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The uncertainty that comes with not knowing where you’re going to spend your next night—sleeping on a friend’s couch, in a shelter, or on the street—can be harrowing enough, but new research shows that the harms associated with youth homelessness extend far beyond the stress of dealing with this daily anxiety.
According to a pair of new studies from researchers at the BC Centre for Excellence in HIV/AIDS (BC-CfE) and the University of British Columbia (UBC), homelessness and a history of childhood sexual abuse place Vancouver street-involved youth at great risk of intravenous injection drug use and potential transmission of HIV and hepatitis C.
The landmark studies, funded by the US National Institute on Drug Abuse and the Canadian Institutes of Health Research, were aimed at identifying why some high-risk youth initiate injection drug use while others do not.
Results published in the peer-reviewed Journal of Adolescent Health showed that youth who were homeless were almost twice as likely to start injecting drugs as youth who were not homeless.
In a separate study published in the peer-reviewed journal Preventive Medicine, researchers found that youth reporting childhood sexual abuse were more than two-and-a-half times as likely to start injecting drugs as those who had no history of such abuse.
“There are serious medical harms associated with injection drug use, including the transmission of HIV and hepatitis C,” said Dr. Kora DeBeck, lead author of the Journal of Adolescent Health study and a post-doctoral fellow at BC-CfE and UBC. “While overall rates of injection drug use are down in Vancouver, there is increasing evidence that expanding addiction treatment interventions and providing other tools like supportive housing can intervene to further reduce rates of injection drug use among street youth.”
Dr. Scott Hadland, lead author of the Preventive Medicine study and chief resident in pediatrics at Harvard University-affiliated Boston Children’s Hospital, added: “The high prevalence of childhood sexual abuse and subsequent injection drug use among homeless and street youth highlights the need to develop addiction and treatment strategies based on the traumatic situations they often face.”
Data for both studies was derived from the BC-CfE’s At-Risk Youth Study (ARYS), a prospective cohort of street-involved youth in Vancouver aged 14 to 26 years old, in an effort to untangle the mystery of why some youth choose to begin injecting drugs while others do not.
Investigators for the Journal of Adolescent Health study interviewed 422 street-involved youth between September 2005 and November 2011. For Preventive Medicine, researchers studied 395 street-involved youth from October 2005 to November 2010. As part of their research, they also identified key risk factors that can be targeted for implementing treatment and prevention programs.
“These are among the first studies to identify early life experiences and subsequent environments that clearly contribute to initiation of injecting drug use,” said Dr. Evan Wood, Canada Research Chair in Inner City Medicine at UBC and senior author of both studies. “This research underscores the urgent need for evidence-based interventions to address homelessness and child abuse, as well as the immediate expansion of evidence-based addiction treatment services for high-risk youth.”
The BC-CfE is actively working to support expanded addiction treatment in B.C.