Socioeconomic factors associated with cessation of injection drug use among street-involved youth

Derek C Chang,Kora Debeck,Scott E Hadland,Ekaterina Nosova,Evan Wood,Thomas Kerr

doi:10.1186/s13011-017-0136-z

Abstract

BackgroundAlthough the initiation of injection drug use has been well characterized among at-risk youth, factors that support or impede cessation of injection drug use have received less attention. We sought to identify socioeconomic factors associated with cessation of injection drug use among street-involved youth.MethodsFrom September 2005 to May 2015, data were collected from the At-Risk Youth Study (ARYS), a prospective cohort study of street-involved youth in Vancouver, Canada. Multivariate extended Cox regression was utilized to identify socioeconomic factors associated with cessation of injection drug use for six months or longer among youth who were actively injecting.ResultsAmong 383 participants, 171 (44.6%) youth reported having ceased injection (crude incidence density 22 per 100 person-years; 95% confidence interval [CI], 19–26) at some point during study follow-up. Youth who had recently dealt drugs (adjusted hazard ration [AHR], 0.50; 95% CI, 0.29–0.87), engaged in prohibited street-based income generation (AHR, 0.41; 95% CI, 0.24–0.69), and engaged in illegal income generating activities (AHR, 0.19; 95% CI, 0.06–0.61) were significantly less likely to report cessation of injection drug use.ConclusionsOur findings suggest that socioeconomic factors, in particular engagement in prohibited street-based and illegal income generating activities, may pose barriers to ceasing injection drug use among this population. Effort to improve access to stable and secure income, as well as employment opportunities may assist youth in transitioning away from injection drug use.Trial registrationOur study is not a randomized controlled trial; thus the trial registration is not applicable.

Highlights

The initiation of injection drug use has been well characterized among at-risk youth, factors that support or impede cessation of injection drug use have received less attention
Injection drug use is recognized as a risky activity by street-involved youth [2], it remains prevalent among this population and is associated with many harms, including infection with
An additional 151 youth reported injection drug use at study enrollment but did not return or were not yet eligible to return for a study visit due to the nature of an open cohort study

Summary

Introduction

The initiation of injection drug use has been well characterized among at-risk youth, factors that support or impede cessation of injection drug use have received less attention. We sought to identify socioeconomic factors associated with cessation of injection drug use among street-involved youth. Multiple studies on drug use trajectories focus on the initiation of injection drug use, and point to the role of unemployment, homelessness, and inability to access addiction treatment as contributing factors to injection initiation [7,8,9]. Chang et al Substance Abuse Treatment, Prevention, and Policy (2017) 12:50 lower likelihood of ceasing injecting among youth [10, 11]. These findings suggest that economic vulnerability plays a role in drug use trajectories and may influence cessation of injection drug use. We sought to examine the potential relationship between socioeconomic factors and cessation of injection drug use among streetinvolved youth in Vancouver, Canada

Methods

Results

Discussion

Conclusion