TY  - JOUR
PY  - 2014//
TI  - The impact of engagement in street-based income generation activities on stimulant drug use cessation among people who inject drugs
JO  - Drug and alcohol dependence
A1  - Ti, Lianping
A1  - Richardson, Lindsey
A1  - Debeck, Kora
A1  - Nguyen, Paul
A1  - Montaner, Julio
A1  - Wood, Evan
A1  - Kerr, Thomas
SP  - 58
EP  - 64
VL  - 141
IS  - 
N2  - BACKGROUND: Despite the growing prevalence of illicit stimulant drug use internationally, and the widespread involvement of people who inject drugs (IDU) within street-based drug markets, little is known about the impact of different types of street-based income generation activities on the cessation of stimulant use among IDU. <br><br>METHODS: Data were derived from an open prospective cohort of IDU in Vancouver, Canada. We used Kaplan-Meier methods and Cox proportional hazards regression to examine the effect of different types of street-based income generation activities (e.g., sex work, drug dealing, and scavenging) on time to cessation of stimulant use. <br><br>RESULTS: Between December, 2005 and November, 2012, 887 IDU who use stimulant drugs (cocaine, crack cocaine, or crystal methamphetamine) were prospectively followed-up for a median duration of 47 months. In Kaplan-Meier analyses, compared to those who did not engage in street-based income generation activities, participants who reported sex work, drug dealing, scavenging, or more than one of these activities were significantly less likely to report stimulant drug use cessation (all p<0.001). When considered as time-updated variables and adjusted for potential confounders in a multivariable model, each type of street-based income generation activity remained significantly associated with a slower time to stimulant drug cessation (all p<0.005). <br><br>CONCLUSIONS: Our findings highlight the urgent need for strategies to address stimulant dependence, including novel pharmacotherapies. Also important, structural interventions, such as low-threshold employment opportunities, availability of supportive housing, legal reforms regarding drug use, and evidence-based approaches that reduce harm among IDU are urgently required.<p />  <p>Language: en</p>
LA  - en
SN  - 0376-8716
UR  - http://dx.doi.org/10.1016/j.drugalcdep.2014.05.003
ID  - ref1
ER  -