Dr. Robert (Dan) Small

Dr. Dan Small, PhD, MPhil is a medical anthropologist and Research Associate inthe Department of Anthropology at the University of British Columbia. He has helped develop and operate a range of healthcare and housing services for marginalized populations including: harm reduction (e.g. syringe distribution, supervised injection, safer crack kits, managed alcohol, intravenous antibiotic treatment and a drug users resource centre), an inner city bank, detox, dental clinic, grocery store for the low income community, art gallery, recovery programsand low-income housing. His role in developing, operating and protecting Insite, North America's only supervised injection facility, took place in a busy socio-political intersection requiring cultural analysis of implicit and explicit values. His experience in medical regulation and medical student assessment has included involvement in the College of Physicians and Surgeons of BC (2000-2014) and Medical Council of Canada (2007-2014).

Latest Update:

  • Insite Safer Injection Site
  • Awards
  • Research Interests

    • The Lived Experience of Illness
    • Medical Healthcare Culture
    • Peer to Peer Regulations and Assessments
    • Therapeutic and Healing Narratives
    • Hereditary Cancer
    • Globalzation, Capitalist Culture and Contemporary Social Problems: Homlessness, Mental Illness and Addiction
    • Removing Healthcare and Housing Barriers
    • Addiction, Harm Reduction and Marginalized Populations
    • Law Enforcement and Harm Reduction

    Medical Council of Canada

    Dr. Small was involved in the Medical Council of Canada (MCC) from 2007-2014. The MCC was established in 1912 by an Act of Parliament. The MCC is responsible for harmonizing standards of medical qualification, the Licentiate of the Medical Council of Canada (LMCC), across Canada.

    Dr. Dan Small was appointed to the Medical Council of Canada in 2007 following a recommendation from the College of Physicians and Surgeonsof BC. He served as a member at large on the Medical Council from 2007to 2014

    He was initially involved in the Legislation Committee as well as the MCC History and Archives Committee. He also served as a member of the committee for the development of purpose-constructed MCC building. He was appointed to the Finance Committee for the MCC from 2010-2014where he served as Chair and as a member of the Executive from 2010 to2014.

    Anthropology 227: Culture, Health and Illness (Medical Anthropology)

    This course surveys some of the fields of medical anthropology thatcan be used to enrich our understanding of illness, healing and clinical encounters. Ultimately, students will also be invited to explore the idea that medicine is not only influenced by culture, it is,in and of itself, a cultural process. From beginning to end, this course will contemplate an important question for medical anthropology and for everyday people experiencing illness: can patients and clinicians stand closer together as they face inevitable illness and mortality? The course will examine narratives and experiences of patients, families and clinicians in an attempt to convince the student that the answer to this question is yes, definitely yes.

    Anthropology 202A: Contemporary Social Problems: Anthropological Examination of Addiction, Mental Illness and Homelessness

    This course examines some of the most significant of contemporarysocial problems with special emphasis on addiction, mental illness, and homelessness from the point of view of anthropology. It focuses on addiction as a case study for a socio-cultural approach to understanding social problems and includes both applied and ethnographic materials relating to implicit or explicit values, narratives and psychosocial interventions. The theoretical framework for the course is rooted in applied, critical and public anthropology that relies on a socio-cultural analysis and includes anexploration of the potential influence of globalization and capitalist narratives on social problems.

    Anthropology 202B: Contemporary Social Problems: AnthropologicalExamination of Drugs, Societal Responses and Moral Order: Drugs, Demons and Damnation

    This course employs anthropology, with its socio-cultural and qualitative approach; to examine drugs and drug related issues. It includes theoretical, applied and ethnographic materials relating to implicit or explicit values, narratives and societal approaches to answer the question: what, exactly, are drugs? Students will learn that in some ways, this is like asking about the difference between a weed and a flower. These questions cannot be answered meaningfully without first exploring the meanings that we have ascribed to the objects we observe. The course will explore moral, legal, scientific, medical and pharmaceutical narratives about drugswithin an historical and cultural context

    SOCI 250: Crime and Society

    This course examines crime and society. It begins with a question: what, exactly, is crime? A diverse range of human activity could be considered criminal such as that relating to persons, the state, environment, property, human rights, hatred, internet and financial systems. However, crime is not an immutable or naturalized phenomenon, but is subject to the vagaries of society. A significant assumption, and assertion, within this course is that notions of crime and deviance are socially constructed and vary across time and jurisdiction. Without sociology, it will be argued, there is no wayto adequately moor our understanding of crime and society. This course attempts to convince students that the examination of sociological currents is not only useful, but necessary, if we are to adequately investigate, understand and address crime and society.

