title: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6; Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada; Viral Hepatitis Epidemiology and Prevention Program, Kirby Institute, Darlinghurst, Sydney, NSW, Australia. Electronic address: wsmall@cfenet.ubc.ca.
authors.forename: Will
authors.initials: W
authors.lastname: Small
authors.forename: Lisa
authors.initials: L
authors.lastname: Maher
authors.forename: Jeff
authors.initials: J
authors.lastname: Lawlor
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Kate
authors.initials: K
authors.lastname: Shannon
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D002170:Canada; D064423:Drug Trafficking / Q000523:psychology*; D006801:Humans; D036301:Qualitative Research; D018570:Risk Assessment; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D014505:Urban Population; D014754:Violence / Q000523:psychology*
keywords: Drug dealing; Injection drug use; Risk environment; Violence