'I guess my own fancy screwed me over': transitions in drug use and the context of choice among young people entrenched in an open drug scene.
BACKGROUND
There is growing interest in describing the broader risk trajectories experienced by young people who use drugs - that is, in describing the sequences of drug use transitions experienced by youth in relation to evolving understandings of risk and harm. This study sought to examine young people's perspectives regarding the evolution of their drug use in the context of a local drug scene in Vancouver, Canada.


METHODS
Semi-structured qualitative interviews with 38 individuals recruited from a cohort of young drug users known as the At-risk Youth Study (ARYS) were supplemented by ongoing ethnographic fieldwork (e.g., observations and informal conversations with youth) conducted within the same cohort population. Interviews were transcribed verbatim and a thematic analysis was conducted.


RESULTS
The majority of youth characterized past transition events as non-exceptional, largely 'spur-of-the-moment' decisions motivated by evolving feelings of curiosity. At the same time, participants' reflections indicated that the social, structural and material contexts of drug scene entrenchment play a powerful role in shaping these decisions and transition experiences.


CONCLUSIONS
Importantly, as young people become increasingly entrenched in the local drug scene, drug use transitions seem to constitute increasingly relevant (and even 'inevitable') choices congruent with everyday lived experience. The implications of these findings for the development of meaningful interventions for youth are discussed.
Fast
Danya
D
British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, Canada.
Small
Will
W
Krüsi
Andrea
A
Wood
Evan
E
Kerr
Thomas
T
D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology / Q000523:psychology*; D000328:Adult; D000884:Anthropology, Cultural / Q000706:statistics & numerical data; D001955:British Columbia / Q000453:epidemiology; D002755:Choice Behavior; D015331:Cohort Studies; D055030:Drug Users / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D013287:Illicit Drugs / Q000191:economics / Q000600:supply & distribution; D007407:Interviews as Topic; D008297:Male; D012309:Risk-Taking; D011477:Sex Work / Q000208:ethnology; D012725:Sexual Behavior; D012931:Social Environment; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000208:ethnology / Q000523:psychology*; D055815:Young Adult
D013287:Illicit Drugs