Vulnerable, Helpless, and Hopeless: Representations of Youth Who Use Drugs in Canadian Substance Use-Focused Anti-Stigma Campaigns (2009–2020)

Abstract

Involuntary treatment policies that remove youth autonomy threaten the well-being of youth who use drugs (YWUD) and constitute a form of structural stigma. Recent debate in British Columbia (BC) on “secure care” legislation (e.g., support from wealthy White parents and opposition by Indigenous organizations) shows how the agency of YWUD is contested and how ageism intersects with racism and substance use stigma. How do substance use anti-stigma campaigns contribute to this debate? We critically analyzed representations of 193 YWUD (15–29 years old) in 66 Canadian substance use-focused anti-stigma campaigns (e.g., videos, posters, social media posts, etc.). We also examined the implicit messages these campaigns expressed about YWUD's rights to autonomy. YWUD in campaigns almost exclusively appeared to be White and just one appeared to be Indigenous. A reflexive thematic analysis of campaign materials identified three themes: framing YWUD as uniquely vulnerable, framing YWUD and parents as powerless, and framing YWUD as forfeiting their autonomy. We discuss how anti-stigma campaigns may target individual stigma but ironically contribute to support for involuntary treatment policies that bolster structural stigma.