Drug‐related harm coinciding with income assistance payments: results from a community‐based cohort of people who use drugs

Background and Aims Income assistance is critical to the health and wellbeing of socio‐economically marginalized people who use illicit drugs (PWUD). However, past literature paradoxically identifies unintended increases in drug‐related harm coinciding with synchronized payments that may magnify sig...

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Veröffentlicht in:Addiction (Abingdon, England) England), 2021-03, Vol.116 (3), p.536-545
Hauptverfasser: Richardson, Lindsey, Dong, Huiru, Kerr, Thomas, Milloy, M‐J, Hayashi, Kanna
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Sprache:eng
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Zusammenfassung:Background and Aims Income assistance is critical to the health and wellbeing of socio‐economically marginalized people who use illicit drugs (PWUD). However, past literature paradoxically identifies unintended increases in drug‐related harm coinciding with synchronized payments that may magnify signals for drug use. The scope of such harm has not been fully characterized among non‐institutionalized populations. This study examined socio‐demographic, health and drug use‐related correlates of payment‐coincident drug‐related harm. Design This observational study uses data from prospective community‐based longitudinal cohorts of PWUD between December 2013 and May 2018. Setting Vancouver, British Columbia, Canada. Participants A total of 1604 PWUD receiving monthly income assistance. Our sample included 586 (36.5%) women, 861 (53.7%) non‐white participants and 685 (42.7%) people living with HIV. Measurements The primary outcome was a self‐reported composite measure of drug‐related harm in the past 6 months coinciding with income assistance, including higher‐frequency substance use, non‐fatal overdose and service barriers or interruptions. Subanalyses disaggregated this outcome. Findings Payment‐coincident drug‐related harm was reported among 77.7% of participants during the study period. In multivariable models, key correlates positively and significantly associated with payment‐coincident harm included: street‐based income generation [adjusted odds ratio (aOR) = 1.48, 95% confidence interval (CI) = 1.26–1.74, P 
ISSN:0965-2140
1360-0443
DOI:10.1111/add.15182