| Summary: | Background: Many youth initiate illicit drugs at a high level. Further, despite the application of preventive interventions to reduce this phenomenon and related harms, there is little evidence that current efforts to prevent illicit drug use and problematic drug use are effective. This research project was therefore undertaken to investigate determinants of, and popular responses to, the initiation of illicit drug use among youth.
Methods: Meta-analytic techniques were used to quantify the evidence on the effectiveness of anti-illicit drug public service announcements. Further, data from the At-Risk Youth Study (ARYS), a prospective cohort of homeless and street-involved youth between the ages of 14 and 26, were analyzed using linear regression analysis to determine factors associated with residing in Vancouver’s downtown eastside (DTES), the location of a large open air illicit drug market, and in the downtown south (DTS), an adjacent neighbourhood. Specifically, between September 2005 and December 2007, participants completed a baseline questionnaire which elicted information on income sources, drug use behaviours, sexual behaviours, and the initiation of illicit drugs.
Results: We identified 7 randomized trials (n = 5,428) and 4 observational trials (n = 17,404). A meta-analysis of eligible randomized trials demonstrated no significant effect, while observational studies showed evidence of both harmful and beneficial effects. Further, among 222 youth participants, having a primary illicit income source and injection heroin use were significantly associated with residing in the DTES in multivariate analysis. No significant differences in risk of drug trade and sex trade involvement, crack use, injection cocaine use, and injection crystal methamphetamine use were found between youth residing in each neighbourhood.
Conclusions: Our findings suggest that current approaches to the prevention of the initiation of illicit drug use among youth may be limited. Further, the results of our linear regression analysis suggest that a consideration of social and structural factors may increase the effectiveness of current preventive interventions. As such, policymakers should consider reorienting current approaches to illicit drug prevention among youth. === Medicine, Faculty of === Population and Public Health (SPPH), School of === Graduate
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