Ironies in the Pursuit of Well-Being: The Perspectives of Low-Income,Substance-Using Women on Service Institutions

Abstract

Interest in improving low-income, drug-using women's access to and utilization of care services tends to focus on remedies to personal, structural and gendered barriers to care. In contrast, this exploratory, qualitative study of women's perspectives illustrates how institutional rules, both within and across agencies, and informal provider practices can constrain women's use of health and social services. This paper draws attention to the ways in which low-income, drug-using women respond to obstacles and interpersonal tensions they experience in service settings. As a means of pursuing their material and social well-being, the women employ forms of resistance that are both protective and potentially harmful. This paper underscores the need to recognize how service institutions are implicated in drug users' everyday struggles for well-being.