Drug Use
Conditions
Keywords
Social Assistance, Drug Use, Drug-Related harm
Brief summary
This study evaluates whether altering the timing and frequency of social assistance disbursement reduces drug related-harms that increase on the days surrounding monthly synchronized government social assistance cheque issue.
Detailed description
Coordinated monthly income assistance payments, while seeking to alleviate poverty, can also have negative and unintended impacts, particularly among people who use illicit drugs (PWUD). Observational research has identified escalations in drug-related harm coinciding with monthly assistance payments, such as overdose, treatment interruption, hospital admissions and public disorder. This project varies the timing and frequency of income assistance disbursement, and evaluates whether varying income assistance disbursement reduces drug-related harm coinciding with coordinated income assistance. Conducted among 273 PWUD, participants will be allocated for 6 income assistance cycles to a control or one of two intervention arms. Participants in the control arm will receive payments according to the existing monthly government schedule. Participants in the intervention arm will receive their income assistance: (1) monthly on a day different from government cheque issue; or (2) semi-monthly on days different from government cheque issue. The intervention will be evaluated using qualitative and quantitative methods for its impact on drug use and related harms.
Interventions
OTHERNon-synchronized social assistance receipt
Social assistance disbursement outside government cheque issue week
OTHERcheque divided into two equal disbursements
Social assistance disbursement divided into two equal payments
Sponsors
BC Centre on Substance Use
University of British Columbia
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
19 Years to 64 Years
Healthy volunteers
Yes
Inclusion criteria
* be ≥19 years of age or older * reside in greater Vancouver, Canada * report regular use of illicit drugs other than cannabis * receive monthly provincial income assistance * are not currently administered (where cheque issue/money is externally managed) * be eligible and willing to be a client of the local credit union who will administer the intervention * report intensified drug use around government cheque issue days * provide written informed consent * be willing to comply with study procedures
Exclusion criteria
* plan to relocate outside Vancouver * have plans to discontinue income assistance
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Illicit drug use on government cheque issue days | 26 weeks | Timeline Follow Back (TLFB) assessed increase of drug use defined as an increase in the frequency of drug use of at least 40% or an increase in the number of drugs used during the 3 days beginning with government cheque issue day, compared to non-cheque issue days. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Illicit drug use on non-government cheque issue days | 26 weeks | Timeline Follow Back (TLFB) assessed increase of drug use defined as an increase in the frequency of drug use of at least 40% or an increase in the number of drugs used during the 3 days beginning with individual cheque issue day (among intervention participants), compared to non-cheque issue days. |
| Hospital admissions on government cheque issue days | 26 weeks | Emergency Department, Emergency Department Mental Health and substance use hospitalizations in the three days beginning with government cheque issue day compared to non-cheque issue days. |
| Overdose | 26 weeks | Self-reported non-fatal overdose and hospital record verified fatal overdose on the three days beginning with government cheque issue day compared to non-cheque issue days. |
| Police service utilization | 26 weeks | Self-reported and police record-verified interactions with police or use of police services on the three days beginning with government cheque issue day compared to non-cheque issue days. |
Countries
Canada
Outcome results
None listed