ABSTRACT
Background: Street-involved youth who use drugs may have limited income-generation options and are known to commonly become immersed in illicit drug markets to generate funds. However, little attention has been given to factors that may drive drug dealing initiation among this vulnerable population. Objectives: This longitudinal study examines drug dealing initiation among street-involved youth. Methods: Data were derived from the At-Risk Youth Study from September 2005 to November 2014; a prospective cohort of 194 street-involved youth who use drugs aged 14–26, in Vancouver, Canada. Extended Cox model was used to identify factors independently associated with time to first drug dealing. Results: Among street-involved youth who had never dealt drugs at baseline, 56 (29%) individuals initiated drug dealing during the study period for an incidence density of 13.0 per 100 person-years (95% confidence interval [CI]: 9.9–17.2). In multivariable Cox regression analysis, male gender (adjusted hazard ratio [AHR] = 1.90, 95% CI: 1.06–3.42), homelessness (AHR = 1.88, 95% CI: 1.05–3.35), crystal methamphetamine use (AHR = 2.48, 95% CI: 1.47–4.20), and crack cocaine use (AHR = 2.35, 95% CI: 1.38–4.00) were positively and independently associated with initiating drug dealing. Conclusion: Homelessness and stimulant drug use were key risk factors for drug dealing initiation among street-involved youth. Findings indicate that evidence-based and innovative interventions, including youth-centric supportive housing, low threshold employment programs, and stimulant addiction treatment should be implemented and evaluated as strategies to help prevent this vulnerable population from engaging in risky illegal income generation practices.
Acknowledgments
The authors thank the study participants for their contribution to the research, as well as current and past researchers and staff. They would specifically like to thank Cody Callon, Jennifer Matthews, Deborah Graham, Peter Vann, Steve Kain, Tricia Collingham, Kristie Starr, and Carmen Rock for their research and administrative assistance.
Funding
With support from: US National Institutes of Health (U01DA038886); the Canadian Institutes of Health Research (MOP–102742); and the Canada Research Chairs programme through a Tier 1 Canada Research Chair in Inner City Medicine, which supports Dr Evan Wood. Dr Kora DeBeck is supported by a MSFHR/St Paul’s Hospital Foundation-Providence Health Care Career Scholar Award and a Canadian Institutes of Health Research New Investigator Award. Brittany Barker is supported by a Canadian Institutes of Health Research Doctoral Award. Funding sources had no further role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication. The authors report no relevant financial conflicts.
Declaration of interest
The authors report no conflicts of interest.