Injection drug users’ involvement in drug dealing in the downtown eastside of Vancouver: Social organization and systemic violence

Abstract

Background

Illicit drug markets are a key component of the risk environment surrounding injection drug use. However, relatively few studies have explored how injection drug users’ (IDUs) involvement in drug dealing shapes their experiences of drug market-related harm. This exploratory qualitative study aims to understand IDUs’ dealing activities and roles, as well as the perceived benefits and risks related to participation in illicit drug markets, including experiences of drug market violence.

Methods

Ten IDUs with extensive involvement in drug dealing activities were recruited from the Vancouver Injection Drug User Study (VIDUS) and participated in semi-structured qualitative interviews, which elicited discussion of experiences dealing drugs, perceived benefits and hazards related to dealing, and understandings of drug market violence.

Results

Participant's involvement in drug market activities included corporate sales, freelance or independent sales, and opportunistic sales termed “middling” as well as drug market-related hustles entailing selling bogus drugs and robbing dealers. Participants primarily dealt drugs to support their own illicit drug use, and we found that arrest and criminal justice involvement, hazards stemming from drug debts, and drug market-related violence were key risks related to dealing activities.

Conclusion

The challenges of managing personal consumption while selling drugs exacerbates the hazards associated with drug dealing. Efforts to address drug dealing among IDUs should consider both drug dependency and the material conditions that propel drug users towards dealing activities. Interventions should explore the potential of combining enhanced drug treatment programs with low threshold employment and alternative income generation opportunities.

Introduction

Contemporary research perspectives emphasize how social-structural forces shape the character of local illicit drug markets and associated harms, and conceptualize drug market activities as representing a key aspect of the risk environment surrounding injection drug use (Fitzgerald, 2009, Rhodes et al., 2005 and Ritter, 2006). Within this ecological view, drug markets consist of the social and physical contexts where drug distribution activities occur, and are shaped by forces within the physical, social, political, and economic environments – which operate at both the micro- and macro-level (Rhodes et al., 2005). Conceptualizing illicit drug markets through the risk environment framework highlights that local markets are influenced by “dynamic interactions between users’ behaviour, drug market characteristics, police activity, [drug] treatment and harm reduction services, and the local community/neighbourhood area” (Ritter, 2006). Each individual drug market is characterized by a particular configuration of drugs sold, social organization of dealing activities, local cultural norms among drug users and drug dealers, as well as specific law enforcement responses deployed (Curtis & Wendel, 2007). The specific social-structural forces which shape local drug markets, also influence the potential for numerous forms of drug market-related harm including the risk of arrest or incarceration, as well as varying types of violence which are common to illicit drug markets (Coomber and Maher, 2006 and Curtis and Wendel, 2007).

Violence is a key driver of drug market-related harm (Erickson, 2001), and multiple forms of violence are common within unregulated drug markets (Goldstein, 1985). Goldstein's typology of drug market violence differentiates between psychopharmacological violence (driven by the pharmacological properties of the drugs consumed), economic-compulsive violence (occurring in the pursuit of money for drugs) and systemic violence (which exists due to the unregulated nature of drug markets and lack of legitimate dispute resolution mechanisms)(Curtis and Wendel, 2007, Erickson, 2001 and Goldstein, 1985). There is growing consensus that the majority of drug-related violence is systemic in nature (Erickson, 2001), arising from various circumstances within unregulated markets including: enforcing normative codes within dealing organizations; collecting drug debts; punishing informers; as well as confrontational interactions with the police. While there have been some efforts to understand the potential for systemic violence in relation to different types of drug markets and key features of specific markets (Coomber and Maher, 2006 and Curtis and Wendel, 2007), systemic violence has remained relatively under-examined since the articulation of Goldstein's framework (Curtis & Wendel, 2007).

Previous ethnographic research has illustrated how social and economic processes drive violence within drug markets (Bourgois, 1995 and Maher, 1997). While cultural norms among drug users perpetuate the expectation that violence will be used to regulate drug markets (Bourgois, 1995), previous work has drawn on intersecting concepts of symbolic and everyday violence to describe how broader historical, social, and economic processes shape street-based drug scenes (Bourgois et al., 2004 and Scheper-Hughes and Bourgois, 2004). “Everyday” violence refers to how the pervasiveness of social suffering among marginalized social groups is often rendered invisible due to its ubiquity (Scheper-Hughes & Bourgois, 2004). Bourdieu's concept of symbolic violence refers to the mechanisms through which social inequality is naturalized (Bourgois et al., 2004), and Bourgois has built upon this notion suggesting that the everyday violence pervading the lives of drug users functions to obscure the role social and political-economic forces play in shaping the production of violence within drug scenes. Bourgois also extended the concept of symbolic violence to encompass a broader range of processes that may legitimize violent acts (Bourgois et al., 2004). For example, within drug scenes violence is constructed as normative and a pragmatic mechanism for resolving disputes and asserting status or prestige (Bourgois et al., 2004). This ethnographic work has also illustrated the gendered nature of violence within drug scenes, and how patriarchal cultural scripts define gender relations and serve to legitimize violence against women (Bourgois et al., 2004).

