Initiation of drug dealing among a prospective cohort of street-involved youth

Abstract

Background Street-involved youth who use drugs may have limited income-generation options and are known to commonly become immersed in illicit drug markets to generate funds. However, little attention has been given to factors that may drive drug dealing initiation among this vulnerable population. Objectives This longitudinal study examines drug dealing initiation among street-involved youth. Methods Data were derived from the At-Risk Youth Study from September 2005 to November 2014; a prospective cohort of 194 street-involved youth who use drugs aged 14 - 26, in Vancouver, Canada. Extended Cox model was used to identify factors independently associated with time to first drug dealing. Results Among street-involved youth who had never dealt drugs at baseline, 56 (29%) individuals initiated drug dealing during the study period for an incidence density of 13.0 per 100 person-years (95% Confidence Interval [CI]: 9.9-17.2). In multivariable Cox regression analysis, male gender (Adjusted Hazard Ratio [AHR] = 1.90, 95% CI: 1.06-3.42), homelessness (AHR = 1.88, 95% CI: 1.05-3.35), crystal methamphetamine use (AHR = 2.48, 95% CI: 1.47-4.20), and crack cocaine use (AHR = 2.35, 95% CI: 1.38-4.00) were positively and independently associated with initiating drug dealing. Conclusion Homelessness and stimulant drug use were key risk factors for drug dealing initiation among street-involved youth. Findings indicate that evidence-based and innovative interventions, including youth-centric supportive housing, low threshold employment programs, and stimulant addiction treatment should be implemented and evaluated as strategies to help prevent this vulnerable population from engaging in risky illegal income generation practices.

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

“…The health, social and economic benefits of integrating employment opportunities for PWUD with substance use treatment have been reported in settings such as Portugal, where the average employment rate of PWUD undergoing treatment is nearly 50% (Goncalves, Lourenco, & Silva, 2015;Hughes & Stevens, 2010). Our finding that selling cannabis was more common among males and is associated with experiencing violence is also congruent with previous research (Bourgois, Prince, & Moss, 2004;Denton, 1999;Hayashi et al, 2016;Hepburn et al, 2016;Mayock, 2005). With no recourse to legal dispute settlement mechanisms, street-based drug dealing is often animated by gendered hierarchies and forms of sociality that position men in dominant roles with greater control over resources, as well as at higher risk for experiencing violence (Bourdieu, 2001;Epele, 2002;Fairbairn, Small, Shannon, Wood, & Kerr, 2008).…”

“…We observed greater likelihoods of cannabis selling among younger individuals and males, consistent with cohort data from at-risk youth in North America reporting that over half of the participants have engaged in drug dealing, while studies of older PWUD report prevalence estimates of 17-25% (Gwadz et al, 2009;Kerr et al, 2008;Semple, Strathdee, Zians, & Patterson, 2013;Werb et al, 2008). Many PWUD initiate and continue drug dealing despite the associated risks, due to the need to support ongoing drug use, as well as the stigmatization and marginalization that persist as barriers to participation in the legal economy (Fast et al, 2017;Hepburn et al, 2016;Small et al, 2013;Werb et al, 2011). Looking beyond economic explanations, qualitative work suggests that drug dealing can enmesh individuals in valued forms of sociality, morality, dignity and belonging in places characterized by entrenched marginalization and exclusion (Bourgois, 1996;Cheng et al, 2016;Fast et al, 2017;Fast, Shoveller, Shannon, & Kerr, 2010;Wakeman, 2016).…”

“…The lowest quasilikelihood under the independence model criterion (QIC) value was used to identify the model with the best overall fit (Pan, 2001). Since engagement with selling illicit drugs has been found to vary by gender and age, and because of strong age and gender correlates of cannabis selling in the preliminary analyses, we also conducted subanalyses to identify predictors of selling cannabis in specific sex and age strata (Bellair & McNulty, 2009;Fast, Shoveller, & Kerr, 2017;Gwadz et al, 2009;Hepburn et al, 2016;Mayock, 2005). These additional models included subgroups of females ≤ 30 years old, males ≤ 30 years old, females > 30 years old, males >30 years old.…”

Socioeconomic factors associated with cessation of injection drug use among street-involved youth

“…We also used an extended Cox proportional hazards regression model with time-updated variables to examine bivariate associations between each of the sociodemographic and socioeconomic factors, and time to cessation of injection drug use. The extended Cox model has been validated [ 15 ] and widely used in previous studies [ 7 , 16 , 17 ]. The inclusion of time-updated covariates in an extended Cox model negates the requirement of the proportional hazards assumption [ 15 ].…”

The costs of crime associated with stimulant use in a Canadian setting

“…Furthermore, acute effects of drug use in reducing impulse control have been found to be more pronounced in stimulants than opiates (Badiani et al, 2011). Economic motivations for criminal activity stemming from stimulant use (such as acquisitive crime and other income generating activities) are perhaps the most direct mechanism for this relationship, given the high cost of illicit drugs (Bennett et al, 2008; Hepburn et al, 2016; Wilkins and Sweetsur, 2011). …”