250-300 street-involved youth, between
the ages of 14 and 24 years old, at any given time in Victoria
(Benoit et al., 2008, p. 329-330)
Saturday, 18 May, 13

10. SUBSTANCE USE
In 2012, 84% of
street-involved
youth used alcohol
and marijuana
within the past 30
days (n=50)
In 2012, 42% of
street-involved
youth used ecstasy
within the past 30
days (n=50)
In 2012, 36% of
street-involved
youth used cocaine
within the past 30
days (n=50)
(n=99, both Victoria & Vancouver)
(Centre for Addictions Research of British Columbia, 2012)
Saturday, 18 May, 13

11. CRYSTAL METHAMPHETAMINE
What is it?
~Psychoactive form of methamphetamine that can bring about feelings of
euphoria, alertness, feelings of endless energy, restlessness,
depression, paranoia, acute psychosis, and sleep deprivation
~Negative consequences of use include deteriorating physical and
mental health, neurological damage leading to impairments in social-
cognitive functioning, social isolation, anxiety, depression, and
physical harm
(Homer et al., 2008)
Common street names: “jib”, “crystal”, “chalk”, “black beauties”, “batu”,
“quick”, “poor man’s cocaine”, “tina”, “tweak”, “yaba”, “yellow bam”,
“shabu”
Saturday, 18 May, 13

12. CRYSTAL METHAMPHETAMINE
In 2008, 17% of street-involved youth used crystal
methamphetamine within the past 30 days (n=487)
In 2012, 40% of street-involved youth used crystal
methamphetamine within the past 30 days (n=50)
(CARBC, 2008 & 2012)
Most street-involved youth said they used CM to stay awake
to protect their belongings, to enhance social
interactions, to cope with negative feelings, and as an
alternative to pharmaceutical medications
(Bungay et al., 2006)
Saturday, 18 May, 13

13. MENTAL HEALTH
Common for street-involved youth to experience concurrent substance use
and mental health struggles; also likely to experience physical abuse as a
child, greater transience, street victimization, and/or previous arrest
(Kirst et al., 2011)
63% of females & 50% of males reported one or more of the following
conditions:
~learning disabilities
~Fetal Alcohol Syndrome (FAS)
~Attention Deficit Hyperactivity Disorder (ADHD/ADD)
~depression
~addiction
~problems with anger & violence
~Post-Traumatic Stress Disorder (PTSD)
(Saewyc et al., 2006; Smith et al., 2007)
Saturday, 18 May, 13

14. MENTAL HEALTH
32% of females vs. 13% of
males reported being
diagnosed with
depression
13% of females vs. 7% of
males reported chronic
anxiety
33% of females vs. 25%
of males reported feeling
very sad, hopeless, or
discouraged in the past
30 days
55% of females and 35%
of males reported being
under high levels of stress
Differences between
males & females:
(n=762, including Vancouver, Victoria, Abbotsford & Mission, Surrey,
Prince Rupert, Nanaimo, Prince George, Kamloops, and Kelowna)
(Smith et al., 2007)
Saturday, 18 May, 13

15. RISK ENVIRONMENT
FRAMEWORK
Envisages drug harms as a product of the social situations and
environments in which individuals participate
Shifts the responsibility for drug harm, and the focus of harm reducing
actions, from individuals alone to include the social and political
institutions which have a role in harm production
Four types of environments (physical, economic, social, policy) that
interact with two “levels of environmental influence” (micro, macro)
Emphasizes the interactions, adaptations, and exchanges between the
various types of environments and levels of environmental influence
(Rhodes, 2002 & 2009)
Saturday, 18 May, 13

16. RISK ENVIRONMENT
FRAMEWORK
Enables harm reduction approaches in four ways:
(1) critiques the tendency of public health and behavioural sciences to
emphasize harm as the primary determinant of individual behaviour and
responsibility
(2) encourages resistance to “blame for harm” being laid upon the affected
individuals
(3) focuses on risk as socially situated and how risk environments are
embodied and experienced as part of everyday life
(4) incorporates harm reduction inside broader frameworks that promote
human rights approaches to public health
Rhodes’ argues that his conception of the risk environment framework is a
call to “mobilize resources in social science towards reducing drug-
related social suffering” (p. 198)
Saturday, 18 May, 13

17. RISK ENVIRONMENT
FRAMEWORK
level of environmental influence
type of environment
micro macro
economic
social
policy
physical
cost of living & healthcare,
employment & income
health service
revenue & expenditures,
uncertain economic transition
social & peer group norms,
local policing norms
gender inequality,
stigmatization & marginalization
of substance users
availability & coverage of harm
reduction supplies,
availability of social housing
public health policy governing
harm reduction, laws governing
possession of drugs
using substances,
using in public & private spaces
drug trafficking & distribution
routes, geographical population
shifts
The interactions between the various types of environment and levels of environmental
influence are essential to Rhodes’ conceptualization of the “risk environment framework”
Saturday, 18 May, 13

18. BRONFENBRENNER’S
MESOSYSTEM
“A mesosystem comprises the interrelations among
major settings containing the developing person at a
particular point in his or her life - a mesosystem is a
system of microsystems”
Can include the interactions and relations among family,
school, peer groups, church, workplace, etc.
(Bronfenbrenner, 1977, p. 515)
Saturday, 18 May, 13

19. BRONFENBRENNER’S
MESOSYSTEM
Four types of interconnections are possible:
(1) Multisetting participation
(2) Indirect linkage
(3) Intersetting communications
(4) Intersetting knowledge
(Bronfenbrenner, 1979, p. 209-210)
Saturday, 18 May, 13