Previous studies indicate that participation in drug dealing is common among injection drug users (IDUs) (DeBeck et al., 2007 and Sherman and Latkin, 2002) and is associated with intense patterns of drug use and high frequency injecting (Kerr et al., 2008 and Sherman and Latkin, 2002). While IDUs who deal drugs are characterized by elevated risk for varying forms of drug-related harm including HIV infection and overdose (Friedman et al., 1998 and Sherman and Latkin, 2002), existing research also suggests that IDUs occupy dangerous drug scene roles that place them at increased risk of arrest and incarceration (Kerr et al., 2008). However, there is a need for qualitative research exploring the lived experience of injectors who engage in drug dealing activities, and knowledge regarding how IDUs understand and experience drug market-related violence. Understanding the lived experience of IDUs engaged in dealing and cultural norms in the drug market may provide important insight regarding motivations for participating in dealing. This knowledge is crucial to informing the development of targeted interventions and policy responses to address drug dealing, as well as identifying the shortcomings and limitations of existing approaches.

Vancouver's Downtown Eastside (DTES) neighbourhood is characterized by a high concentration of drug market activity and approximately 5000 IDUs reside in the DTES (Wood & Kerr, 2006). The large drug market operating in the DTES features high levels of street-based drug sales, and drugs sold include powder cocaine (cocaine salt), crack or “rock” (cocaine base), heroin, crystal methamphetamine, and a range of diverted pharmaceutical drugs (i.e., benzodiazepines and opioids including dilaudid and morphine) (Urban Health Research Initiative, 2009). In the past decade, the DTES drug market has been the focus of a number of policing initiatives that have attempted to disrupt dealing activities (Small et al., 2006 and Wood et al., 2003). However, there is a lack of research describing the social organization of the DTES drug market, and how IDUs engage with this market beyond buying drugs for personal consumption (Heed, 2005). Therefore, we sought to qualitatively explore the experiences of IDUs who have sold drugs within the DTES drug market to better understand their engagement with the local drug market. We conducted a small series of qualitative interviews with IDUs who had extensive involvement in dealing within the DTES drug market in order to develop a contextualized and detailed understanding of the their participation in dealing. We also sought to document IDUs’ reasons for engaging in dealing, and their perspectives regarding the associated benefits and hazards. An additional objective was to examine how individual's participation in dealing activities may shift over time (and in relation to ongoing illicit drug use) by viewing the evolution of dealing activities as a dealing “career”. Finally, we sought to explore IDUs’ perspectives regarding drug market violence and understand how the potential for violence varies in relation to specific drug market activities.

Methods

This exploratory qualitative study of IDUs’ participation in drug dealing activities was conducted as part of an ongoing ethno-epidemiological investigation of the risk environment surrounding injection drug use in the DTES. This longitudinal investigation has utilized a range of ethnographic and qualitative methods in connection with large epidemiological cohort studies of drug users to examine the influence of social and structural forces in the production of drug-related harm (Fast et al., 2009, Small et al., 2007 and Small et al., 2009). Information and knowledge derived from our previous ethnographic work informed the objectives of the current study, the development of the interview guide used to explore experiences of dealing, our recruitment and sampling decisions, as well as the analysis of data generated through interviews. Our previous fieldwork suggested that participation in drug dealing may play an influential role shaping drug use careers among local IDUs, and propel individuals along trajectories characterized by increased potential for drug-market related harm including experiences of violence. Therefore, we conducted the current qualitative study to explore a broad range of dealing activities in an in-depth manner, to generate insights that could be further investigated through future ethnographic and epidemiological research. In this way, the current study is exploratory and is intended to inform subsequent investigation of drug market related experiences based within this research program.

We conducted a series of 10 in-depth qualitative interviews with IDUs recruited from the Vancouver Injection Drug Users Study (VIDUS), a prospective cohort study composed of over 1000 HIV-negative injection drug users (Kerr et al., 2008). Undertaking this research within a large cohort study provided unique opportunities to explore IDUs drug-dealing activities and experiences by facilitating access to research participants who had recent experience dealing drugs, as well as extensive previous experiences in the local drug market.

Qualitative in-depth interviews were conducted in July and August 2010. During this time, VIDUS participants attending the study office, who reported current involvement in drug dealing activities during their most recent follow-up visit as well as extensive previous participation in dealing were invited to participate in a qualitative interview. We used screening questions to identify suitable interviewees among VIDUS participants attending the study office. Our sampling strategy sought to capture the maximum variation in participant experiences, so we recruited a diverse sample of participants and ensured adequate representation of women, in an attempt to understand the broadest range of drug market experiences. A semi-structured interview guide was used to facilitate discussion of initiation into drug dealing, dealing activities and experiences, reasons for dealing, benefits and hazards of dealing, as well as perspectives regarding drug market violence. This interview guide drew on knowledge regarding the local drug market derived from previous ethnographic research, and contained targeted questions and probes regarding dealing activities that we knew to be common within the local scene. Interviews lasted 40–80 min, were audio-recorded, and transcribed verbatim. Interviews were conducted by JL or WS. All participants provided written informed consent, and there were no refusals to participate and no dropouts during the interview process. All participants received a $20 CDN honoraria. The University of British Columbia/Providence Health Care Research Ethics Board provided ethical approval for the study.

