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


Autoři: Kanna Hayashi aff001;  Lianping Ti aff001;  Huiru Dong aff001;  Brittany Bingham aff002;  Andrew Day aff005;  Ronald Joe aff005;  Rolando Barrios aff005;  Kora DeBeck aff001;  M-J Milloy aff001;  Thomas Kerr aff001
Působiště autorů: British Columbia Centre on Substance Use, Vancouver, BC, Canada aff001;  Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada aff002;  Department of Medicine, University of British Columbia, Vancouver, BC, Canada aff003;  School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada aff004;  Vancouver Coastal Health Authority, Vancouver, BC, Canada aff005;  School of Public Policy, Simon Fraser University, Vancouver, Canada aff006
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0224993

Souhrn

Background

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. 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.

Methods

Data 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.

Results

In 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).

Conclusions

Nearly 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.

Klíčová slova:

Drug research and development – Hepatitis C virus – Housing – Neighborhoods – Opioids – Recreational drug use – Socioeconomic aspects of health


Zdroje

1. Waal H, Clausen T, Gjersing L, Gossop M. Open drug scenes: responses of five European cities. BMC Public Health. 2014;14: 853. doi: 10.1186/1471-2458-14-853 25128331

2. Bless R, Korf DJ, Freeman M. Open drug scenes: a cross-national comparison of concepts and urban strategies. Eur Addict Res. 1995;1: 128–138. doi: 10.1159/000259053

3. Connolly J. Responding to open drug scenes and drug-related crime and public nuisance: towards a partnership approach. Strasbourg: Pompidou Group; 2006. Available from: https://www.drugsandalcohol.ie/6044/1/2993-RespondingToOpenDrugScenes.pdf

4. Reuter P. Systemic violence in drug markets. Crime Law Soc Change. 2009;52: 275–284. doi: 10.1007/s10611-009-9197-x

5. Rhodes T. The “risk environment”: a framework for understanding and reducing drug-related harm. Int J Drug Policy. 2002;13: 85–94.

6. McNeil R, Shannon K, Shaver L, Kerr T, Small W. Negotiating place and gendered violence in Canada’s largest open drug scene. Int J Drug Policy. 2014;25: 608–615. doi: 10.1016/j.drugpo.2013.11.006 24332972

7. Werb D, Rowell G, Guyatt G, Kerr T, Montaner J, Wood E. Effect of drug law enforcement on drug market violence: a systematic review. Int J Drug Policy. 2011;22: 87–94. doi: 10.1016/j.drugpo.2011.02.002 21392957

8. Kerr T, Small W, Wood E. The public health and social impacts of drug market enforcement: a review of the evidence. Int J Drug Policy. 2005;16: 210–220.

9. Fuchs WJ, Grob PJ. Harm reduction in an open drug scene. Eur Addict Res. 1995;1: 106–114. doi: 10.1159/000259049

10. Rachlis B, Brouwer KC, Mills EJ, Hayes M, Kerr T, Hogg RS. Migration and transmission of blood-borne infections among injection drug users: Understanding the epidemiologic bridge. Drug Alcohol Depend. 2007;90: 107–119. doi: 10.1016/j.drugalcdep.2007.03.014 17485179

11. McCoy HV, Correa R, Fritz E. HIV diffusion patterns and mobility: gender differences among drug users. Popul Res Policy Rev. 1996;15: 249–264.

12. Knight R, Fast D, DeBeck K, Shoveller J, Small W. “Getting out of downtown”: a longitudinal study of how street-entrenched youth attempt to exit an inner city drug scene. BMC Public Health. 2017;17: 376. doi: 10.1186/s12889-017-4313-9 28464942

13. Fast D, Shoveller J, Shannon K, Kerr T. Safety and danger in downtown Vancouver: understandings of place among young people entrenched in an urban drug scene. Health Place. 2010;16: 51–60. doi: 10.1016/j.healthplace.2009.07.004 19733496

14. Buxton J. Vancouver drug use epidemiology: Vancouver site report for the Canadian Community Epidemiology Network on Drug Use (CCENDU). 2005 Jun. Available from: https://chodarr.org/sites/default/files/chodarr0139.pdf

15. Urban Health Research Initiative. Drug situation in Vancouver. Vancouver, BC: British Columbia Centre for Excellence in HIV/AIDS; 2013. Available from: http://www.bccsu.ca/wp-content/uploads/2016/08/dsiv2013.pdf

16. Campbell L, Boyd N, Culbert L. A thousand dreams: Vancouver’s Downtown Eastside and the fight for its future. Vancouver, BC: Greystone Books; 2009.