    Education Background

    Dr. Dan Small is trained as a medical anthropologist with a PhD from the University of British Columbia. His doctoral research examined healing strategies for patients and families experiencing hereditary non-polyposis colorectal cancer as well as the understandings of cancer genetics by patients, families and clinicians. His master's degree was from the University Cambridge, England and focused on substance misuse and thesocial determinants of health in Inuit communities. He has a BA in sociology and anthropology from Simon Fraser University with first class honours. His honours thesis explored the culture of psychiatry. His first degree was in psychology from Simon Fraser University with first class honours. He completed an honours thesis on the etiology of addiction.

    Applied Work: Developing Healthcare and Housing Innovations for Hard to Reach Populations Page

    HEALTH CARE AND HOUSING PROGRAM DEVELOPMENT: Between 1996 and 2014, Dr. Small was Director Research,Development and Harm Reduction Services for a non-profitorganization dedicated to providing healthcare, housing andsupport services to hard to reach populations facing multiplehealth and psychosocial challenges including active intravenousdrug addiction, HIV/AIDS, mental illness, Hepatitis, conflict withthe law, sex trade involvement and adverse life events. He wasa key lead in establishing, managing and protecting NorthAmerica’s first Supervised Injection Facility (Insite), alcohol anddrug free recovery housing, peer to peer needle distributionprogram, a community based intravenous antibiotic health clinicfor people with active addictions and low barrier housing. I havebeen involved in the development hundreds of housing projects(including Woodwards), various low threshold treatmentservices as well as a dental clinic, vocational services, creditunion and art centre for low income residents of the DowntownEastside

    College of Physicians and Surgeons (2000-2014)

    Medical practice is regulated by Colleges of Physicians and Surgeons in Canada. Dr. Small was involved in the regulatory movement through the College of Physicians and Surgeons of British Columbia between 2000 and 2014.

    College of Physicians and Surgeons of BC Discipline Committee

    Under the Health Professions Act, Dr. Small was appointed by the Board of the College and Physicians of BC to the Discipline Committee 2009 and served until 2014

    College of Physicians and Surgeons of BC Ethics Committee

    Under the Health Professions Act, I was appointed by the Boardof the College and Physicians of BC to the Ethics Committee from 2009 to 2014.

    College of Physicians and Surgeons of BC Medical Inquiry Committees

    Under the legislation preceding the Health Practitioners Act, the Medical Practitioners Act, Dr. Small served as a public appointee to medical inquiries for over a decade.

    College of Physicians and Surgeons of BC

    From 2000-2002, Dr. Small served as a member of Council for the College of Physicians. He also served on the Quality of Medical Performance Committee as well as the Executive for the Council.

    Mental Health

    Between 1991 and 1995, Dr. Small was the program manager for a non-profit organization providing psychosocial support and housing for individuals living with serious and persistent mental illnesses. The organization, the Langley Stepping Stone Rehabilitative Society operated with a Clubhouse Model in order to provide vocational rehabilitation programs, He also developed the Langley Consumer/Family Partnership Education Speakers Bureau, was involved in the Closer to Home Initiative and Co-developed the Langley Consumer Outreach Program.

    Forensic Psychiatry

    In 1990-1991, Dr. Small was the founder of the Colonist Resident Newsletter Program and participated in the creation of a Multicultural Program, co-developed the Forensic Coping Fair and assisted in development of a First Nations brotherhood as well as an Aids Education Program.

    Psychosocial Rehabilitation Training for Front-line Workers

    Dr. Small acted as Chairman of an Education Committee for the Non-profit community agencies in the Fraser Valley/North ShoreRegion. Co-developed a 3-month training event for mental health workers in community mental health agencies using an adult learning model of education.

    Partnership Education Workshops for Consumers, Families, and Professionals

    Dr. Small facilitated numerous workshops on the Partnership Education Model premised on the validation of the experiences of family members and individuals with serious and persistent mental illness.

    Boards and Trusts

    Dr. Small served on a wide range of boards. He was chairman for three private charitable trusts. He has also served as a member of the Editorial Board for the Harm Reduction Journal as well as an external reviewer for peer-reviewed academic publications in numerous journals including: Biological Psychiatry, the American Journal of Public Health, Canadian Medical Association Journal, International Journal of Drug Policy, Drug and Alcohol Review, Harm Reduction Journal, Addiction, Research and Theory. He was also a member of the several other boards including: Langley Stepping Stone Rehabilitative Society, the West Fraser Housing Society, The Mental Patients Association, the Canadian Mental Health Association, the International Association for Psychosocial Rehabilitation, and the Gastown Safety Improvement Society.

