Observational studyAddiction (Abingdon, England)2021
Drug-related harm coinciding with income assistance payments: results from a community-based cohort of people who use drugs.
Observational study in Addiction (Abingdon, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Effect of modified income assistance payment schedules on substance use service access: Evidence from an experimental study.The International journal on drug policy · 2024Trial
- Effect of alternative income assistance schedules on drug use and drug-related harm: a randomised controlled trial.The Lancet. Public health · 2021Trial
- Payday Loan Use Among People With Lived and Living Experience of Substance Use.Drug and alcohol review · 2026Article
- The Earned Income Tax Credit and short-term changes in financial strain and drug use.Health affairs scholar · 2026Article
- Impact of Alternative Income Assistance Payment Schedules on Health and Social Service Access in Canada: Evidence from an Experimental Study.Journal of social service research · 2025Article
- Article
- No change in substance use disorders or overdose after implementation of state Earned Income Tax Credit (EITC).Drug and alcohol dependence · 2024Article
- 'It was like coming back from the clouds': a qualitative analysis of the lived experience of overdose consequent to drug use among a cohort of people who use drugs in Scotland.Harm reduction journal · 2024Article
- Multi-level influences on increased overdose risk behaviors during the COVID-19 pandemic among people who use drugs in Rhode Island: a qualitative investigation.Harm reduction journal · 2023Article
- Changes in the unregulated opioid drug supply during income assistance payment weeks in Vancouver, Canada: An exploratory analysis.The International journal on drug policy · 2022Article
- COVID-19 economic impact payments and opioid overdose deaths.The International journal on drug policy · 2022Observational
- PERSPECTIVE: Current US COVID-19 Pandemic Substance Use Research and Ideas for Research That May Help Us Learn More.The journal of mental health policy and economics · 2021Review
- Differential impacts of COVID-19 across racial-ethnic identities in persons with opioid use disorder.Journal of substance abuse treatment · 2021Article
- Income generation and the patterning of substance use: A gender-based analysis.Drug and alcohol dependence · 2021Article
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Authors and funding
5 authors.
Funding
Abstract
BACKGROUND AND
aimsIncome assistance is critical to the health and wellbeing of socio-economically marginalized people who use illicit drugs (PWUD). However, past literature paradoxically identifies unintended increases in drug-related harm coinciding with synchronized payments that may magnify signals for drug use. The scope of such harm has not been fully characterized among non-institutionalized populations. This study examined socio-demographic, health and drug use-related correlates of payment-coincident drug-related harm.
designThis observational study uses data from prospective community-based longitudinal cohorts of PWUD between December 2013 and May 2018.
settingVancouver, British Columbia, Canada.
participantsA total of 1604 PWUD receiving monthly income assistance. Our sample included 586 (36.5%) women, 861 (53.7%) non-white participants and 685 (42.7%) people living with HIV. MEASUREMENTS: The primary outcome was a self-reported composite measure of drug-related harm in the past 6 months coinciding with income assistance, including higher-frequency substance use, non-fatal overdose and service barriers or interruptions. Subanalyses disaggregated this outcome.
findingsPayment-coincident drug-related harm was reported among 77.7% of participants during the study period. In multivariable models, key correlates positively and significantly associated with payment-coincident harm included: street-based income generation [adjusted odds ratio (aOR) = 1.48, 95% confidence interval (CI) = 1.26-1.74, P < 0.001], sex work (aOR = 1.66, 95% CI = 1.35-2.04, P < 0.001), illegal income generation (aOR = 1.57, 95% CI = 1.35-1.83 P < 0.001), homelessness (aOR = 1.34, 95% CI = 1.13-1.58, P < 0.001), exposure to violence (aOR = 1.31, 95% CI = 1.03-1.66, P = 0.032), daily crack cocaine use (aOR = 1.99, 95% CI = 1.59-2.50, P < 0.001), heavy alcohol use (aOR = 1.64, 95% CI = 1.37-1.97, P < 0.001) and injection drug use (aOR = 2.55, 95% CI = 2.01-3.23, P < 0.001). In subanalyses, specific harms were more likely among individuals reporting social, structural and health vulnerabilities.
conclusionsIn Vancouver, Canada, people who use illicit drugs who receive income assistance report high prevalence of payment-coincident drug-related harm, particularly people experiencing socioeconomic and structural marginalization or engaging in high-intensity drug use.
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