Drug-related harm coinciding with income assistance payments: results from a community-based cohort of people who use drugs.
Drug-related harm coinciding with income assistance payments: results from a community-based cohort of people who use drugs.
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DOI：
10.1111/add.15182
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Hayashi K
中科院分区：
文献类型：
--
作者：
Richardson L;Dong H;Kerr T;Milloy MJ;Hayashi K
收入援助对于社会经济边缘化的非法药物使用者的健康和福祉至关重要。然而，过去的文献自相矛盾地确定了与药物有关的伤害的意外增加，同时同步付款，可能会放大药物使用的信号。在非收容机构人口中，这种伤害的范围尚未得到充分描述。本研究探讨了社会人口，健康和药物使用相关的支付一致的药物相关的伤害。这项观察性研究使用了2013年12月至2018年5月期间基于社区的前瞻性PWUD纵向队列的数据。加拿大不列颠哥伦比亚省的温哥华。共有1 604名残疾人和女童每月领取收入援助。我们的样本包括586名（36.5%）女性，861名（53.7%）非白人参与者和685名（42.7%）艾滋病毒感染者。主要结局是过去6个月内与收入援助一致的药物相关伤害的自我报告综合指标，包括更高频率的物质使用，非致命性过量以及服务障碍或中断。次级分析对这一结果进行了分类。在研究期间，77.7%的参与者报告了与药物相关的损害。在多变量模型中，与支付-同时损害正相关且显著相关的关键因素包括：街头创收（调整后的比值比[AOR]=1.48，95%置信区间[CI]=1.26-1.74，P<0.001），性工作（AOR=1.66，95%CI =1.35-2.04，P<0.001），非法创收（AOR=1.57，95%CI =1.35-1.83 P<0.001）;无家可归（AOR=1.34，95% CI=1.13-1.58，P<0.001）;暴力暴露（AOR=1.31，95% CI=1.03-1.66，P=0.032），每日使用快克可卡因（AOR=1.99，95% CI=1.59-2.50，P<0.001）、酗酒（AOR=1.64，95% CI=1.37-1.97，P<0.0001）和注射毒品（AOR=2.55，95% CI=2.01-3.23，P<0.001）。在子分析中，报告社会、结构和健康脆弱性的个人更有可能受到具体伤害。在加拿大的温哥华，接受收入援助的非法药物使用者报告说，与支付同时发生的药物相关伤害的发生率很高，特别是经历社会经济和结构边缘化或从事高强度药物使用的人。
Income assistance is critical to the health and well-being of socioeconomically marginalized people who use illicit drugs (PWUD). However, past literature paradoxically identifies unintended increases in drug-related harm coinciding with synchronized payments that may magnify signals for drug use. The scope of such harm has not been fully characterized among non-institutionalized populations. This study examined sociodemographic, health and drug use-related correlates of payment-coincident drug-related harm. This observational study using data from prospective community-based longitudinal cohorts of PWUD between December 2013 and May 2018. Vancouver, British Columbia, Canada. A total of 1604 PWUD receiving monthly income assistance. Our sample included 586 (36.5%) women, 861 (53.7%) non-white participants, and 685 (42.7%) people living with HIV. Primary outcome was a self-reported composite measure of drug-related harm in the past 6 months coinciding with income assistance, including higher frequency substance use, non-fatal overdose, and service barriers or interruptions. Subanalyses disaggregated this outcome. Payment-coincident drug-related harm was reported among 77.7% of participants during the study period. In multivariable models, key correlates positively and significantly associated with payment-coincident harm included: street-based income generation (Adjusted Odds Ratio [AOR]=1.48, 95% Confidence Interval [CI]=1.26–1.74, P<0.001), sex work (AOR=1.66, 95% CI=1.35–2.04, P<0.001), illegal income generation (AOR=1.57, 95% CI=1.35–1.83 P<0.001); homelessness (AOR=1.34, 95% CI=1.13–1.58, P<0.001); exposure to violence (AOR=1.31, 95% CI=1.03–1.66, P=0.032), daily crack-cocaine use (AOR=1.99, 95% CI=1.59–2.50, P<0.001); heavy alcohol use (AOR=1.64, 95% CI=1.37–1.97, P<0.0001) and injection drug use (AOR=2.55, 95% CI=2.01–3.23, P<0.001). In subanalyses, specific harms were more likely among individuals reporting social, structural and health vulnerabilities. In Vancouver, Canada, people who use illicit drugs who receive income assistance report high prevalence of payment-coincident drug-related harm, particularly people experiencing socioeconomic and structural marginalization or engaging in high-intensity drug use.
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影响因子：
4.8
作者：
Fast, Danya;Shoveller, Jean;Kerr, Thomas
通讯作者：
Kerr, Thomas
影响因子：
4.4
作者：
Boyd, Jade;Richardson, Lindsey;McNeil, Ryan
通讯作者：
McNeil, Ryan
影响因子：
4.8
作者：
Kenworthy, L
通讯作者：
Kenworthy, L
DOI：
10.1007/s11524-011-9575-4
发表时间：
2011-08
影响因子：
6.6
作者：
DeBeck, Kora;Wood, Evan;Zhang, Ruth;Buxton, Jane;Montaner, Julio;Kerr, Thomas
通讯作者：
Kerr, Thomas
DOI：
10.1016/s0140-6736(14)61132-6
发表时间：
2014-10-25
期刊：
Lancet (London, England)
影响因子：
--
作者：
Fazel S;Geddes JR;Kushel M
通讯作者：
Kushel M