Moving into an urban drug scene among people who use drugs in Vancouver, Canada: Latent class growth analysis.

Kanna Hayashi,Huiru Dong,Thomas Kerr,M-J Milloy,Kora Debeck,Brittany Bingham,Rolando Barrios,Lianping Ti,Andrew Day,Ronald Joe,Cecilia Benoit

doi:10.1371/journal.pone.0224993

Abstract

BackgroundUrban drug scenes are characterized by high prevalence of illicit drug dealing and use, violence and poverty, much of which is driven by the criminalization of people who use illicit drugs (PWUD) and the associated stigma. Despite significant public health needs, little is understood about patterns of moving into urban drug scenes among PWUD. Therefore, we sought to identify trajectories of residential mobility (hereafter ‘mobility’) among PWUD into the Downtown Eastside (DTES), an urban neighbourhood with an open drug scene in Vancouver, Canada, as well as characterize distinct trajectory groups among PWUD.MethodsData were derived from three prospective cohort studies of community-recruited PWUD in Vancouver between 2005 and 2016. We used latent class growth analysis (LCGA) to identify distinct patterns of moving into the DTES among participants residing outside of DTES at baseline. Multivariable multinomial logistic regression was used to determine baseline factors associated with each trajectory group.ResultsIn total, 906 eligible participants (30.9% females) provided 9,317 observations. The LCGA assigned four trajectories: consistently living outside of DTES (52.8%); early move into DTES (11.9%); gradual move into DTES (19.5%); and move in then out (15.8%). Younger PWUD, those of Indigenous ancestry, those who were homeless or living in a single-room occupancy hotel (SRO), and those injecting drugs daily were more likely to move in then out of DTES (all p<0.05). Living in an SRO, daily injection drug use, and recent incarceration were also positively associated with early mobility (all p<0.05).ConclusionsNearly half of the participants moved into the DTES. Younger PWUD and Indigenous peoples appeared to have particularly high mobility, as did those with markers of social-structural vulnerability and high intensity drug use. These findings indicate a need to tailor existing social and health services within the DTES and expand affordable housing options outside the DTES.

Highlights

Urban drug scenes, which are typically characterized by a high prevalence of illicit drug dealing and use, violence and poverty, can be found in many urban cities around the world [1,2,3]
Urban drug scenes are characterized by high prevalence of illicit drug dealing and use, violence and poverty, much of which is driven by the criminalization of people who use illicit drugs (PWUD) and the associated stigma
Living in an single-room occupancy hotel (SRO), daily injection drug use, and recent incarceration were positively associated with early mobility

Summary

Introduction

Urban drug scenes, which are typically characterized by a high prevalence of illicit drug dealing and use, violence and poverty, can be found in many urban cities around the world [1,2,3]. While some European cities have been successful in closing down their drug scenes via coordinated law enforcement and public health efforts, globally, many urban drug scenes remain active. This raises concerns that these settings may attract young PWUD and facilitate ongoing cycles of problematic substance use [1]. We sought to identify trajectories of residential mobility (hereafter ‘mobility’) among PWUD into the Downtown Eastside (DTES), an urban neighbourhood with an open drug scene in Vancouver, Canada, as well as characterize distinct trajectory groups among PWUD

Methods

Results

Conclusion