17. Knight KR, Lopez AM, Comfort M, Shumway M, Cohen J, Riley ED. Single room occupancy (SRO) hotels as mental health risk environments among impoverished women: the intersection of policy, drug use, trauma, and urban space. Int J Drug Policy. 2014;25: 556–61. doi: 10.1016/j.drugpo.2013.10.011 24411945

18. Shannon K, Ishida T, Lai C, Tyndall MW. The impact of unregulated single room occupancy hotels on the health status of illicit drug users in Vancouver. Int J Drug Policy. 2006;17: 107–14.

19. Csete J, Kamarulzaman A, Kazatchkine M, Altice F, Balicki M, Buxton J, et al. Public health and international drug policy. Lancet. 2016;387: 1427–1480. doi: 10.1016/S0140-6736(16)00619-X 27021149

20. Sandberg S, Pedersen W. “A magnet for curious adolescents”: the perceived dangers of an open drug scene. Int J Drug Policy. 2008;19: 459–66. doi: 10.1016/j.drugpo.2007.02.001 18378132

21. Wood E, Stoltz JA, Montaner JS, Kerr T. Evaluating methamphetamine use and risks of injection initiation among street youth: the ARYS study. Harm Reduct J. 2006;3: 18. doi: 10.1186/1477-7517-3-18 16723029

22. Wood E, Kerr T, Marshall BD, Li K, Zhang R, Hogg RS, et al. Longitudinal community plasma HIV-1 RNA concentrations and incidence of HIV-1 among injecting drug users: prospective cohort study. BMJ. 2009;338: b1649. doi: 10.1136/bmj.b1649 19406887

23. Strathdee SA, Palepu A, Cornelisse PGA, Yip B, O’Shaughnessy MV, Montaner JSG, et al. Barriers to use of free antiretroviral therapy in injection drug users. JAMA. 1998;280: 547–549. doi: 10.1001/jama.280.6.547 9707146

24. Hayashi K, Milloy M-JJ, Lysyshyn M, DeBeck K, Nosova E, Wood E, et al. Substance use patterns associated with recent exposure to fentanyl among people who inject drugs in Vancouver, Canada: A cross-sectional urine toxicology screening study. Drug Alcohol Depend. 2018;183: 1–6. doi: 10.1016/j.drugalcdep.2017.10.020 29220642

25. Andruff H, Carraro N, Thompson A, Gaudreau P, Louvet B. Latent Class Growth Modelling: a tutorial. Tutor Quant Methods Psychol. 2009;5: 11–24. doi: 10.20982/tqmp.05.1.p011

26. Norris MJ, Clatworthy S. Aboriginal mobility and migration within Canada’s Friendship Centre Areas: patterns, levels, and implications based on the 2006 census. In: Dinsdale P, White J, Hanselmann C, editors. Urban Aboriginal communities in Canada. Thompson Educational Publishing, Inc.; 2013. pp. 173–218.

27. Snyder M, Wilson K. “Too much moving …there’s always a reason”: Understanding urban Aboriginal peoples’ experiences of mobility and its impact on holistic health. Health Place. 2015;34: 181–9. doi: 10.1016/j.healthplace.2015.05.009 26057895

28. Belanger YD, Awosoga O, Head GW. Homelessness, Urban Aboriginal People, and the Need for a National Enumeration. Aboriginal Policy Studies. 2013;2: 4–33. doi: 10.5663/aps.v2i2.19006

29. Jung T, Wickrama KAS. An introduction to latent class growth analysis and growth mixture modeling. Soc Personal Psychol Compass. 2008;2: 302–317. doi: 10.1111/j.1751-9004.2007.00054.x

30. Lennon H, Kelly S, Sperrin M, Buchan I, Cross AJ, Leitzmann M, et al. Framework to construct and interpret latent class trajectory modelling. BMJ Open. 2018;8: e020683. doi: 10.1136/bmjopen-2017-020683 29982203

31. de Schoot R van, Sijbrandij M, Winter SD, Depaoli S, Vermunt JK. The GRoLTS-Checklist: Guidelines for reporting on latent trajectory studies. Struct Equ Modeling. 2016;24: 451–467. doi: 10.1080/10705511.2016.1247646

32. Burnham KP, Anderson DR. Model selection and multimodel inference: a practical information-theoretic approach. second. New York, NY: Springer-Verlag; 2002.

33. Shannon K, Rusch M, Shoveller J, Alexson D, Gibson K, Tyndall MW. Mapping violence and policing as an environmental-structural barrier to health service and syringe availability among substance-using women in street-level sex work. Int J Drug Policy. 2008;19: 140–147. doi: 10.1016/j.drugpo.2007.11.024 18207725

34. Somers JM, Moniruzzaman A, Rezansoff SN. Migration to the Downtown Eastside neighbourhood of Vancouver and changes in service use in a cohort of mentally ill homeless adults: a 10-year retrospective study. BMJ Open. 2016;6: e009043. doi: 10.1136/bmjopen-2015-009043 26739726