The examination of qualitative interview data was similarly informed by knowledge of the local drug scene generated previous fieldwork within the DTES drug scene, which served to contextualize interview data produced by the current study. Analysis began early in the data collection process and continued as interviews were completed. Emergent analysis of early interviews served to inform the focus of subsequent interviews, as well as ongoing analyses regarding participation in dealing activities. At the completion of the interview series, interviews were yielding limited new information regarding perceived benefits and risks of dealing, as well as the drivers of drug market violence, suggesting that we had achieved saturation in particular topic areas. The coding framework employed made use of a priori codes derived from the topics used to structure the interview guide, as well as emergent codes based upon the content of the interviews. ATLAS.ti software was used to assist with the analysis of interview transcripts and the management of qualitative data. All interview data were reviewed and text segments related to each individual code were compiled, and memos authored to summarize the content and themes related to particular codes. In the following section, we present a thematic analysis of participants’ drug market involvement and perspectives regarding perceived risks and benefits of dealing, including drug market-related violence. We also sought to identify common trajectories within study participants’ drug dealing careers. The analysis emerged from participant accounts, through grounded comparison of each participant's reports and examination of negative evidence, to identify the range and diversity of perspectives contained within the interview data. This analytical work was conducted by JL and WS.

Qualitative interviewees

The ten individuals participating in qualitative interviews included 4 females and 6 male IDUs. The age of participants ranged from 28 to 66 years, and the median age of participants was 49.5 years. All participants had extensive experience dealing drugs within the DTES drug market, and most had sold a range of drugs through varying modes of dealing.

Results

Vancouver's Downtown Eastside (DTES) drug market

The drug market in the DTES is primarily “open”, as individuals unknown to dealers can readily purchase drugs, and sales primarily occur in public venues (e.g., street corners). However, there is a “closed” segment of the market with some dealers operating within SRO rooms, while others conduct delivery sales, and a small number of local stores operate as a “front” where the operator sells drugs to select clients.

Drug dealing activities and other drug market related hustles

Participant's involvement in drug market activities included drug dealing activities and related drug market “hustles”. Drug dealing activities included “corporate” style sales, “freelance” sales, and opportunistic sales or “middling”. Following Maher (1997), this analysis considers not only drug dealing activities, but also hustles associated with “the transfer of goods and/or services directly related to the distribution and consumption of illicit drugs” (Maher, 1997, p. 83). These types of activities included selling “bunk” (bogus drugs) and robbing dealers.

Corporate-style sales: being a “worker”

Study participants had commonly participated in dealing through “corporate” sales, where an individual functions as a “worker” within a team selling retail units of a drug in street settings under the supervision of a “boss” who supplies the drugs being sold. Individuals may fulfil a variety of roles, similar to the division of labour characterizing street-based crack sales (Maher, 1997, p. 85), including “holders” (who possess the drug for sale), “steerers” (who direct customers towards holders), or “lookouts” (who watch for police patrols and undercover officers). Within the DTES drug market, it was reported that IDUs may act in any of the above-mentioned roles, and typically work in 4–8 h “shifts” receiving one or two of the units they are selling as payment. While the division of labour may suggest that these arrangements are sophisticated, the separation of tasks primarily functions to confound police efforts to monitor dealing activities, prevent the confiscation of money, and insulate the “boss” from criminal charges by ensuring that workers face the greatest risk of encounters with the police and arrest.

Freelance or independent sales

“Freelance” involvement in dealing, involving independent acquisition and sale of drugs was common among study participants. Individuals operating independently typically purchase an amount of drugs, or obtain drugs on consignment from a supplier, and make retail sales themselves:

Get some work [dope] from somebody… maybe an eight ball of rock and I’ll just sell enough dope to support what I smoke. That's all. So the outlay of money doesn’t go out of my pocket.

(Male participant age 56, Interview #10)

This type of dealing was reported to be intertwined with other sources of income (e.g., social assistance) or other income generation activities, among participants who purchase drugs rather than obtaining them on consignment. For example, one female respondent reported that she used the money she derived from street-based sex work to purchase modest quantities of rock cocaine, which she subsequently sold:

I go out to work [sex trade] … I stay on the corner until I make enough money or do enough dates so that I can pick up a half ball [1.75 grams]… I go home and I cut it up into ten little rocks and sell it to the girls in my building.

(Female participant age 28, Interview #8)

One male participant utilized a social relationship with a supplier to obtain drugs for personal use by selling a modest quantity of drugs received on consignment:

I got my buddy, right? […] he generally throws me down [five] small papers. Two of them are mine, right? And then it goes on and on like that.

