Patterns of Non-injection Drug Use Associated with Injection Cessation among Street-Involved Youth in Vancouver, Canada

Lake, Stephanie; Nosova, Ekaterina; Milloy, M-J; Wood, Evan; DeBeck, Kora

doi:10.1007/s11524-017-0225-3

Cited by 7 publications

(3 citation statements)

References 46 publications

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“…One recent study among the same cohort of youth found that cessation of some forms of high intensity drug use (e.g. injection drug use) may occur while youth continue to use other, less harmful, forms of drugs such as cannabis . This suggests that non‐abstinence models may be suitable for some, and indeed many countries have accepted managed use as a treatment outcome goal in certain cases .…”

Section: Discussionmentioning

confidence: 99%

Homelessness and incarceration associated with relapse into stimulant and opioid use among youth who are street‐involved in Vancouver, Canada

Goldman-Hasbun

Nosova

Wood

et al. 2019

Drug and Alcohol Review

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Introduction and Aims. While much research has sought to identify the factors associated with initiation and cessation of various forms of drug use among vulnerable youth, little is known about relapse into drug use in this population. We sought to characterise relapse into stimulant and opioid use among street-involved youth in Vancouver, Canada. Design and Methods. Data were collected between 2005 and 2017 from the At-Risk Youth Study, a prospective cohort study of streetinvolved youth who use illicit drugs in Vancouver. Multivariable extended Cox regression was utilised to identify factors associated with relapse into illegal stimulants and/or opioids among youth who had previously ceased using stimulants and/or opioids for 6 months or longer. Results. Among 246 participants who reported a period of cessation lasting 6 months or longer, 165 (67.1%) relapsed at some point during study follow-up. Youth who were recently incarcerated (adjusted hazard ratio [AHR]: 1.46), homeless (AHR: 1.43), or had a history of daily stimulant use (AHR: 1.48) were significantly more likely to report relapse, while youth of who identified as white (AHR: 0.74) were significantly less likely to report relapse (all P < 0.05). Discussion and Conclusions. Relapse into stimulants and/or opioids was common among youth in our setting, and incarceration, homelessness, and daily stimulant use were found to be positively associated with relapse among youth. Findings suggest that increased access to youth housing supports and alternatives to the criminalisation of drug use may help to reduce the rates of relapse into stimulants and/or opioids in this population. [Goldman-Hasbun J, Nosova E, Kerr T, Wood E, DeBeck K. Homelessness and incarceration associated with relapse into stimulant and opioid use among youth who are street-involved in Vancouver, Canada. Drug Alcohol Rev 2019;38: [428][429][430][431][432][433][434]

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Section: Discussionmentioning

confidence: 99%

Homelessness and incarceration associated with relapse into stimulant and opioid use among youth who are street‐involved in Vancouver, Canada

Goldman-Hasbun

Nosova

Wood

et al. 2019

Drug and Alcohol Review

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“…Further research is needed to understand how the use of cannabis among youth experiencing street entrenchment might be protective in our and other similar settings in the context of the current crisis. At minimum, we must acknowledge cannabis use as an emic harm reduction and treatment strategy that is commonly employed among some highly vulnerable youth to facilitate periods of transition away from what are perceived as more dangerous forms and modes of drug use, resulting in significant-albeit usually intermittent-reductions in risk and harm from both an emic and public health perspective [36,54].…”

Section: Plos Onementioning

confidence: 99%

“Something that actually works”: Cannabis use among young people in the context of street entrenchment

et al. 2020

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Background Cannabis is one of the most widely used substances among vulnerable young people (<26 years of age) experiencing street entrenchment. Although previous research has documented the role cannabis can play in harm reduction, substance use and mental health treatment and pain management, this research has predominantly been quantitative and focused on adult drug-using populations. Little qualitative work has examined how young people who use drugs understand, experience, and engage with cannabis in the context of street entrenchment and drug use trajectories that include the use of other substances such as alcohol, opioids and crystal methamphetamine (meth).

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“…This phenomenon has been observed in several contexts. For example, in Canada, one study found that 63% of people who were actively injecting drugs reported the concurrent smoking of crack cocaine [ 7 ]. In Australia, a similar phenomenon has been seen with the co‐occurrence of smoking and injecting methamphetamine amongst people entering treatment for methamphetamine use [ 8 ], amongst community samples of people who inject methamphetamine [ 9 ] and people who inject drugs more broadly [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Patterns of smoking and injecting methamphetamine and their association with health and social outcomes

McKetin

Sutherland

Peacock

et al. 2021

Drug and Alcohol Review

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Introduction We examine how smoking and injecting methamphetamine change over time and correlate with specific health and social outcomes. Methods. Panel data from a longitudinal cohort dependent on methamphetamine (N = 444; 891 months). Random effects regression models examined the relationship between smoking and/or injecting methamphetamine and past month outcomes (substance use, ≥daily injection, needle/syringe sharing, psychological distress, poor mental and physical health, sexual behaviour, psychotic symptoms, violent behaviour and crime). Effects were adjusted for between-group differences at baseline. Results. At baseline, 56% of participants only injected methamphetamine in the past month, 18% only smoked and 26% both injected and smoked (concurrent injecting and smoking). Compared to injecting only, concurrent injecting and smoking was associated with more days of methamphetamine use (b = 1.3, P < 0.001; adjusted [A] b = 1.2, P < 0.001), more frequent injection [odds ratio (OR) 1.8, P = 0.013; adjusted OR (AOR) 1.6, P = 0.042], violent behaviour (OR 2.1, P = 0.001; AOR 1.8, P = 0.013] and crime (OR 3.1, P < 0.001; AOR 2.5, P < 0.001). Non-injecting related outcomes did not differ significantly for only smoking versus only injecting. There was no significant transition from injecting methamphetamine at baseline to non-injecting methamphetamine use at follow up, or from exclusively smoking methamphetamine at baseline to any methamphetamine injection at follow up. Discussion and Conclusion. Efforts are needed to address heavier methamphetamine use, more frequent drug injection and elevated violent behaviour and crime among people who concurrently smoke and inject methamphetamine.

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Patterns of Non-injection Drug Use Associated with Injection Cessation among Street-Involved Youth in Vancouver, Canada

Cited by 7 publications

References 46 publications

Homelessness and incarceration associated with relapse into stimulant and opioid use among youth who are street‐involved in Vancouver, Canada

Homelessness and incarceration associated with relapse into stimulant and opioid use among youth who are street‐involved in Vancouver, Canada

“Something that actually works”: Cannabis use among young people in the context of street entrenchment

Patterns of smoking and injecting methamphetamine and their association with health and social outcomes

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