Melissa Beaulac1, Lindsey Richardson2, Samuel Tobias3, Mark Lysyshyn4, Cameron Grant3, Lianping Ti5. 1. British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada; Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V6H 0A5, Canada. 2. British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada; Department of Sociology, University of British Columbia, 6303 NW Marine Dr., Vancouver, BC, V6T 1Z1, Canada. 3. British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada. 4. Vancouver Coastal Health Authority, 801-601 West Broadway, Vancouver, BC, V5Z 4C2, Canada; School of Population and Public Health, University of British Columbia, 2206 E. Mall, Vancouver, BC, V6T 1Z3, Canada. 5. British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada; Department of Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC, V6H 0A5, Canada. Electronic address: bccsu-lt@bccsu.ubc.ca.
Abstract
BACKGROUND: Increased drug-related harms, including overdoses (poisonings), have been reported in the days around income assistance payments, yet little is known about changes in the unregulated drug supply during this time. In this exploratory analysis, we investigated whether changes in the unregulated opioid drug supply are associated with income assistance payment weeks. METHODS: Using data from drug checking services in Vancouver, BC, we conducted modified Poisson and linear regression models to examine the association between income assistance payment weeks and three key outcomes: (1) proportion of fentanyl positivity among expected opioid samples, (2) fentanyl concentration among fentanyl-positive expected opioid samples, and (3) proportion of benzodiazepine positivity among expected opioid samples. RESULTS: Between October 2017 and December 2019, 4306 (90.41%) of expected opioid samples tested positive for fentanyl, and the median fentanyl concentration was 7.0% (quartile [Q]1 - Q3: 5.1% - 9.8%). Income assistance payment week was associated with an increased prevalence of fentanyl positivity among expected opioid samples (prevalence ratio [PR]: 1.03; 95% confidence interval [CI]: 1.00, 1.05); however, we failed to find a statistically significant association between income assistance payment week and fentanyl concentration (regression coefficient: 0.70; 95% CI: 0.44, 1.09). Additionally, income assistance payment week was associated with an increased prevalence of benzodiazepine positivity among expected opioid samples (PR: 1.86; 95% CI: 1.07, 3.24). CONCLUSION: These findings suggest that during income assistance payment weeks, there may be more fentanyl and benzodiazepines circulating in the unregulated opioid drug supply. The rise in fentanyl and benzodiazepine-adulterated opioids during income assistance payment weeks may be contributing to the increase in illicit drug overdoses seen during this time of the month.
BACKGROUND: Increased drug-related harms, including overdoses (poisonings), have been reported in the days around income assistance payments, yet little is known about changes in the unregulated drug supply during this time. In this exploratory analysis, we investigated whether changes in the unregulated opioid drug supply are associated with income assistance payment weeks. METHODS: Using data from drug checking services in Vancouver, BC, we conducted modified Poisson and linear regression models to examine the association between income assistance payment weeks and three key outcomes: (1) proportion of fentanyl positivity among expected opioid samples, (2) fentanyl concentration among fentanyl-positive expected opioid samples, and (3) proportion of benzodiazepine positivity among expected opioid samples. RESULTS: Between October 2017 and December 2019, 4306 (90.41%) of expected opioid samples tested positive for fentanyl, and the median fentanyl concentration was 7.0% (quartile [Q]1 - Q3: 5.1% - 9.8%). Income assistance payment week was associated with an increased prevalence of fentanyl positivity among expected opioid samples (prevalence ratio [PR]: 1.03; 95% confidence interval [CI]: 1.00, 1.05); however, we failed to find a statistically significant association between income assistance payment week and fentanyl concentration (regression coefficient: 0.70; 95% CI: 0.44, 1.09). Additionally, income assistance payment week was associated with an increased prevalence of benzodiazepine positivity among expected opioid samples (PR: 1.86; 95% CI: 1.07, 3.24). CONCLUSION: These findings suggest that during income assistance payment weeks, there may be more fentanyl and benzodiazepines circulating in the unregulated opioid drug supply. The rise in fentanyl and benzodiazepine-adulterated opioids during income assistance payment weeks may be contributing to the increase in illicit drug overdoses seen during this time of the month.
Authors: Maria Zlotorzynska; M-J S Milloy; Lindsey Richardson; Paul Nguyen; Julio S Montaner; Evan Wood; Thomas Kerr Journal: Int J Drug Policy Date: 2014-04-04
Authors: Samuel Tobias; Aaron M Shapiro; Cameron J Grant; Priya Patel; Mark Lysyshyn; Lianping Ti Journal: Drug Alcohol Depend Date: 2020-10-22 Impact factor: 4.492