(Male participant age 52, Interview #3)

While these arrangements resemble working in corporate drug sales, they do not involve any supervision or division of labour, although there is a clear expectation that supplier will receive payment for drugs obtained on consignment.

Opportunistic sales – “middling”

Most participants reported engaging in opportunistic sales, obtaining drugs for fellow drug users and acting as a go-between, commonly termed “middling”. This involves taking someone else's money and purchasing drugs from a supplier, often in the closed segment of the market. The “middler” will typically retain a portion of the purchased drugs as a form or payment, or will be given a share when the drugs are being consumed. Participants who had experience middling explained how it enabled them to easily access drugs:

I always knew people that had it and I always knew people who wanted it …so all I had to do was put them together and some fell off for me.

(Male participant age 56, Interview #10)

Individuals engaging in middling often had previous experience with other modes of dealing, and middling was seen to be ideal by some because it permitted access to drugs without being involved in corporate sales or freelancing (which requires investing one's money or owing a supplier for drugs provided on consignment). In this way middling was seen to maximize the benefits of dealing while minimizing the risks associated with corporate and freelance sales:

I use everybody else's money to make more money, but I don’t have possession of drugs long enough to fuck up… it's a lot safer.

(Female participant age 58, Interview #1)

Female respondents who had experience in the sex trade reported that opportunities to middle drugs arise when male clients want drugs, but are unable to obtain it from the street-based drug scene themselves:

I have a lot of regular customers [sex trade clients] … and they use; they smoke rock or do heroin. And what they do is they give me the money, I go and pick it up, I come back, and the date is half cash and half drugs.

(Female participant age 58, Interview#1)

Auxiliary drug market hustles: “Bunking” and robbing dealers

Beyond the dealing modes outlined above, selling bogus drugs and robbing dealers represent additional activities through which injectors may obtain money or drugs from the drug market. These activities were represented as “desperate” due to the potential for violence entailed.

“Bunking” involves selling a substance which is purported to be drugs, but which is in fact an everyday item that mimics the physical appearance of a particular type of drug, or is wrapped to resemble the conventional retail packaging (Maher, Dixon, Lynskey, & Hall, 1998):

I was sick [in withdrawal] and I just needed some money to get better, so I made up these two big spitballs [small retail unit]. I’d sell it to people [who] wouldn’t do it right there, obviously. They’d go into a back lane somewhere [to do it] …by that time I’d be down the street getting my heroin or morphine.

(Male age 54, Interview #6)

In order to avoid the buyer realizing that the substance is fraudulent, bunk sales are hastily made in high-traffic areas, and the seller usually flees from the sales location immediately. When drugs supplied on consignment have been diminished through personal consumption, injectors may increase the bulk of the remaining drug by adding adulterants. This permits the dealer to sell additional units but it may reduce quality to an unacceptable level where customers who purchase these units may perceive that they have been “bunked”.

In addition to selling bunk, some participants reported robbing dealers for drugs and/or money. For example, a female participant described how she had robbed dealers in the past, asserting that anyone possessing quantities of drugs could be targeted for a robbery. Only a small number of participants reported that they had engaged in such activity, and robbing dealers was represented as desperate and highly dangerous.

Perceived benefits associated with drug dealing

For all participants, current involvement in dealing activities was motivated by the need to support drug dependency. Participants described how dependence encourages involvement in dealing activities, due to the lack of opportunities to generate income through legitimate means or conventional employment:

I’m on disability [social assistance] but that's not enough to support my drug addiction. So I, you know, I just sell dope to support my habit.

(Male participant age 38, Interview #2)

In the context of long-term drug dependency, dealing was perceived to be an effective means to support one's own drug consumption. Enhanced access to drugs, facilitated by participation in dealing, was described as the key motivation for engaging in dealing activities. Accessing drugs through dealing permitted participants to avoid opiate withdrawal, either by setting aside a “get-well” dose for use the next day or being able to immediately obtain heroin when they are dopesick. Non-opiate users similarly viewed dealing to be beneficial as they were able to easily obtain powder cocaine, crack and methamphetamine, through dealing opportunities. In addition, the accounts of participants suggest that participation in dealing may sometimes allow drug users to temporarily avoid less preferred income generation strategies. For example, a small number of female participants reported that engagement in dealing activities permitted them to reduce their sex trade involvement at specific points in time.

Perceived risks associated with drug dealing

I’ve seen guys get stabbed for their dope down here. I’ve seen fights [between dealers] … I’ve been jumped [for drugs] … I’ve sold to undercover cops.

(Male age 48, Interview #5)

While participation in dealing was perceived to be advantageous the hazards related to dealing were viewed as serious by study participants. A range of dealing-related risks were discussed, including the potential for arrest or incarceration, being robbed for money or drugs while dealing, and harms associated with drug debts. The threat of drug market-related violence represents a central theme within participants’ perspectives regarding the risks related to dealing.

