Integrating the Notions of Complexity and Social Suffering to Provide Better Care to Sexually and Gender-Diverse Men Who Use Methamphetamine

The problematic use of methamphetamine among sexually and gender-diverse men (SGDM) is a public health issue. We must question the context in which these individuals use as well as their needs and the efficacy of addiction services in order to propose guidelines that integrate two essential notions: 1) the complexity of this social problem which requires the use of several types of knowledge and disciplines; 2) the social suffering experienced by this population and understood as a specific relationship to social and psychological difficulties, compounded by social factors that may be conducive to methamphetamine use.

Using the Rapid Assessment Process, we conducted semi-structured interviews with SGDM that use methamphetamine (n=25), managers (n=7), and counsellors (n=15) working with this population in three administrative regions of Quebec (Canada). A thematic analysis was conducted.

SGDM who use methamphetamine struggle to get their needs met in existing services, which are slow to integrate their situated knowledge as substance users and an interdisciplinary and holistic approach. Counsellors and resource managers describe services, existing in silos, that reflect disciplinary overspecialization and fail to consider the complex realities of SGDM. We propose the integration of the notions of complexity and social suffering to provide better care to SGDM through: the development of collaborative partnerships between counsellors, sexologists, and psychologists; the integration of peer researchers; the development of workshops on interdisciplinarity and social suffering among SGDM intended for all resource staff; and the development of measures to combat LGBTQ+- phobia.

We take an innovative look at understanding methamphetamine use among SGDM. An interdisciplinary approach is needed to better support these men whose social suffering remains unheard due to the inability of services to draw on multiple sources of knowledge and promote a holistic, comprehensive vision of health.