Two Way Prayer: A Lost Tool for Practicing the 11th Step

Two Way Prayer formed an essential part of Oxford Group and early Alcoholics Anonymous (AA) spiritual practices. Pioneer AA members considered it more essential for recovery than attendance at meetings; however, it was gradually lost as a component of contemporary 12-Step programs. The article gives an overview of its history and provides a model for a more contemporary form of its practice. Initial evaluation suggests promising outcomes among a sampling of youth and adults engaged in a peer-support group for drug and alcohol recovery. The article includes a discussion of its use with individuals not having a religious conception of spirituality.     

Stigma,sex work,and substance use: a comparative analysis

Stigma is a widely used concept in social science research and an extensive literature claims that stigmatisation contributes to numerous negative health outcomes. However, few studies compare groups that vary in the extent to which they are stigmatised and even fewer studies examine stigma's independent and mediating effects. This article addresses these gaps in a comparative study of perceived stigma and drug use among three low‐income feminised service occupations: sex work, food and alcoholic beverage serving, and barbering and hairstyling. An analysis of longitudinal data shows positive associations between sex work, perceived stigma, and socially less acceptable drug use (for example, heroin and cocaine), and that stigma mediates part of the link between sex work and the use of these drugs. Our overall findings suggest that perceived stigma is pronounced among those who work in the sex industry and negatively affects health independently of sex work involvement.     

‘Underclassism’ and access to healthcare in urban centres

In this article, we draw on findings from an ethnographic study that explored experiences of healthcare access from the perspectives of Indigenous and non‐Indigenous patients seeking services at the non‐urgent division of an urban emergency department (ED) in Canada. Our aim is to critically examine the notion of ‘underclassism’ within the context of healthcare in urban centres. Specifically, we discuss some of the processes by which patients experiencing poverty and racialisation are constructed as ‘underclass’ patients, and how assumptions of those patients as social and economic Other (including being seen as ‘drug users’ and ‘welfare dependents’) subject them to marginalisation, discrimination, and inequitable treatment within the healthcare system. We contend that healthcare is not only a clinical space; it is also a social space in which unequal power relations along the intersecting axes of ‘race’ and class are negotiated. Given the largely invisible roles that healthcare plays in controlling access to resources and power for people who are marginalised, we argue that there is an urgent need to improve healthcare inequities by challenging the taken‐for‐granted assumption that healthcare is equally accessible for all Canadians irrespective of differences in social and economic positioning.