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“There was so much crack in the neighbourhood that users and outreach workers nicknamed the area Rochelaga.”

When anthropologist Nelson Arruda explored an east-end Montreal neighbourhood, he expected to find shooting galleries — dark, clandestine places where people inject drugs — and sex slaves addicted to the next high.

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What he found in Hochelaga-Maisonneuve were crack houses — located every three blocks, and concentrated on a stretch spanning 20 streets — governed according to strict rules that included a ban on injecting and prostitutes who on the surface operated independently. To get inside, users had to be known to the house “gatekeeper” or seller. Arruda, who was already working closely with community street workers involved in harm-reduction programs for four years in downtown Montreal, got introduced to the east-end “Rocklaga” scene.

In a first Canadian study of its kind led by Dr. Élise Roy, professor at the faculty of medicine and health sciences at the Université de Sherbrooke and research chair on addiction, Arruda spent a year on the trail of high-risk behaviours at the intersection of illicit cocaine use. Starting July 2011, Arruda observed and interviewed crack cocaine users inside crack houses that are commonly called “piaules” in French, or tiny apartments. What Arruda found underscores the importance of the environment in public health approaches to addiction, drug abuse and health risks.