Dataset Information

Hospitalization among street-involved youth who use illicit drugs in Vancouver, Canada: a longitudinal analysis.

ABSTRACT: BACKGROUND:Street-involved youth who use illicit drugs are at high risk for health-related harms; however, the profile of youth at greatest risk of hospitalization has not been well described. We sought to characterize hospitalization among street-involved youth who use illicit drugs and identify the most frequent medical reasons for hospitalization among this population. METHODS:From January 2005 to May 2016, data were collected from the At-Risk Youth Study (ARYS), a prospective cohort study of street-involved youth in Vancouver, Canada. Multivariable generalized estimating equation (GEE) was used to identify factors associated with hospitalization. RESULTS:Among 1216 participants, 373 (30.7%) individuals reported hospitalization in the previous 6 months at some point during the study period. The top three reported medical reasons for hospital admission were the following: mental illness (37.77%), physical trauma (12.77%), and drug-related issues (12.59%). Factors significantly associated with hospitalization were the following: past diagnosis of a mental illness (adjusted odds ratio [AOR]?=?1.85; 95% confidence interval [95% CI] 1.47-2.33), frequent cocaine use (AOR?=?2.15; 95% CI 1.37-3.37), non-fatal overdose (AOR?=?1.76; 95% CI 1.37-2.25), and homelessness (AOR?=?1.40; 95% CI 1.16-1.68) (all p?

SUBMITTER: Chang DC

PROVIDER: S-EPMC5859496 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Hospitalization among street-involved youth who use illicit drugs in Vancouver, Canada: a longitudinal analysis.

Chang Derek C DC Rieb Launette L Nosova Ekaterina E Liu Yang Y Kerr Thomas T DeBeck Kora K

Harm reduction journal 20180320 1

<h4>Background</h4>Street-involved youth who use illicit drugs are at high risk for health-related harms; however, the profile of youth at greatest risk of hospitalization has not been well described. We sought to characterize hospitalization among street-involved youth who use illicit drugs and identify the most frequent medical reasons for hospitalization among this population.<h4>Methods</h4>From January 2005 to May 2016, data were collected from the At-Risk Youth Study (ARYS), a prospective ...[more]

PMID: 29558943

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Project description:BACKGROUND:The illicit selling and use of cannabis is prevalent among marginalized people who use illicit drugs (PWUD). Given that participation in illicit drug markets has been previously associated with a range of health and social harms, we sought to examine the predictors of selling cannabis among PWUD in Vancouver, Canada, a setting with a de facto legalized cannabis market, on the eve of the planned implementation of legalized non-medical cannabis including measures to regulate the existing illicit market. METHODS:Multivariable generalized estimating equations (GEE) logistic regression was used to analyze longitudinal factors associated with selling illicit cannabis among three prospective cohorts of PWUD between September 2005 and May 2015. RESULTS:Among the 3258 participants included in this study, 328 (10.1%) reported selling illicit cannabis at baseline, and 46 (5.1%) initiated cannabis selling over the study period. In the multivariable analysis of the whole sample, factors significantly associated with selling cannabis included cannabis use (Adjusted Odds Ratio [AOR]?=?4.05), dealing other drugs (AOR?=?3.87), being male (AOR?=?1.83), experiencing violence (AOR?=?1.40), non-medical prescription opioid use (AOR?=?1.32), non-custodial involvement in the criminal justice system (AOR?=?1.31), being stopped by police (AOR?=?1.30), crack use (AOR?=?1.25), homelessness (AOR?=?1.23), age (AOR?=?0.96 per year) and participation in sex work (AOR?=?0.67) (all p?<?0.05). The subanalyses indicated that dealing drugs other than cannabis, cannabis use, and non-custodial involvement in the criminal justice system were the only factors significantly associated with selling cannabis in all four subgroups. CONCLUSION:These findings support existing evidence indicating that selling illicit cannabis is often a survival-driven strategy to support the basic needs and substance use of some PWUD. Our findings suggest jurisdictions with planned or impending cannabis legalization and regulation should consider the vulnerability of PWUD when seeking to eradicate illicit cannabis markets, for example, in setting criminal penalties for selling cannabis outside of regulatory frameworks.

Project description:BackgroundIllicit drug use rates are high among Canadian youth, and are particularly pronounced in Northern Ontario. The availability and accessibility of effective substance use-related treatments and services are required to address this problem, especially among rural and remote Northern communities. In order to assess specific service and treatment needs, as well as barriers and deterrents to accessing and utilizing services and treatments for youth who use illicit drugs in Northern Ontario, we conducted the present study.MethodsThis study utilized a mixed-methods design and incorporated a community-based participatory research approach. Questionnaires were administered in conjunction with audio-recorded semi-structured interviews and/or focus groups with youth (aged 14-25) who live in Northern Ontario and use illicit drugs. Interviews with 'key informants' who work with the youth in each community were also conducted. Between August and December 2017, the research team traveled to Northern Ontario communities and carried out data collection procedures.ResultsA total of 102 youth and 35 key informants from eleven different Northern Ontario communities were interviewed. The most commonly used drugs were prescription opioids, cocaine and crack-cocaine. Most participants experienced problems related to their drug use, and reported 'fair' mental and physical health status. Qualitative analyses highlighted an overall lack of services; barriers to accessing treatment and services included lack of motivation, stigmatization, long wait-lists and transportation/mobility issues. Articulated needs revolved around the necessity of harm reduction-based services, low-threshold programs, specialized programming, and peer-based counselling.ConclusionsAlthough each community varied in terms of drug use behaviors and available services, an overall need for youth-specific, low-threshold services was identified. Information gathered from this study can be used to help inform rural and remote communities towards improving treatment and service system performance and provision.

Project description:BACKGROUND:Urban drug scenes are characterized by high prevalence of illicit drug dealing and use, violence and poverty, much of which is driven by the criminalization of people who use illicit drugs (PWUD) and the associated stigma. Despite significant public health needs, little is understood about patterns of moving into urban drug scenes among PWUD. Therefore, we sought to identify trajectories of residential mobility (hereafter 'mobility') among PWUD into the Downtown Eastside (DTES), an urban neighbourhood with an open drug scene in Vancouver, Canada, as well as characterize distinct trajectory groups among PWUD. METHODS:Data were derived from three prospective cohort studies of community-recruited PWUD in Vancouver between 2005 and 2016. We used latent class growth analysis (LCGA) to identify distinct patterns of moving into the DTES among participants residing outside of DTES at baseline. Multivariable multinomial logistic regression was used to determine baseline factors associated with each trajectory group. RESULTS:In total, 906 eligible participants (30.9% females) provided 9,317 observations. The LCGA assigned four trajectories: consistently living outside of DTES (52.8%); early move into DTES (11.9%); gradual move into DTES (19.5%); and move in then out (15.8%). Younger PWUD, those of Indigenous ancestry, those who were homeless or living in a single-room occupancy hotel (SRO), and those injecting drugs daily were more likely to move in then out of DTES (all p<0.05). Living in an SRO, daily injection drug use, and recent incarceration were also positively associated with early mobility (all p<0.05). CONCLUSIONS:Nearly half of the participants moved into the DTES. Younger PWUD and Indigenous peoples appeared to have particularly high mobility, as did those with markers of social-structural vulnerability and high intensity drug use. These findings indicate a need to tailor existing social and health services within the DTES and expand affordable housing options outside the DTES.

Dataset Information

Hospitalization among street-involved youth who use illicit drugs in Vancouver, Canada: a longitudinal analysis.

Publications

Hospitalization among street-involved youth who use illicit drugs in Vancouver, Canada: a longitudinal analysis.

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