    Awards

    • Special Guest of the United States Government Under the International Visitor Leadership Program Nov-Dec 2005
    • University Graduate Fellowship 2000-2001
    • S.S.H.R.C. Doctoral Fellowship 1997-20001
    • Koerner Doctoral Fellowship (declined) 1997-19981
    • University Graduate Fellowship (declined) 1997-1999
    • U.B.C. Canadian Airlines Travel Prize 1998
    • U.B.C. in 2010 Essay Competetion Prize 1998
    • Overseas Research 3 Year Fellowship (declined) 1996
    • Queen Elizabeth II Centennial Scholarship 1996
    • Simon Fraser University Open Scholarship 1993
    • Simon Fraser University Open Scholarship 1992
    • Simon Fraser University Open Scholarship 1992

    Selected Publication

    Drucker, E., K. Anderson, R. Haemmig, R. Heimer, D. Small, A. Walley, E. Wood and I. v. Beek (2016). "Treating Addictions: Harm Reduction in Clinical Care and Prevention." Journal of Bioethical Inquiry 13(1): 1-13.

    Gurstein, P. and D. Small (2005). "From Housing to Home: Reflexive Management for those Deemed Hard to House." Housing Studies 20(5): 717-735.

    Kerr, T., E. Wood, D. Small, A. Palepu and M. W. Tyndall (2003). "PotentialUse of Safer Injecting Facilities Among Injection Drug Users in Vancouver's Downtown Eastside." Canadian Medical Association Journal 169(8): 1-5

    Small, D. (2004). "Mental Illness, Addiciton and the Supervised Injection Facility: New Narratives on the Downtown Eastside." Visions: BC's Mental Health and Addictions Journal 2(5): 29-30.

    Small, D. (2005). "Two cultures passing in the night." International Journal of Drug Policy 16: 221-222.

    Small, D. (2006). "Patient, prisoner or person?" Harm Reduction Journal 3(23): 1-2.

    Small, D. (2007). "Fools rush in where angels fear to tread: Playing God with Vancouver’s Supervised Injection Facility in the political borderland." International Journal of Drug Policy 8: 18-26.

    Small, D. (2008). "Amazing grace: Vancouver's supervised injection facilitygranted six-month lease on life." Harm Reduction Journal 5(3): 1-6.

    Small, D. (2008). "Fighting addiction's death row: British Columbia Supreme Court Justice Ian Pitfield shows a measure of legal courage." Harm Reduction Journal 5(31): 1-16.

    Small, D. (2009). "Foundation skills assessment and expectancies: Pygmalion returns?" Teacher: Newsmagazine of the BC Teachers' Federation 2(4): 1-3.

    Small, D. (2009). "Love as harm reduction: fighting AIDS and stigma in Vietnam." Harm Reduction Journal 6(34): 1-5.

    Small, D. (2010). "An appeal to humanity: legal victory in favour of North America's only supervised injection facility." Harm Reduction Journa 7(23): 1-3.

    Small, D. (2011). "An anthropological examination of an exotic tribe: The Naicisyhp." BC Medical Journal 53(1): 1.

    Small, D. (2012). "Canada's highest court unchains injection drug users; implications for harm reduction as standard of healthcare." Harm Reduction Journal 9(34): 1-11.

    Small, D. (2012). "Visual AIDS: Standard of Caring." CATIE: Canada's source for HIV and hepatitis C information:1-2.

    Small, D. (2016). "Cultural Alchemy and Supervised Injection: Anthropological Activism and Application." Practicing Anthropology 39(2): 26-31.

    Small, Dan. 2016b Obituary: Ian Whitaker (1928-2016). Polar Record.

    Small, D. and E. Drucker (2006). "Policy makers ignoring science and scientists ignoring policy: the medical ethical challenges of heroin treatment." Harm Reduction Journal 3(16): 1-14.

    Small, D. and E. Drucker (2007). "Closed to reason: time for accountabilityfor the International Narcotic Control Board." Harm Reduction Journal 4(13): 1-8.

    Small, D. and E. Drucker (2008). "Return to Galileo? The Inquisition of the International Narcotic Control Board." Harm Reduction Journal 5(16): 1-6.

    Small, D., A. Glickman, G. Rigter and T. Walter (2010). "The Washington Needle Depot: fitting healthcare to injection drug users rather than injection drug users to healthcare: moving from a syringe exchange to syringe distribution model." Harm Reduction Journal 7(1): 1-12.

    Small, D., A. Palepu and M. W. Tyndal (2006). "The establishment of NorthAmerica's first state sanctioned supervised injection facility: a case study in culture change." International Journal of Drug Policy: 1-10.

    © 2017 Robert Small