Study participants viewed encounters with the police, arrest, and incarceration as primary hazards stemming from dealing. All participants recounted interactions with police resulting from their dealing activities, which resulted in arrests and criminal charges for some participants. Participants who had served jail and prison sentences as a result of participation in dealing were primarily male. Encounters with the police were also seen to be a key source of drug market violence, and some male participants described being kicked, punched and beaten during dealing-related encounters with police.

The threat of robbery represents another key risk stemming from participation in dealing. Participants described how dealers are often the target of robberies, because they typically possess considerable quantities of drugs and/or money. It was reported that drug users who attempt to rob, or successfully rob, dealers are routinely subjected to violent retribution and that this violence often occurs in public settings where it is visible as a warning. It was reported regular customers may attempt to perpetrate a robbery, particularly when they are lacking the resources needed to purchase drugs:

X was a dollar short from a twenty rock. And [the dealer] wouldn’t sell it to him, and X got really choked [upset]. And X takes out a knife. Slashes him [the dealer] in the cheek and then grabs the bag… [After that] I said “you’re gonna get hurt really bad man”. And sure enough …about a week later… He got stabbed a couple of times.

(Male participant age 48, Interview#5)

Within participant accounts, the pervasiveness of the understanding that those who rob dealers will be sought out and subjected to retaliatory violence is readily evident. A female participant who described how she had robbed dealers in the past asserted that the risk of robbery is inherent when one possesses quantities of drugs, even if an individual does not regularly deal drugs:

It's a dangerous thing, it is. Because once you go and rob a dealer, you’re a dealer for the week. But then you got to watch your back for people trying to rob you ‘cause you’re a dealer now.

(Female participant age 28, Interview #8)

Drug debts: managing consumption as a user-dealer

The challenges of managing one's addiction while dealing drugs was a key theme within participant's accounts, and the difficulties resulting from consuming drugs intended for sale were well recognized. Many participants described how their drug dependency and active drug use undermined their dealing endeavours:

Well, I’m not very good at selling drugs, because I’m more of a drug addict than a [dealer].

(Female participant age 45, Interview #4)

When selling independently and purchasing drugs for sale, over consumption was a relatively minor problem, although it did diminish efforts to subsidize personal drug use through dealing:

There's been a few cheque days when I bought half a ball [1.75 grams] and gone out [selling it] … but then I end up smoking it all away anyway, so [laughter] it doesn’t matter.

(Male age 38, Interview #2)

However, failure to control one's own drug use has serious consequences when participating in corporate sales or independently selling drugs provided on consignment. The difficulty of successfully functioning as a worker while being drug dependent was well recognized, as many participants described “fucking up” while dealing – referring to losing drugs, stealing drugs, or being short with the money owed to the supplier. One female participant described how she was unable to avoid “fucking up” with drugs she was given to sell, despite her knowledge of the consequences:

I was given the dope to work [sell]… And I wanted to do one, and of course my addiction doesn’t work like that. As soon as I started using, well that's it. It's game over, right? … you don’t do that, right? I ended up screwing up with drugs that weren’t mine. I ended up taking off with the dope. Which is kind of uh, putting my life in [jeopardy]. […]But my addiction has taken me to resorting to doing things that uh, are like very irrational and very like, insane. And desperate.

(Female participant age 45, Interview #4)

This participant used all the drugs she was supposed to sell and became worried about her safety due to her unfulfilled obligations to her supplier. This was just one of many incidents described by participants where they became indebted due to an inability to successfully balance their drug dealing activities and their own consumption, and many participants reported amassing drug debts that they could not repay. This type of situation was said to lead to violence perpetrated by suppliers, and it was reported that broken legs, stabbings, having one's head shaved, and repeated beatings were sometimes the result of drug debts:

They’ll break their legs…there's a couple of things they’re talking about doing to certain people that are like torture […] you know, beating and torturing them.

(Female participant age 58, Interview #1)

The expectation of violence related to drug debts led some participants to avoid particular dealing opportunities, due to the hazards involved in obtaining drugs from particular suppliers. One female participant described how she had declined dealing opportunities because of the supplier's reputation for violence, anticipating that her drug dependency would result in unmanageable debts:

They were really mean people. They’re like, the kind of people that used to like, cut off fingers and hands and toes. If you were like, fifty dollars short, you lost a finger. They were trying to front dope [to me] to sell for them, and nuh-unh [no way]. If you give me more I’d be dead.

(Female participant age 50, Interview #9)

Another form of punishment arising from drug debts involved exclusion from dealing opportunities, when a supplier refuses to provide further access to drugs and communicates to other suppliers that the user-dealer is in bad standing:

They won’t give you any more dope to work. Like you can’t get work with anybody. All of a sudden now you’re prostituting again. Oh, you’re a guy? Too bad! There's boy's town [male sex worker stroll], you know? They’re ruthless; they’re cold; they don’t care.

(Female participant age 58, Interview #1)

Punishing those who owe drug debts by withholding access to dealing opportunities, did indeed lead one female participant back into sex work, as she could no longer generate income through drug market activities. Conversely, some suppliers may allow a debtor to continue to deal drugs until their debt is cleared:

Well there's one girl working [selling] at the park, she owes them [thousands of dollars]. Yeah, they keep her going because she's still making them money, even though she's in the hole […], she's got a debt … they beat her up every once in a while, and they taser her [but they keep her working].

