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In this commentary, we argue that the use of amendments to bylaws by Ontario cities and municipalities to restrict where and how methadone maintenance treatment (MMT) clinics and pharmacies operate may run counter to efforts to prevent record high rates of opioid-related overdoses. As the province of Ontario seeks to reform the opioid treatment system, it is crucial to understand the structural (e.g., stigma) and treatment system organization factors that drive the actions of municipalities such as those described above. Changes that exacerbate these factors may lead to increased use of bylaws to curtail access at a time when efforts are underway to reduce alarming rates of opioid-related overdose.

Today, in Canada, Aboriginal peoples continue to experience marginalization, over representation in the child welfare system, and a higher prevalence of poverty and substance misuse challenges. These experiences affect for Aboriginal women in particular because of the oppressive experiences of systemic racism and discrimination they face, including legislation such as the Indian Act and the Child and Family Services Act, which directly targets them. This article is based on a research project conducted in Toronto, Ontario that implemented Aboriginal research methodologies to explore ways to increase collaboration between Aboriginal families, treatment counsellors, and child welfare workers. One significant theme that emerged out of this project was the concept of time as related to policy and legislation that negatively impact Aboriginal pregnant and/or parenting women. In this analysis, we focus on the concept of time as connected to four policy areas that emerged from the findings: historical trauma caused by discriminatory legislation, the family court system, the bureaucracy of child welfare, and the need for further research and long-term solutions.

Today, in Canada, Aboriginal peoples continue to experience marginalization, over representation in the child welfare system, and a higher prevalence of poverty and substance misuse challenges. These experiences affect for Aboriginal women in particular because of the oppressive experiences of systemic racism and discrimination they face, including legislation such as the Indian Act and the Child and Family Services Act, which directly targets them. This article is based on a research project conducted in Toronto, Ontario that implemented Aboriginal research methodologies to explore ways to increase collaboration between Aboriginal families, treatment counsellors, and child welfare workers. One significant theme that emerged out of this project was the concept of time as related to policy and legislation that negatively impact Aboriginal pregnant and/or parenting women. In this analysis, we focus on the concept of time as connected to four policy areas that emerged from the findings: historical trauma caused by discriminatory legislation, the family court system, the bureaucracy of child welfare, and the need for further research and long-term solutions.

Situational analysis has, as an emerging poststructuralist approach to grounded theory, recently grown in use across a diverse range of disciplines and substantive areas. In this paper, we consider the complementarity of Foucauldian governmentality as a theoretical framework for supporting and enriching situational analyses. Our work is based on the findings of a recent study, informed by situational analysis, in which we interviewed 27 HIV-positive (n=16) and HIV-negative (n=11) gay men ages 50 and over about their health care experiences, and used these data to examine processes of subjugation and resistance reflected in their accounts. Drawing on our analytical process, we consider the utility of governmentality in identifying salient discursive forces within a situation of interest, in theorizing how contextual factors operate on and influence the experiences of key actors in a field of inquiry, and in generating insight on fluid uses of power within an area under examination.

We report on the extent of cannabis treatment-seeking within an addiction treatment system in Canada. Data represent all new admissions in fiscal year 2000 to substance abuse treatment agencies in the province of Ontario (n = 47,995). Analyses examine the prevalence of cannabis problems by demographic and treatment characteristics and provide contrasts with other client subgroups (alcohol, cocaine, and opiates). Clients reporting cannabis as their primary problem substance (13%) were more likely to be male, single, under age 20 and in high school. Legal system involvement and school- or family-based pressure to enter treatment were commonly reported, but less so by older cannabis clients. The distinctiveness of these clients within the larger treatment system raises questions of the relevance to cannabis clients of interventions designed for other substance-abusing populations.

Situational analysis has, as an emerging poststructuralist approach to grounded theory, recently grown in use across a diverse range of disciplines and substantive areas. In this paper, we consider the complementarity of Foucauldian governmentality as a theoretical framework for supporting and enriching situational analyses. Our work is based on the findings of a recent study, informed by situational analysis, in which we interviewed 27 HIV-positive (n=16) and HIV-negative (n=11) gay men ages 50 and over about their health care experiences, and used these data to examine processes of subjugation and resistance reflected in their accounts. Drawing on our analytical process, we consider the utility of governmentality in identifying salient discursive forces within a situation of interest, in theorizing how contextual factors operate on and influence the experiences of key actors in a field of inquiry, and in generating insight on fluid uses of power within an area under examination.

Using qualitative methods, this study examined how, and under what circumstances, suicidal men used mental health services. In particular, the analyses focused on fragmented pathways to care. Fifteen men with a history of suicidal and aggressive behaviors and a diagnosis of borderline personality disorder and/or antisocial personality disorder participated in semistructured interviews that consisted of questions about their mental health status and experiences with mental health and addiction services. Interviews were taped and transcribed. An iterative, inductive qualitative analytic process was used. Men followed a cyclical pattern wherein negative experiences with health care providers were said to be followed by avoidance of health care settings, crisis, and then by involuntary service utilization. Men identified five health care provider and three personal practices, and two types of episodes they believed to contribute to their fragmented pathways to care. Implementation of specialized interventions, and providing patients with more information and more opportunity to participate in decisions, may improve interactions between patients and providers and improve patients' mental health status.