20. TURNER’S
MESODYNAMICS
The macro realm of reality consists of:
(1) institutional domains
(2) stratification systems
(3) societies
(4) the systems of societies
The meso realm of reality includes:
(1) corporate units
(2) categoric units
The micro realm of reality is composed of:
(1) focused encounters
(2) unfocused encounters
(Turner, 2012)
Saturday, 18 May, 13

21. TURNER’S
MESODYNAMICS
Turner theorizes that at some point in almost all societies, discrimination
on the basis of categoric-unit memberships and the formation of
stratification systems will encourage “victims” to mobilize and create
their own corporate units that have “ever-more clear agendas”
For Turner, escalating grievances, continuous discrimination, and
unrelenting marginalization are the basis for social movement
organizations; however, he is careful to note that social movements do
not always successfully achieve what they originally intended
Saturday, 18 May, 13

22. INTEGRATING A
MESO-LEVEL ANALYSIS
Meso-level analysis allows for the investigation of Victoria as a
community and organizations within the city, specifically the
Victoria Youth Clinic (VYC), where I currently volunteer
The VYC is a wonderful example of a “corporate unit” that experiences
pressure from both the micro and macro levels on a daily basis
Currently, I am considering including a small reflexive chapter within
my dissertation that will examine meso-level community
organizations.
I hope to use and integrate a number of my personal experiences
within the busy, clinical setting of VYC to explore the elements of
meso-level organizations
Saturday, 18 May, 13

23. AMENDING THE RISK
ENVIRONMENT FRAMEWORK
level of environmental influence
type of environment
micro meso macro
economic
social
policy
physical
cost of living & healthcare,
employment & income
funding for community-
based organizations
health service revenue &
expenditures, uncertain
economic transition
social & peer group norms,
local policing norms,
psychosocial integration
strong, cohesive community
groups & organizations,
stigmatization of illicit drug use
within neighbourhoods &
communities
gender inequality,
stigmatization &
marginalization of
substance users
availability & coverage of
harm reduction supplies,
availability of social housing
organizational policy
regarding harm reduction
distribution
public health policy
governing harm reduction,
laws governing possession
of drugs
using substances,
using in public & private
spaces
accessible & public
community spaces,
especially for youth
drug trafficking &
distribution routes,
geographical population
shifts
Saturday, 18 May, 13

24. TIMELINE
May - August 2013:
~draft thesis proposal
September - December 2013:
~defend thesis proposal
~finish two final course-based credits
January - April 2014:
~research & analysis of Risky Business & Healthy Youth Survey data
May - August 2014:
~finish analysis & write, write, write!
~submit final thesis
September 2014:
~defend final thesis
Saturday, 18 May, 13

25. WORKS CITED
Benoit, C., Jansson, M., Hallgrimsdotter, H., & Roth, E. (2008). Street Youth’s Life-Course Transitions.
Comparative Social Research, 25(1), 325-353. doi:10.1016/S0199.
Bronfenbrenner, U. (1977). Toward an Experimental Ecology of Human Development. American Psychologist, July
2007, 515-531.
Bronfenbrenner, U. (1979). Ecology of Human Development: Experiments by Nature & Design. Cambridge,
Massachusetts: Harvard University Press.
Bungay, V., Malchy, L., Buxton, J. A., Johnson, J., MacPherson, D., & Rosenfeld, T. (2006). Life with jib: A
snapshot of street youth’s use of crystal methamphetamine. Addiction Research & Theory, 14(3), 235–251. doi:
10.1080/16066350500270901.
Centre for Addictions Research of British Columbia. (2008 & 2012). Alcohol and Other Drug Monitoring Project:
High Risk Populations. Retrieved from http://carbc.ca/FactsStats/AODMonitoring/HighRiskPopulations.aspx.
Homer, B. D., Solomon, T. M., Moeller, R. W., Mascia, A., DeRaleau, L., & Halkitis, P. N. (2008).
Methamphetamine abuse and impairment of social functioning: a review of the underlying neurophysiological causes and
behavioral implications. Psychological Bulletin, 134(2), 301–10. doi:10.1037/0033-2909.134.2.301.
Kirst, M., Frederick, T., & Erickson, P. G. (2011). Concurrent Mental Health and Substance Use Problems among
Street-Involved Youth. International Journal of Mental Health and Addiction, 9(5), 543–553. doi:10.1007/
s11469-011-9328-3.
Rhodes, T. (2002). The “risk environment”: a framework for understanding and reducing drug-related harm.
International Journal of Drug Policy, 13(2), 85–94. doi:10.1016/S0955-3959(02)00007-5.
Rhodes, T. (2009). Risk environments and drug harms: a social science for harm reduction approach. International
Journal of Drug Policy, 20(3), 193–201. doi:10.1016/j.drugpo.2008.10.003.
Saewyc, E., Wang, N., Chittenden, M., Murphy, A., and the McCreary Centre Society. (2006). Building
Resilience in Vulnerable Youth. Vancouver, B.C.: The McCreary Centre Society.
Smith, A., Saewyc, E., Albert, M., MacKay, L., Northcott, M., and the McCreary Centre Society. (2007).
Against the Odds: A profile of marginalized and street-involved youth in B.C. Vancouver, B.C.: The McCreary Centre
Society.
Turner, J. H. (2012). Theoretical Principles of Sociology, Volume 3: Mesodynamics. United States: Springer Science.
Saturday, 18 May, 13

26. FEEDBACK & DISCUSSION
THANK YOU!
Saturday, 18 May, 13