Social-structural factors influencing periods of injection cessation among marginalized youth who inject drugs in Vancouver, Canada: an ethno-epidemiological study
Abstract Background Injection drug use is associated with HIV and hepatitis C transmission, overdose, and other preventable harms. These harms are heightened for structurally vulnerable injection drug-using populations, as their social conditions pose barriers to safer injecting. Previous research o...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-06-01
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| Series: | Harm Reduction Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12954-017-0159-9 |
| _version_ | 1811281818682392576 |
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| author | Jade Boyd Danya Fast Megan Hobbins Ryan McNeil Will Small |
| author_facet | Jade Boyd Danya Fast Megan Hobbins Ryan McNeil Will Small |
| author_sort | Jade Boyd |
| collection | DOAJ |
| description | Abstract Background Injection drug use is associated with HIV and hepatitis C transmission, overdose, and other preventable harms. These harms are heightened for structurally vulnerable injection drug-using populations, as their social conditions pose barriers to safer injecting. Previous research on injection cessation has largely focused on adult drug-using populations. Little qualitative work has examined the social, structural, and environmental factors that shape periods of injection cessation among youth and young adults. Such research is essential to understanding how we can best reduce harms among this vulnerable population as they move in and out of periods of injection cessation. Methods We conducted 22 semi-structured, qualitative interviews with street-involved young people who use drugs (SY), focused on characterizing their transitions into periods of injection cessation and perceived barriers to injection cessation. Adopting an ethno-epidemiological approach, participants who had experienced at least 6 months of injection cessation were purposively recruited from an ongoing prospective cohort study of SY in Vancouver, Canada to participate in qualitative interviews. Qualitative interview findings were triangulated with the findings of a longitudinal program of ethnographic research with SY in this setting. This ethno-epidemiological approach allowed for a more robust exploration of contextual factors surrounding drug use patterns than would be possible through traditional epidemiological methods alone. Results Findings indicate that periods of injection cessation were influenced by access to harm reduction-informed youth-focused services, transitions in route of administration (e.g., from injecting methamphetamine to the smoking of methamphetamine), and the provision of housing and social supports (e.g., from friends, family, and care providers). Conversely, participants indicated that inadequate social supports and, for some, abstinence-focused treatment methods (e.g., 12-step programs), impeded efforts to cease injecting. Conclusions To reduce harms, it is imperative to reorient attention toward the social, structural, and spatial contexts that surround injection drug use and shape periods of injection cessation for SY. There is an urgent need for more comprehensive youth-focused services for those engaged in injection drug use, and further study of innovative means of engaging youth. |
| first_indexed | 2024-04-13T01:40:27Z |
| format | Article |
| id | doaj.art-0b2d689ca7184629969c32b16639cc45 |
| institution | Directory Open Access Journal |
| issn | 1477-7517 |
| language | English |
| last_indexed | 2024-04-13T01:40:27Z |
| publishDate | 2017-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Harm Reduction Journal |
| spelling | doaj.art-0b2d689ca7184629969c32b16639cc452022-12-22T03:08:12ZengBMCHarm Reduction Journal1477-75172017-06-0114111110.1186/s12954-017-0159-9Social-structural factors influencing periods of injection cessation among marginalized youth who inject drugs in Vancouver, Canada: an ethno-epidemiological studyJade Boyd0Danya Fast1Megan Hobbins2Ryan McNeil3Will Small4British Columbia Centre on Substance Use, St. Paul’s HospitalBritish Columbia Centre on Substance Use, St. Paul’s HospitalFaculty of Health Sciences, Simon Fraser UniversityBritish Columbia Centre on Substance Use, St. Paul’s HospitalBritish Columbia Centre on Substance Use, St. Paul’s HospitalAbstract Background Injection drug use is associated with HIV and hepatitis C transmission, overdose, and other preventable harms. These harms are heightened for structurally vulnerable injection drug-using populations, as their social conditions pose barriers to safer injecting. Previous research on injection cessation has largely focused on adult drug-using populations. Little qualitative work has examined the social, structural, and environmental factors that shape periods of injection cessation among youth and young adults. Such research is essential to understanding how we can best reduce harms among this vulnerable population as they move in and out of periods of injection cessation. Methods We conducted 22 semi-structured, qualitative interviews with street-involved young people who use drugs (SY), focused on characterizing their transitions into periods of injection cessation and perceived barriers to injection cessation. Adopting an ethno-epidemiological approach, participants who had experienced at least 6 months of injection cessation were purposively recruited from an ongoing prospective cohort study of SY in Vancouver, Canada to participate in qualitative interviews. Qualitative interview findings were triangulated with the findings of a longitudinal program of ethnographic research with SY in this setting. This ethno-epidemiological approach allowed for a more robust exploration of contextual factors surrounding drug use patterns than would be possible through traditional epidemiological methods alone. Results Findings indicate that periods of injection cessation were influenced by access to harm reduction-informed youth-focused services, transitions in route of administration (e.g., from injecting methamphetamine to the smoking of methamphetamine), and the provision of housing and social supports (e.g., from friends, family, and care providers). Conversely, participants indicated that inadequate social supports and, for some, abstinence-focused treatment methods (e.g., 12-step programs), impeded efforts to cease injecting. Conclusions To reduce harms, it is imperative to reorient attention toward the social, structural, and spatial contexts that surround injection drug use and shape periods of injection cessation for SY. There is an urgent need for more comprehensive youth-focused services for those engaged in injection drug use, and further study of innovative means of engaging youth.http://link.springer.com/article/10.1186/s12954-017-0159-9Injection drug useInjection cessationStreet youthHarm reductionQualitative researchSocial and economic marginalization |
| spellingShingle | Jade Boyd Danya Fast Megan Hobbins Ryan McNeil Will Small Social-structural factors influencing periods of injection cessation among marginalized youth who inject drugs in Vancouver, Canada: an ethno-epidemiological study Harm Reduction Journal Injection drug use Injection cessation Street youth Harm reduction Qualitative research Social and economic marginalization |
| title | Social-structural factors influencing periods of injection cessation among marginalized youth who inject drugs in Vancouver, Canada: an ethno-epidemiological study |
| title_full | Social-structural factors influencing periods of injection cessation among marginalized youth who inject drugs in Vancouver, Canada: an ethno-epidemiological study |
| title_fullStr | Social-structural factors influencing periods of injection cessation among marginalized youth who inject drugs in Vancouver, Canada: an ethno-epidemiological study |
| title_full_unstemmed | Social-structural factors influencing periods of injection cessation among marginalized youth who inject drugs in Vancouver, Canada: an ethno-epidemiological study |
| title_short | Social-structural factors influencing periods of injection cessation among marginalized youth who inject drugs in Vancouver, Canada: an ethno-epidemiological study |
| title_sort | social structural factors influencing periods of injection cessation among marginalized youth who inject drugs in vancouver canada an ethno epidemiological study |
| topic | Injection drug use Injection cessation Street youth Harm reduction Qualitative research Social and economic marginalization |
| url | http://link.springer.com/article/10.1186/s12954-017-0159-9 |
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