2S/LGBTQ+ youth substance use and pathways to homelessness: A photovoice study

•2S/LGBTQ+ youth narrated their substance use and homelessness trajectories.•They took refuge in drugs to survive early-life hardships and becoming homeless.•2S/LGBTQ+ youth also used drugs for release and to shift away from marginalization.•Stimulants were used for pleasure, connection, and experimentation amid inequity.•Drugs simultaneously invoked discomforts, including eviction from the family home. Studies have posited that substance use is associated with, or contributes to, homelessness for 2S/LGBTQ+ youth. However, interconnections between these issues are poorly articulated. This community-based photovoice study describes the narratives used by 2S/LGBTQ+ youth about how substance use featured in their pathways to homelessness. Employing constructionist narrative analysis, two storylines were inductively derived from participant-produced photographs and photovoice interviews with 32 2S/LGBTQ+ youth in Vancouver, Canada. Taking refuge narratives centered on 2S/LGBTQ+ youths’ use of substances to cope with intersecting hardships and minority stressors they had faced growing up, and when transitioning to homelessness. From playing into precarity narratives focused on the shifting possibilities and tensions of what sexualized crystal methamphetamine use can surface for 2S/LGBTQ+ youth in terms of facilitating connection and release and simultaneously invoking discomforts, including eviction from their family home. These narratives can usefully be anticipated and recognized to better understand and address the social contexts in which 2S/LGBTQ+ youth experience substance use and associated harms, especially homelessness. They affirm the need for tailored supports for 2S/LGBTQ+ youth who use drugs in the lead-up to and after becoming homeless, including the provision of care that better recognizes youths’ pursuits of becoming and belonging in the context of marginalization, and that takes a harm reduction approach to addressing the role of substance use in these pursuits.