35. Goodman A, Fleming K, Markwick N, Morrison T, Lagimodiere L, Kerr T, et al. “They treated me like crap and I know it was because I was Native”: The healthcare experiences of Aboriginal peoples living in Vancouver’s inner city. Soc Sci Med. 2017;178: 87–94. doi: 10.1016/j.socscimed.2017.01.053 28214449

36. McNeil R, Small W, Wood E, Kerr T. Hospitals as a “risk environment”: an ethno-epidemiological study of voluntary and involuntary discharge from hospital against medical advice among people who inject drugs. Soc Sci Med. 2014;105: 59–66. doi: 10.1016/j.socscimed.2014.01.010 24508718

37. Piat M, Polvere L, Kirst M, Voronka J, Zabkiewicz D, Plante M-C, et al. Pathways into homelessness: Understanding how both individual and structural factors contribute to and sustain homelessness in Canada. Urban Stud. 2015;52: 2366–2382. doi: 10.1177/0042098014548138

38. Rachlis BS, Hogg RS, Wood E, Li K, Kerr T. Factors associated with geographic migration among a cohort of injection drug users. Health Place. 2008;14: 536–43. doi: 10.1016/j.healthplace.2007.10.006 18410717

39. Adair CE, Streiner DL, Barnhart R, Kopp B, Veldhuizen S, Patterson M, et al. Outcome trajectories among homeless individuals with mental disorders in a multisite randomised controlled trial of Housing First. Can J Psychiatry. 2017;62: 30–39. doi: 10.1177/0706743716645302 27310238

40. To MJ, Palepu A, Aubry T, Nisenbaum R, Gogosis E, Gadermann A, et al. Predictors of homelessness among vulnerably housed adults in 3 Canadian cities: a prospective cohort study. BMC Public Health. 2016;16: 1041. doi: 10.1186/s12889-016-3711-8 27716129

41. Fleming T, Damon W, Collins AB, Czechaczek S, Boyd J, McNeil R. Housing in crisis: A qualitative study of the socio-legal contexts of residential evictions in Vancouver’s Downtown Eastside. Int J Drug Policy. 2019. doi: 10.1016/j.drugpo.2018.12.012 30926217

42. To MJ, Palepu A, Matheson FI, Ecker J, Farrell S, Hwang SW, et al. The effect of incarceration on housing stability among homeless and vulnerably housed individuals in three Canadian cities: A prospective cohort study. Can J Public Health. 2017;107: e550–e555. doi: 10.17269/cjph.107.5607 28252374

43. Dumont DM, Brockmann B, Dickman S, Alexander N, Rich JD. Public health and the epidemic of incarceration. Annu Rev Public Health. 2012;33: 325–39. doi: 10.1146/annurev-publhealth-031811-124614 22224880

44. Clatworthy S, Norris MJ. Aboriginal mobility and migration: trends, recent patterns, and implications: 1971–2001. Aboriginal Policy Research Consortium International (APRCi). 2007. Available from: https://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=1341&context=aprci

45. Distasio Jino, Sylvestre Gina, Wall-Wieler Elizabeth. The migration of Indigenous peoples in the Canadian prairie context: exploring policy and program implications to support urban movers. Geography Research Forum. 2013;33: 38–63.

46. Norris Mary Jane, Clatworthy Stewart. Aboriginal mobility and migration within urban Canada: outcomes, factors and implications. In: Newhouse D, Peters EJ, editors. Not strangers in these parts: urban Aboriginal peoples. Ottawa, Ont.: Policy Research Initiative; 2003. pp. 51–78. Available from: http://ra.ocls.ca/ra/login.aspx?inst=centennial&url= https://www.deslibris.ca/ID/228455

47. Truth and Reconcilliation Commission of Canada. Honouring the truth, reconciling for the future: summary of the final report of the Truth and Reconcilliation Commission of Canada. Winnipeg, Manitoba: The Truth and Reconciliation Commission of Canada; 2015. Available from: http://epe.lac-bac.gc.ca/100/201/301/weekly_acquisition_lists/2015/w15-24-F-E.html/collections/collection_2015/trc/IR4-7-2015-eng.pdf

48. Johnston C. Shifting the paradigm: the history of the Vancouver STOP HIV/AIDS Project. Broeckaert L, editor. Canadian AIDS Treatment Information Exchange; 2013. Available from: http://www.deslibris.ca/ID/241909

49. Milloy MJ, Wood E, Kerr T, Hogg B, Guillemi S, Harrigan PR, et al. Increased prevalence of controlled viremia and decreased rates of HIV drug resistance among HIV-positive people who use illicit drugs during a community-wide treatment-as-prevention initiative. Clin Infect Dis. 2016;62: 640–647. doi: 10.1093/cid/civ929 26553011

50. Darke S. Self-report among injecting drug users: a review. Drug Alcohol Depend. 1998;51: 253–63-discussion 267–8. doi: 10.1016/s0376-8716(98)00028-3 9787998


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