(Female participant age 58, Interview #1)

Participant accounts suggest that inability to repay debts may sometimes result in a form of debt servitude, where an individual is forced to continue dealing drugs, and in some instances is regularly subjected to violence as a form of punishment. It was reported that it is largely impossible to negotiate reasonable repayment terms with suppliers, and the best way to avoid these situations was to avoid working for certain individuals:

You will keep working for them, and you will sit there and sell. […] they’re making [money] hand over fist, and you’re getting to smoke a couple rocks each day, you’re getting a paper of heroin […] I mean you’re a hostage whether you like it or not, so the best thing is don’t go, don’t work for them.

(Female participant age 58, Interview #1)

This account communicates the exploitative relationship that suppliers may have with user-dealers, where an indebted worker is coerced to sell drugs and is unable to stop dealing.

Understandings and experiences of drug market violence

Drug market violence was a key theme within participants’ accounts, and some participants reported that violence was an “everyday” feature of the local drug market, and was so ubiquitous that it was regarded as almost mundane:

I saw one guy get stabbed last week. I seen one get stabbed a week before that.

(Male participant age 54, Interview #6)

This perspective illustrates how drug market violence represents a form of “everyday” violence, as it is taken for granted as a natural component of drug markets and viewed, by some, to be an omnipresent threat. Participants reported that a significant proportion of the drug-market violence in the DTES was directly related to bunking, and described violent altercations that occurred when those who have been “ripped-off” administered violent retribution to the individual who “burned” them. Drug debts were seen to be central to the drug market-violence that participants had witnessed or had knowledge of. It was reported that violence was not reserved for large debts, and participants described violence that had been perpetrated in relation to relatively small debts (as little as $5), and these incidents included beatings with weapons (e.g., pieces of metal pipe or bats). Participants described how female drug users were sometimes subjected to extreme forms of violence which were intended to humiliate them and serve as a marker of their unpaid debt; describing how suppliers would shave a woman's head or take their clothes leaving them naked in the street.

However, some participants had contrasting views of drug market violence, reporting that violence was relatively rare in the DTES drug market. Participants reporting this perspective explained that most suppliers try to minimize violence, as it draws heightened scrutiny from the police and is therefore “bad for business”. However, one participant who asserted that the level of drug market violence in the DTES was low, went on to describe how he attempts to pre-empt the need for violence by limiting the amount of drugs he supplies to individual clients:

I never give anybody that much dope… But I give them at the most five, ten [dollar] papers, at the most [$50 dollars worth of dope]. I’m not going to shave somebody's head for that. I know there's people that do it. I wouldn’t do it. They do it for you know, ten bucks, some of them, but that's when they get heat [police scrutiny].

(Male participant age 52, Interview #3)

The above statement contains implicit recognition that when individuals “fuck up” and fail to honour their obligations in the drug market, this must be addressed. While participant accounts indicate there is a gradation of responses employed to address transgressions, ranging from excluding a debtor from further dealing opportunities to the above noted form of debt servitude, within the unregulated market these responses often involve some form of violence. The need to address transgressions was discussed further by a female participant who described how she was compelled to perpetrate violence upon an associate who had tried to “rip her off”:

Oh, I hit her. I can’t let somebody go and steal from me and – or try to steal from me …And get caught red-handed […] now you’re trying to steal from me and you’re lying to me. And if I let one person get away from that, then everybody in the building is going to try to get away with that. […] So I used her as an example, to set an example, right? She wasn’t allowed to come buy off me for a week and a half. And if she smartens up, then I’ll let her come back. And if she hasn’t smartened up, I’ll cut her off again.

(Female participant age 50, Interview #9)

As indicated by this account, IDUs may deploy violence against other drug users in order to maintain one's reputation and avoid the perception that one can be taken advantage of (Maher, 1997). The need to address offences within the unregulated drug market not only places IDUs who deal drugs at risk of being the victims of violence, but also creates situations where they are compelled to perpetrate violence.

The perceived vulnerability of females engaged in dealing

Participant accounts contained extensive discussion of the role of gender in shaping dealing opportunities, hazards, and vulnerability to violence. It was noted that female dealers were less likely to be subjected to police scrutiny, but many participants discussed how women were perceived to be more “vulnerable” within drug scenes asserting that women do not have the same ability as males to deploy violence to resolve disputes and protect themselves:

[if] a woman gets ripped off, she can’t go and punch someone in the head, whereas a man can…

(Male age 38, Interview #2)

Some participants reported that women were less likely to be subjected to physical violence to address debts and transgressions, and that suppliers were more likely to employ “symbolic” types of punishments (e.g., head shaving) that serve as a marker of an individual's transgression. However, others described how some suppliers are equally likely to subject female dealers to punishments involving physical violence. These perspectives convey the central role that physical violence plays in regulating drug markets, and how male dominance within drug market is viewed as a “natural” fact due to the perceived necessity of violence.

