Sector News

  1. Risky Income Activities of Vancouver’s Street- Youth

    Background

    Due to unemployment and poverty, street-involved youth may turn to risky activities such as sex work, salvaging/recycling, squeegeeing car windows for donations, panhandling, drug dealing, theft and other criminal activities to generate income. The authors used a prospective cohort design (2005 – 2012) to study risky employment of street-involved youth in Vancouver.

    Street-involved: recently homeless or having used services designated for street-youth in the last year.

    Findings:

    • Of the 1008 participants during the 6-year study, 735 (73%) reported engaging in risky income generation activities at their baseline study visit, and 826 (82%) participants reported engaging in risky income generation activities at some point during the study period.
    • Those with intense addition such as binge drug use, injection drug use, and drug overdose were more likely to engage in risky income generating activities. Since this finding is substantiated in previous research, reducing the intensity of substance use may be an opportunity to reduce risky income generation.
    • A sub-analysis of 825 participants found that 63% mentioned “dealing drugs” as an income generation activity.
    • Approximately 53% (n=440) said they would be willing to give up a source of risky income if they were not using drugs. The need for income to fund drug ongoing drug use is a key factor perpetuating risky income generating activities.
    • Youth who recently attended addiction treatment were significantly more willing to give up their risky income generating activities if they did not use drugs.
    • Still, a large proportion, 47%, said they would persist with their risky income sources regardless of substance use. Based on this, we know that substance use is not the only factor pushing youth to engage in risky income generation.
    • The role of age in influencing substance use and income generation trajectories should also be explored as the authors found older age to be associated with willingness to give up risky income sources.
    • Income assistance programs in the current study setting have high barriers to access and do not provide adequate financial support to meet basic survival need.
    • Overall, there is limited availability and access to economically sufficient legal income sources in the participant’s environment. This highlights the need to explore ways to reduce the economic vulnerability of youth.

    Conclusion

    The high prevalence of risky income generating activities among street involved youth, particularly those who use drugs, highlights the need for policy-makers to address deficiencies in accesses to timely addiction treatment for youth. However, the large percentage of youth who still intended to participate in risky income generation activities suggests a need to evaluate structural interventions to target the economic vulnerability of youth.

    Cheng, T., Kerr, T., Small, W., Nguyen, P., Wood, E., and DeBeck, K. (2016). High prevalence of risky income generation among street-involved youth in a Canadian setting. International Drug Policy People. Vol. 28, pp. 91-97.

  2. Posted in:

    Encounters with Security Guards in Vancouver’s Eastside

    Background

    The number of licensed security guards in British Columbia has doubled in the last decade. Currently, there are 17,000 licensed security guards in the province, which is twice the number of police officers. Security guards are often hired to patrol areas frequented by people who inject drugs (PWID) such as Vancouver’s Eastside. Recent qualitative research found that people who use drugs in this area are often subject to discriminatory surveillance and abuse by security guards. As well, previous findings suggest that security guard presence may prevent access to health care services.

    Findings:

    • One third of the sample reported at least one encounter with a security guard in the course of the 8-year study.
    • Of the 1172 reported encounters with security guards, participants most commonly reported that they were told to move on (70.6%); verbally abused (15.6%); assaulted (7.6%); detained (5.4%); or chased (5.1%) by security guards.
    • People who inject drugs (PWID) who have encounters with security guards were generally marginalized on several markers of vulnerability and drug related harm such as unstable housing, experiencing violence, non-fatal overdose, syringe sharing, public injection and inability to access addiction treatment.
    • Security guards may be overstepping their legal authority when interacting with people who inject drugs, such as controlling access to public space and using excessive force.
    • The authors found an association between security guard contact and high-risk drug use behaviours, which aligns with previous research. For example, intensified police presence has been shown to promote rushed injections, hinder access to sterile injection equipment from harm reduction services, which could contribute to syringe sharing.
    • Interaction with security guards was positively associated with inability to access addiction treatment, which was also found in a previous study.

    Conclusion

    Accounts of specific interactions with security guards suggest that reforms need to be made to ensure that security guards do to not overstep their legal boundaries in their interactions with people who inject drugs. Broader structural interventions are required to assess risk and harm for people who inject drugs in public spaces.

    Kennedy, M.C., Milloy, M.-J., Markwik, N. et al. (2016). Encounters with private security guards among people who inject drugs in a Canadian setting. International Journal of Drug Policy. 28:124-127.

  3. Racialized Risk Environments of those Who Inject Drugs in the United States

    Key terms
    Radicalized Risk Environment: occurs when racial/ethnic groups inhabit places that do not have protective resources (for example, substance abuse treatment programs).

    Risk Environment Model: addresses social situations, structures, and places that generate vulnerability to HIV transmission and other drug-and HIV-related harms among people who inject drugs (PWID).

    Participant population
    The sample included 9170 people who inject drugs from 15 states across the United States.

    Findings:
    – Across all measures black PWID were more likely than white PWID to live in areas associated with vulnerability to HIV and poorer outcomes for those living with HIV.
    – Black PWID lived in more socially and economically distressed areas, had poorer access to substance abuse treatment, experienced greater exposure to drug-related law enforcement, were isolated in environments that lacked ethnic diversity and were more likely to experience the combination of hyper segregation and concentrated poverty.
    – Black PWID participants tended to live in states with laws that did not facilitate access to sterile syringes (where a prescription was required for purchase and possession of syringes). Laws restricting syringe access are connected with higher HIV prevalence. Laws limiting sterile syringe access may exacerbate racial/ethnic disparities in HIV prevalence.
    – Interestingly, the authors found a tendency for a law and order approach in states where people who misuse substances are more likely to be thought of as black and a more public health approach where people who misuse substances are thought to be white.
    – Black PWID had better spatial access to HIV testing than white PWID, yet they had worse access to substance abuse treatment. The US public health system made an effort to increase HIV testing amongst black adults; the authors suggest that similar initiatives are needed to increase access to substance abuse treatment as well.
    – The authors encourage those outside of the US to explore the “racialized risk environment” in their own countries. Previous studies have found large disparities in HIV prevalence in Canada among First Nations, the ethnic minority PWID, vs. the ethnic majority PWID. This may result from systematic differences in exposure to high-risk environments that perpetuate social inequality.

    Conclusion
    The environments of people who inject drugs appear to be racialized in the US. Future research should assess risk environments in other countries.

    Cooper, H.L.F., Linton, S.L., Kelley, M.E. (2016). Racialized risk environments in a large sample of people who inject drugs in the United States. International Journal of Drug Policy. 27: pp.43-55.