High-Intensity Drug Use and Health Service Access among Street-Involved Youth in a Canadian Setting
BACKGROUND/OBJECTIVES:
Addiction
severity has been associated with numerous social- and health-related harms.
This study sought to examine the prevalence and correlates of high-intensity
drug use among street-involved youth in a Canadian setting with a focus on
high-risk drug use practices and health service access.
METHODS:
Data were
derived from the At-Risk Youth Study, a Vancouver-based prospective cohort of
street-involved youth aged 14-26. We used generalized estimating equations to
examine variables associated with high-intensity drug use, defined as daily use
of crack cocaine, cocaine, heroin, or crystal methamphetamine.
RESULTS:
From
September 2005 to November 2012, of 1017 youth included in the analyses, 529
(52%) reported high-intensity drug use as defined above at least once during
the study period. In a multivariate analysis, older age; residing in the Downtown Eastside of Vancouver;
homelessness; recent incarceration; inability to
access addiction treatment; and crack pipe sharing and/or used
syringe injecting, were all positively and independently associated
with high-intensity drug use. The most common barrier to
accessing addiction treatment reported by these youth was long waiting lists.
CONCLUSIONS:
High-intensity
drug use among street-involved youth was prevalent and associated with structural
and geographical disadvantages in addition to high-risk drug administration
practices. Youth reporting more frequent drug use also reported barriers to
accessing addiction treatment, highlighting the need to expand addiction
services tailored to youth at greatest risk of harm from illicit drug use and
street-involvement.
- 1a BC Centre for Excellence in HIV/AIDS , Urban Health Research Initiative , Vancouver , Canada.
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