Dataset Information

Prevalence and correlates of selling illicit cannabis among people who use drugs in Vancouver, Canada: A ten-year prospective cohort study.

ABSTRACT: 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?

SUBMITTER: Reddon H

PROVIDER: S-EPMC7039539 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Prevalence and correlates of selling illicit cannabis among people who use drugs in Vancouver, Canada: A ten-year prospective cohort study.

Reddon Hudson H Fast Danya D DeBeck Kora K Werb Dan D Hayashi Kanna K Wood Evan E Milloy M-J MJ

The International journal on drug policy 20190420

<h4>Background</h4>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 ...[more]

PMID: 31015080

Similar Datasets

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.

Project description:BACKGROUND:People who inject drugs (PWID) experience elevated rates of premature mortality. Although previous studies have demonstrated the role of supervised injection facilities (SIFs) in reducing various harms associated with injection drug use, including accidental overdose death, the possible impact of SIF use on all-cause mortality is unknown. Therefore, we examined the relationship between frequent SIF use and all-cause mortality among PWID in Vancouver, Canada. METHODS AND FINDINGS:Data were derived from 2 prospective cohort studies of PWID in Vancouver, Canada, between December 2006 and June 2017. Every 6 months, participants completed questionnaires that elicited information regarding sociodemographic characteristics, substance use patterns, social-structural exposures, and use of health services including SIFs. These data were confidentially linked to the provincial vital statistics database to ascertain mortality rates and causes of death. We used multivariable extended Cox regression analyses to estimate the independent association between frequent (i.e., at least weekly) SIF use and all-cause mortality. Of 811 participants, 278 (34.3%) were women, and the median age was 39 years (IQR 33-46) at baseline. In total, 432 (53.3%) participants reported frequent SIF use at baseline, and 379 (46.7%) did not. At baseline, frequent SIF users were on average younger than nonfrequent users, and a higher proportion of frequent SIF users than nonfrequent users were unstably housed, resided in the Downtown Eastside neighbourhood, injected in public, had a recent non-fatal overdose, used prescription opioids at least daily, injected heroin at least daily, injected cocaine at least daily, and injected crystal methamphetamine at least daily. A lower proportion of frequent SIF users than nonfrequent users were HIV positive and enrolled in addiction treatment at baseline. The median duration of follow-up among study participants was 72 months (IQR 24-123). In total, 112 participants (13.8%) died during the study period, yielding a crude mortality rate of 22.7 (95% CI 18.7-27.4) deaths per 1,000 person-years. The median years of potential life lost per death was 34 (IQR 27-42) years. In a time-updated multivariable model, frequent SIF use was inversely associated with risk of all-cause mortality after adjusting for potential confounders, including age, sex, HIV seropositivity, unstable housing, at least daily cocaine injection, public injection, incarceration, enrolment in addiction treatment, and calendar year of interview (adjusted hazard ratio 0.46, 95% CI 0.26-0.80, p = 0.006). The main study limitations are the limited generalizability of findings due to non-random sampling, the potential for reporting biases due to reliance on some self-reported information, and the possibility that residual confounding influenced findings. CONCLUSIONS:We observed a high burden of premature mortality among a community-recruited cohort of PWID. Frequent SIF use was associated with a lower risk of death, independent of relevant confounders. These findings support efforts to enhance access to SIFs as a strategy to reduce mortality among PWID. Further analyses of individual-level data are needed to determine estimates of, and potential causal pathways underlying, associations between SIF use and specific causes of death.

Dataset Information

Prevalence and correlates of selling illicit cannabis among people who use drugs in Vancouver, Canada: A ten-year prospective cohort study.

Publications

Prevalence and correlates of selling illicit cannabis among people who use drugs in Vancouver, Canada: A ten-year prospective cohort study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets