Evaluating methamphetamine use and risks of injection initiation among street youth: the ARYS study

Evan Wood,Jo-Anne Stoltz,Thomas Kerr,Julio Sg Montaner

doi:10.1186/1477-7517-3-18

Evan Wood, Jo-Anne Stoltz + Show 2 more

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https://doi.org/10.1186/1477-7517-3-18

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Abstract

Many Canadian cities are experiencing ongoing infectious disease and overdose epidemics among injection drug users (IDU). These health concerns have recently been exacerbated by the increasing availability and use of methamphetamine. The challenges of reducing health-related harms among IDU have led to an increased recognition that strategies to prevent initiation into injection drug use must receive renewed focus. In an effort to better explore the factors that may protect against or facilitate entry into injection drug use, the At Risk Youth Study (ARYS) has recently been initiated in Vancouver, Canada. The local setting is unique due to the significant infrastructure that has been put in place to reduce HIV transmission among active IDU. The ARYS study will seek to examine the impact of these programs, if any, on non-injection drug users. In addition, Vancouver has been the site of widespread use of methamphetamine in general and has seen a substantial increase in the use of crystal methamphetamine among street youth. Hence, the ARYS cohort is well positioned to examine the harms associated with methamphetamine use, including its potential role in facilitating initiation into injection drug use. This paper provides some background on the epidemiology of illicit drug use among street youth in North America and outlines the methodology of ARYS, a prospective cohort study of street youth in Vancouver, Canada.

Highlights

It is estimated that approximately 340,000 Americans [1] and 100,000 Canadians are current injection drug users (IDU) [2]
In addition to the morbidity and mortality associated with infectious diseases [3], overdose fatalities among IDU have been a leading cause of death within the general population in many urban areas in North America in recent years [4,5], including British Columbia, Canada, where approximately one overdose death per day was recorded throughout the late 1990s [6]
In light of the above concerns, and the fact that infectious diseases and other harms persist despite human immunodeficiency virus (HIV) prevention programming targeted towards injection drug users, it has recently been argued that the injection-related infection risk hierarchy should be updated so that the prevention of injection drug use is given greater priority [31,32]

Summary

Introduction

It is estimated that approximately 340,000 Americans [1] and 100,000 Canadians are current injection drug users (IDU) [2]. Injection drug use can lead to overdose, infectious disease, loss of social and economic functioning and extensive engagement in criminal activity. In addition to the morbidity and mortality associated with infectious diseases [3], overdose fatalities (usually opioid) among IDU have been a leading cause of death within the general population in many urban areas in North America in recent years [4,5], including British Columbia, Canada, where approximately one overdose death per day was recorded throughout the late 1990s [6]. Injection drug use has been estimated to account for approximately 25% of new HIV infections and 63% of new HCV infections in Canada, with similar rates observed in the US [11,12].

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