Inability to access addiction treatment predicts injection initiation among street-involved youth in a Canadian setting
Open accessAbstract
BACKGROUND: Preventing injection drug use among vulnerable youth is critical for reducing serious drug-related harms. Addiction treatment is one evidence-based intervention to decrease problematic substance use; however, youth frequently report being unable to access treatment services and the impact of this on drug use trajectories remains largely unexplored. This study examines the relationship between being unable to access addiction treatment and injection initiation among street-involved youth. METHODS: Data were derived from the At-Risk Youth Study (ARYS), a prospective cohort of street-involved youth aged 14-26 who use illicit drugs, from September 2005 to May 2014. An extended Cox model with time-dependent variables was used to identify factors independently associated with injection initiation. RESULTS: Among 462 participants who were injection naïve at baseline, 97 (21 %) initiated injection drug use over study follow-up and 129 (28 %) reported trying but being unable to access addiction treatment in the previous 6 months at some point during the study period. The most frequently reported reason for being unable to access treatment was being put on a wait list. In a multivariable Cox regression analysis, being unable to access addiction treatment remained independently associated with a more rapid rate of injection initiation (Adjusted Hazard Ratio =2.02; 95 % Confidence Interval: 1.12-3.62), after adjusting for potential confounders. CONCLUSION: Inability to access addiction treatment was common among our sample and associated with injection initiation. Findings highlight the need for easily accessible, evidence-based addiction treatment for high-risk youth as a means to prevent injection initiation and subsequent serious drug-related harms.
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There is a link between difficulties in receiving services and the onset use of injectable drugs among individuals already experiencing substance use disorders.
“This situation is even more concerning given the link between difficulties in receiving services and the onset use of injectable drugs among individuals already experiencing substance use disorders (59).”
From Mobile intervention for individuals with psychosis, dual disorders, and their common comorbidities: A literature review (2019) · cites this paper as [59]
The Results report that inability to access addiction treatment was associated with faster injection initiation, and the Discussion says affected youth were more than twice as likely to initiate injection drug use. However, the Methods describe street-involved youth who used illicit drugs; the paper does not establish that participants had substance use disorders, so the claim extends beyond the studied population. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIssues regarding the availability of services are one of the main barriers to access in addiction issues, particularly in relation to waiting time.
“Issues regarding the availability of services seem to be one of the main barriers to access in addiction issues, particularly in relation to the problem of waiting time (59, 61–65).”
From Mobile intervention for individuals with psychosis, dual disorders, and their common comorbidities: A literature review (2019) · cites this paper as [59]
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References 32 · Cited by 62
- Authors
- DeBeck, K., Kerr, T., Nolan, S., Dong, H., Montaner, J., & Wood, E.
- Affiliations
- Simon Fraser University (CA)
- University of British Columbia (CA)
- BC Centre for Excellence in HIV/AIDS (CA)
- Corresponding author
- DeBeck, Kora
- Venue
- Substance Abuse Treatment, Prevention, and Policy
- Published
- 2016-01-06
- Volume
- 11
- Issue
- 1
- Pages
- 1-1
- ISSN
- 1747-597X (ISSN-L)
- PMC
- PMC4702392
- OpenAlex
- W2232240524
- Cited by
- 62
- References
- 32
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 14 · 2020: 6 · 2019: 8 · 2018: 9 · 2017: 13 · 2016: 3
- FWCI
- 10.32
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Substance Abuse Treatment Prevention and Policy (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- cIRcle (University of British Columbia) (submittedVersion, cc-by)
- Open Collections
- Funders
- St. Paul's Hospital-Providence Health Care Career Scholar Award
- Canadian Institutes of Health Research (New Investigator Award)
- Canada Research Chairs (Tier 1 Canada Research Chair in Inner City Medicine)
- BC ministry of health
- National Institutes of Health (R01DA036307)
- Topics
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Keywords
- access to addiction treatment, street children, substance use prevention, illicit drug use
- MeSH terms
- Adolescent, Adult, Canada, Female, Health Services Accessibility, Humans, Male, Prospective Studies, Substance Abuse, Intravenous, Behavior, Addictive, Homeless Youth, Young Adult
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