Search results

The prevalence of older people who use drugs is increasing in many countries, with evidence that some women continue or begin illicit substance use in midlife and older age. While research on older people who use drugs is limited, evidence of risk behaviours among older women who use drugs is particularly inadequate. Unsafe drug use and sexual practices that are prolonged and sustained over many years increase the possibilities for poorer health, leading to potentially greater morbidity and early mortality among older drug users. This chapter is a timely contribution to the extant literature and explores our current knowledge of the risk behaviours of older women who use drugs.

Although midlife is viewed as a transition period in the life course, the normative role expectations of midlife and older women run parallel to the stereotypes of women who use drugs. Furthermore, drug-using bodies are politically and culturally shaped through control and containment practices centred around notions of difference and risk. Acknowledging the intersection of age, race and gender, this chapter frames its position around the concepts of ‘risk’ and ‘edgework’. Utilising these theoretical concepts, this chapter argues that a shift towards a support-focussed model, rather than control of, older women who use drugs is required. The absence of a focussed, gendered analysis of the lives and experiences of older drug users, and older women who use drugs in particular, limits our understanding. Consequently, the chapter concludes with a call for well-designed studies of this increasing and largely hidden cohort of drug users.

The purpose of this paper was to develop deeper insights into the practices enacted by entrepreneurial healthcare managers to enhance the implementation of a partnership logic in integrated care models for older adults.

A multiple case study design in two urban centres in two jurisdictions in Canada, Ontario and Quebec. Data collection included 65 semi-structured interviews with policymakers, managers and providers and analysis of key policy documents. The institutional entrepreneur theory provided the theoretical lens and informed a reflexive iterative data analysis.

While each case faced unique challenges, there were similarities and differences in how managers enhanced a partnership’s institutional logic. In both cases, entrepreneurial healthcare managers created new roles, negotiated mutually beneficial agreements and co-located staff to foster inter-organisational partnerships between public, private and community organisations in the continuum of care for older adults. In addition, managers in Ontario secured additional funding, while managers in Quebec organised biannual meetings and joint training to enhance inter-organisational partnerships.

This study has two main implications. First, efforts to enhance inter-organisational partnerships should strategically include institutional entrepreneurs. Second, successful institutional changes may be supported by investing in integrated implementation strategies that target roles of staff, co-location and inter-organisational agreements.

This chapter presents a broad introduction to women’s varied interactions with drugs and drug markets. It provides a brief overview of the international framework of drug control and the ways in which drug policy enforcement differently impacts women and men. It highlights the negative and disproportionate impacts on women of criminalisation-based approaches and how drug policy serves to reinforce existing problems of structural discrimination. This provides context for the contributions to this edited collection, which are summarised in the introduction. The book situates drug policy reform as a crucial and underlooked feminist issue.