Health and social harms associated with crystal methamphetamine use among street-involved youth in a Canadian setting

Authors

  • Sasha Uhlmann MD,

    1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada
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  • Kora DeBeck PhD,

    1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada
    2. School of Public Policy, Simon Fraser University, Vancouver, BC, Canada
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  • Annick Simo MSc,

    1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada
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  • Thomas Kerr PhD,

    1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada
    2. Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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  • Julio S.G. Montaner MD,

    1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada
    2. Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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  • Evan Wood MD, PhD

    Corresponding author
    1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada
    2. Division of AIDS, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
    • Address correspondence to Wood, M.D., Ph.D., F.R.C.P.C., Professor of Medicine, Division of AIDS, Canada Research Chair in Inner City Medicine, University of British Columbia, 608–1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. E-mail: uhri-ew@cfenet.ubc.ca.

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Abstract

Background and Objectives

Despite recent increases in crystal methamphetamine use among high-risk populations such as street-involved youth, few prospective studies have examined the health and social outcomes associated with active crystal methamphetamine use.

Methods

We enrolled 1,019 street-involved youth in Vancouver, Canada, in a prospective cohort known as the at-risk youth study (ARYS). Participants were assessed semi-annually and a generalized estimating equation (GEE) logistic regression was used to identify factors independently associated with active crystal methamphetamine use.

Results

Among 1,019 participants recruited into ARYS between 2005 and 2012 the median follow up duration was 17 months, 320 (31.4%) participants were female and 454 (44.6%) had previously used crystal methamphetamine at baseline. In adjusted GEE analyses, active crystal methamphetamine use was independently associated with Caucasian ethnicity (adjusted odds ratio [AOR] = 1.37; 95% confidence interval [CI]: 1.04–1.81), homelessness (AOR = 1.34; 95% CI: 1.15–1.56), injection drug use (AOR = 3.40; 95% CI: 2.76–4.19), non-fatal overdose (AOR = 1.46; 95%CI: 1.07–2.00), being a victim of violence (AOR = 1.19; 95% CI: 1.02–1.38), involvement in sex work (AOR = 1.39; 95% CI: 1.03–1.86), and drug dealing (AOR = 1.60; 95% CI: 1.35–1.90).

Discussion and Conclusions

Prevalence of crystal methamphetamine use was high in this setting and active use was independently associated with a range of serious health and social harms.

Scientific Significance

Evidence-based strategies to prevent and treat crystal methamphetamine use are urgently needed. (Am J Addict 2014;23:393–398)

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