Drug dealing careers: evolving engagement in drug market activities

Most participants had experience with more than one type of dealing, and shifts between various forms of engagement with the drug market were common within participant accounts. Dealing activities typically evolved over time and in relation to ongoing drug use and growing drug dependency, over the course of an individual's dealing “career”. A shift from being a worker in corporate sales to dealing independently through freelance or middling activities was a common trajectory evident within participant accounts. Individuals may be excluded from corporate sales as a result of mistakes or transgressions, fostering a shift towards freelancing or middling as a tactic to avoid violence and other risks attributed to corporate sales. The overarching transition evident within participant accounts was a long term shift from dealing for profit, to dealing solely to support one's own drug use as drug dependence increases. The small number of participants who reported that they had resorted to bunking other drug users or robbing dealers, explained that they did so at points in their dealing career when they had no other means of generating income or were unable to access dealing opportunities. While the career trajectories of male participants featured frequent arrests, episodes of incarceration and experiences of police violence, arrest and incarceration were not perceived as a significant deterrent to participation in dealing. The career trajectories of female participants suggest that there is a complex interplay between dealing activities and sex work for women who have participated in both activities, as some women utilized income derived from sex work to purchase drugs and sell as a freelancer, while others engaged in opportunistic sales to male sex trade clients.

Discussion

This study explored IDUs’ engagement in drug dealing within the DTES drug market, as well as the perceived benefits and risks related to participation in dealing activities. Participation in drug market activities included corporate, freelance, and opportunistic sales, as well as drug market-related hustles entailing selling bogus drugs and robbing dealers. While participation in drug dealing provides IDUs with access to drugs, extensive and diverse drug market-related violence was reported. The hazards associated with dealing are exacerbated by the difficulty of managing personal consumption, which may lead to increased susceptibility to violence, and the inability to stop dealing when debts accrue. Our examination of the evolution of individual's dealing activities suggests that dealing careers are characterized by a progression from for profit dealing towards dealing drugs support one's own illicit drug use, as drug dependency increases.

We documented a diverse range of dealing roles through which IDUs engaged in drug market activities, although all roles were low level retail activities (May & Hough, 2004). Drug hustles like bunking and robbing dealers were perceived to be important drug market-related activities, and these practices represent recognized strategies through which IDUs attempt to obtain drugs or money (Maher, 1997). Differing modes of engagement with the drug market were perceived to be characterized by particular risks. While opportunistic sales involving middling, were seen to be relatively safe, corporate sales and obtaining drugs on consignment were seen to hold greater risk, due to the potential for violence deployed in response to unpaid debts and transgressions. Selling bunk and robbing dealers were also perceived to be particularly risky, due to the potential for violent retribution associated with both of these activities. The reasons reported for dealing by participants in this study are consistent with findings from other studies (Dwyer & Moore, 2010), as dealing represents a core survival strategy among street-entrenched drug users (DeBeck et al., 2007 and Friedman et al., 1998). While providing access to drugs was perceived to be the primary benefit of participation in dealing, it appears that participation allowed some participants to temporarily avoid less preferred forms of income generation used to acquire money for drugs, including sex work among female participants. However, while our analysis echoes the findings of Maher (1997) by suggesting that participation in sex work may shape female IDUs’ participation in dealing, opportunities to avoid sex work by generating income through dealing may be short-lived, as a range of complications can eliminate the potential to continue dealing. Therefore, based on this analysis dealing should be viewed as providing temporary respite from sex work activities, and the interrelationship between sex work and participation in dealing should be explored further in future research.

The current study suggests that participation in dealing represents a significant source of violence and coercion among IDUs. Participants reported diverse forms of physical violence related to drug market activities, and included both accounts of victimization and perpetrating violence. While our findings regarding the relationship between participation in dealing and violence are derived from a small scale study, they are consistent with quantitative research which has documented that individuals involved in dealing are more likely to be the victim of violence (Marshall, Li, & Kerr, 2008), as well as being more likely to perpetrate an assault (Neale, Bloor, & Weir, 2005). We also documented a range of violent and non-violent sanctions that suppliers may enact to respond to transgressions and debts, including exclusion from the drug market and “debt servitude”. While participants’ accounts of extremely violent acts may appear exaggerated, recent police actions in the DTES reflect the descriptions of violence contained in participant accounts. Specifically, within the DTES, a number of individuals were recently charged with criminal offenses stemming from violent forced confinements, and allegedly torturing drug users to compel them to sell drugs (Dhillon, 2011).

