Interest in low-threshold employment among people who inject illicit drugs: Implications for street disorder

Abstract

Background Income generation opportunities available to people who use illicit drugs have been associated with street disorder. Among a cohort of injection drug users (IDU) we sought to examine street-based income generation practices and willingness to forgo these sources of income if other low-threshold work opportunities were made available. Methods Data were derived from a prospective community recruited cohort of IDU. We assessed the prevalence of engaging in disorderly street-based income generation activities, including sex work, drug dealing, panhandling, and recycling/salvaging/vending. Using multivariate logistic regressions based on Akaike information criterion and the best subset selection procedure, we identified factors associated with disorderly income generation activities, and assessed willingness to forgo these sources of income during the period of November 2008 to July 2009. Results Among our sample of 874 IDU, 418 (48%) reported engaging in a disorderly income generation activity in the previous six months. In multivariate analyses, engaging in disorderly income generation activities was independently associated with high intensity stimulant use, as well as binge drug use, having encounters with police, being a victim of violence, sharing used syringes, and injecting in public areas. Among those engaged in disorderly income generation, 198 (47%) reported a willingness to forgo these income sources if given opportunities for low-threshold employment, with sex workers being most willing to engage in alternative employment. Conclusion Engagement in disorderly street-based income generation activities was associated with high intensity stimulant drug use and various markers of risk. We found that a high proportion of illicit drug users were willing to cease engagement in these activities if they had options for causal low-threshold employment. These findings indicate that there is a high demand for low-threshold employment that may offer important opportunities to reduce drug-related street disorder and associated harms.

Prevalence and correlates of prescription opioid residue injection

“…This result is consistent with other studies that showed significant associations between illegal or marginal income sources and injection risk behaviours or risky patterns of drug use (Richardson et al, 2010;DeBeck et al, 2007;. For instance, in Vancouver, such sources of income have been linked to daily heroin injection (Richardson et al, 2010;Debeck et al, 2007;, injecting in public places (Richardson et al, 2010;DeBeck et al, 2011), binge drug use and syringe sharing (DeBeck et al, 2011). For drug residue injection, it can be hypothesized that, compared to legal income sources, marginal or criminal sources of income likely produce more irregular or weak income streams, which could force PO injectors to fall back on PO residues.…”

Socioeconomic marginalisation in the structural production of vulnerability to violence among people who use illicit drugs

“…39 table 3. Strangers were the most common perpetrators of violence (46.7%) and beatings were the most common types of violence (70.8%).…”

Police confrontations among street-involved youth in a Canadian setting

“…This is consistent with previous studies demonstrating that street-involved youth continue to be involved in high-risk income generating activities common within drug markets as a means to support their drug use behaviour and basic survival needs (Kerr, Marshall, et al, 2009; O’Grady & Gaetz, 2004). However, a study in Vancouver indicated that almost half of IDU involved in these income-generating activities were willing to engage in alternative, low-threshold employment if given the opportunity (DeBeck et al, 2011). Prior research has demonstrated that social factors such as poverty, unstable housing, and drug dependence are drivers of youth participation in high-income generating activities (Chettiar, Shannon, Wood, Zhang, & Kerr, 2010; Lankenau, Clatts, Welle, Goldsamt, & Gwadz, 2005; Werb, Kerr, Li, Montaner, & Wood, 2008).…”