Abstract
BackgroundStreet-involved youth are known to be an economically vulnerable population that commonly resorts to risky activities such as drug dealing to generate income. While incarceration is common among people who use illicit drugs and associated with increased economic vulnerability, interventions among this population remain inadequate. Although previous research has documented the role of incarceration in further entrenching youth in both the criminal justice system and street life, less is known whether recent incarceration predicts initiating drug dealing among vulnerable youth. This study examines the relationship between incarceration and drug dealing initiation among street-involved youth.MethodsBetween September 2005 and November 2014, data were collected through the At-Risk Youth Study, a cohort of street-involved youth who use illicit drugs, in Vancouver, Canada. An extended Cox model with time-dependent variables was used to examine the relationship between recent incarceration and initiation into drug dealing, controlling for relevant confounders.ResultsAmong 1172 youth enrolled, only 194 (16.6%) were drug dealing naïve at baseline and completed at least one additional study visit to facilitate the assessment of drug dealing initiation. Among this sample, 56 (29%) subsequently initiated drug dealing. In final multivariable Cox regression analysis, recent incarceration was significantly associated with initiating drug dealing (adjusted hazard ratio = 2.31; 95% confidence interval (CI) 1.21–4.42), after adjusting for potential confounders. Measures of recent incarceration lagged to the prior study follow-up were not found to predict initiation of drug dealing (hazard ratio = 1.50; 95% CI 0.66–3.42).ConclusionsThese findings suggest that among this study sample, incarceration does not appear to significantly propel youth to initiate drug dealing. However, the initiation of drug dealing among youth coincides with an increased risk of incarceration and their consequent vulnerability to the significant harms associated therein. Given that existing services tailored to street-involved youth are inadequate, evidence-based interventions should be invested and scaled up as a public health priority.
Highlights
Street-involved youth are known to be an economically vulnerable population that commonly resorts to risky activities such as drug dealing to generate income
There were no significant differences with respect to gender (p = 0.205), ethnicity (p = 0.695), or history of incarceration (p = 0.427) between the 194 youth who represented the eligible study sample and the 78 drug dealing naïve youth who were ineligible because they were not enrolled in the cohort long enough to be due for a study follow-up or did not have a follow-up visit at the time this analysis was conducted
At some point during the study period, 55 (28%) youth reported being recently incarcerated. Among those who reported being recently incarcerated, there were 2 (0.2%) reports of being held in a youth detention centre, 49 (5.8%) reports of being held in a local jail, 29 (3.49%) reports of being held in a provincial jail, and 1 (0.1%) report of being held in a federal prison, and the median length of stay was 3 days (IQR 1–18)
Summary
Street-involved youth are known to be an economically vulnerable population that commonly resorts to risky activities such as drug dealing to generate income. Prior research of street-involved youth indicates that they are a population vulnerable to economic hardship and poor health outcomes [1,2,3,4,5]. This group is highly susceptible to various health-related harms due to problematic substance use, high-risk sexual behaviour, Hoy et al Harm Reduction Journal (2016) 13:32. Similar research involving youth who engage in this prohibited incomegenerating activity suggests that youth are frequently driven by personal consumption needs [12] Economic vulnerability is another contributing factor for street-involved youths’ involvement in drug dealing. While a number of health and social services exist with the mandate of addressing some of these vulnerabilities, a recent analysis in our study setting found that more than 60% of streetinvolved youth reported experiencing difficulty accessing one or more of these services in the last 6 months (e.g. housing, food bank, employment services) [17]
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