|Titre :||Displacement of Canada's largest public illicit drug market in response to a police crackdown|
|Titre traduit :||(Déplacement du plus grand marché public canadien de drogues illicites en réaction à des mesures répressives policière)|
|Auteurs :||E. WOOD ; P. M. SPITTAL ; W. SMALL ; T. KERR ; K. LI ; R. S. HOGG ; M. W. TYNDALL ; J. S. G. MONTANER ; M. T. SCHECHTER|
|Type de document :||Périodique|
|Année de publication :||2004|
|Format :||1551-1556 / tabl.|
|Note générale :||Canadian Medical Association Journal, 2004, 170, (10), 1551-1556|
|Discipline :||MAR (Marchés / Markets)|
Thésaurus TOXIBASEREPRESSION ; POLICE ; EFFICACITE ; USAGER ; VOIE INTRAVEINEUSE ; COHORTE ; EPIDEMIOLOGIE DESCRIPTIVE ; MARCHE DE LA DROGUE ; QUARTIER ; PRIX ; CONSOMMATION ; EVOLUTION
Background: Law enforcement is often used in an effort to reduce the social, community and health-related harms of illicit drug use by injection drug users (IDUs). There are, however, few data on the benefits of such enforcement or on the potential harms. A large-scale police "crackdown" to control illicit drug use in Vancouver's Downtown Eastside provided us with an opportunity to evaluate the effect.
Methods: As part of our ongoing prospective cohort study of IDUs in Vancouver, we examined data collected from 244 IDUs in the 3 months before the police crackdown and from 142 IDUs in the 3 months after the start of the crackdown, on Apr. 7, 2003. All study subjects were active drug users. We also examined external data on needle exchanges and syringe disposal.
Results: The 2 groups of IDUs were statistically similar: they were mainly young (mean age 39 years) and male (63%), and they had injected illicit drugs for 13 years on average. Ethnic background and the proportion homeless were also similar. There were no statistically significant reported differences (all p > 0.1) in the street price of heroin, cocaine or "crack" in the 2 periods. In the 3-month periods before and after the crackdown, respectively, the rates of daily heroin injection were 27.9% and 26.8%, daily cocaine injection 28.7% and 27.5%, and daily crack use 59.4% and 60.6% (all p > 0.1). The proportions of study subjects receiving methadone treatment, 41.0% and 44.4% (p = 0.516), did not differ. However, the proportions reporting a change in where drugs were used, 22.5% and 33.8% (p Interpretation: The effort to control illicit drug use did not alter the price of drugs or the frequency of use, nor did it encourage enrolment in methadone treatment programs. Several measures indicated displacement of injection drug use from the area of the crackdown into adjacent areas of the city, which has implications for both recruitment of new initiates into injection drug use and HIV prevention efforts.
|Domaine :||Drogues illicites / Illicit drugs|
|Refs biblio. :||38|
|Affiliation :||Division of Epidemiology and Population Health, British Columbia Centre for Excellence in HIV/AIDS, Vancouver BC, Canada|
|Numéro Toxibase :||1300974|
|Centre Emetteur :||13 OFDT|