The unregulated nature of drug markets and the lack of legitimate dispute resolution mechanisms result from political, legal and economic forces (including the criminalization of drug use) perpetuate both violence within illicit drug markets and IDUs’ participation in dealing activities (Bourgois, 1998 and Shannon et al., 2008). The physical violence and non-physical punishments which female drug users were subjected to address debts and transgressions can be seen as manifestations of the subordinate position of female drug users within the street economy, as well as male centred ideology within the drug market (Fairbairn et al., 2008,Maher, 1997 and Shannon et al., 2008). The intersection of symbolic and everyday violence within drug markets highlights the need for structural level interventions to address health, economic, and gender-based inequalities, as well as the impact of the ongoing criminalization of drug use (Wood et al., 2010). While a number of countries have begun to experiment with alternative drug policies that include decriminalization of personal possession of drugs, and some positive benefits have been noted (Hughes & Stevens, 2007), the impact of these policies on IDUs’ in involvement in dealing and drug market violence remains unknown.

A risk environment perspective emphasises that drug market violence is driven by a combination of social and structural forces, including legal and policy structures that criminalize drug use and drive unregulated drug markets. While public health perspectives focus on dealing as a significant source of health risks (Erickson, 2001), from the perspective of drug users, drug market-related harms (including violence) represent just one dimension of the “everyday” and “relative” risks individuals confront as a consequence of their drug dependency (Moore, 2005). Within the situated risk perceptions of IDUs, drug market violence is understood in relation to other health-related hazards (including withdrawal, overdose and infectious disease acquisition), as well as arrest and incarceration (Bourgois, 1998, Maher et al., 1998 and Moore, 2005). Within the risk perceptions of highly marginalized IDUs, forgoing dealing opportunities may result in elevated potential for other everyday forms of risk, including withdrawal or beatings at the hands of suppliers. There is also a gendered dimension to these situated risk perceptions, as dealing may allow some female drug users to temporarily avoid or reduce their involvement in sex work, and thereby moderate their exposure to the risk of extreme violence, including murder, which drug using sex trade workers in the DTES have experienced (Shannon et al., 2008).

The findings of this study, while based on a small study sample, have implications for public policy and interventions targeting drug dealing. Firstly, the fact that many dealers within the retail sector of the drug market are IDUs may pose problems for “balanced” drug policy approaches, such as those implemented in Vancouver, in which public health programs target users and law enforcement efforts target dealers (Csete and Cohen, 2006 and Wood and Kerr, 2006). Consistent with previous research from other settings (Dwyer and Moore, 2010 and Fitzgerald, 2009), our findings suggest the distinction between “dealers” and “users” may often be illusory within the DTES drug market. Secondly, the fact that study participants view dealing as a viable means to manage their drug dependency, despite the inherent risks, highlights the need to enhance existing drug treatment programs. The lack of substitution therapies for stimulant dependent individuals represents a major challenge in the DTES context due to the large number of local cocaine and methamphetamine users (Buxton, 2005). While opiate dependent IDUs are often dissatisfied with methadone maintenance programs (Bourgois, 2000), innovative opiate prescription programs represent a promising strategy to reduce reliance on street drugs (Ferri, Davoli, & Perucci, 2010), but these programs have only operated on a pilot basis in North America. Finally, in addition to addressing drug dependency, the economic and material conditions that drive drug users’ participation in dealing must be considered within drug policy responses (Fitzgerald, 2009). Interventions combining enhanced drug treatment programs, with low threshold employment and alternative income generation opportunities should be explored (DeBeck et al., 2007). Previous research among IDUs in the DTES indicates that the majority of individuals involved in dealing would be willing to forgo participation in drug market activities, if they did not need to access street drugs to support their drug dependency (DeBeck et al., 2007).

This study has limitations that should be recognized. Our exploration of IDUs’ experiences dealing drugs is specific to the DTES area and may not reflect the experiences of IDUs selling drugs in other markets. Further, this analysis does not constitute a definitive and exhaustive examination of drug dealing in the DTES. The study was conducted among a small non-random sample of drug users in this locale, and may not represent the perspectives or experiences of others engaged in the local market. Although this study explored individual's shifting patterns of drug dealing activities in a retrospective manner, these data generate considerable insight regarding the co-evolution of drug dealing and drug using careers. While some participants had contrasting views regarding the prevalence of drug market violence in this locale, this should be explored through future quantitative research in this setting.

Despite these limitations, this analysis has produced insights and hypotheses regarding IDUs’ participation in dealing that can inform future research. We have identified some broad transitions that appear to be common within the dealing careers of IDUs, and these should be further examined through future ethnographic and qualitative research in this setting. Our findings suggest that IDUs are more likely to experience drug market-related harm, including violence in relation to corporate and independent sales, and this should be examined through quantitative research. Additionally, in light of the significance of violence within the perceived harms stemming from participation in drug dealing, future quantitative research should examine the impact of experiences of violence upon other forms of health risk and health outcomes.

In conclusion, we found that among IDUs in Vancouver's DTES engagement in drug dealing roles and drug market-related activities provides access to drugs for personal consumption. However, these activities carry significant potential for drug market-related harm, including violence, and the hazards associated with drug market involvement are exacerbated by the difficulties of managing personal consumption while selling drugs. These findings should inform future research investigating the impacts of novel initiatives on drug dealing and associated violence among IDUs, as well as efforts to develop targeted and structural-level interventions to address IDUs participation in drug dealing and reduce the associated harms.