British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada; CIHR Canadian HIV Trials Network, 588-1081 Burrard Street, Vancouver, BC, V6B 3E6, Canada.
British Columbia Centre on Substance Use, 1045 Howe Street, Vancouver, BC, V6Z 2A9, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 1081 Burrard St, Vancouver, BC, V6Z 1Y6, Canada.
Int J Drug Policy. 2019 Jul;69:16-23. doi: 10.1016/j.drugpo.2019.02.006. Epub 2019 Apr 20.
The illicit selling and use of cannabis is prevalent among marginalized people who use illicit drugs (PWUD). Given that participation in illicit drug markets has been previously associated with a range of health and social harms, we sought to examine the predictors of selling cannabis among PWUD in Vancouver, Canada, a setting with a de facto legalized cannabis market, on the eve of the planned implementation of legalized non-medical cannabis including measures to regulate the existing illicit market.
Multivariable generalized estimating equations (GEE) logistic regression was used to analyze longitudinal factors associated with selling illicit cannabis among three prospective cohorts of PWUD between September 2005 and May 2015.
Among the 3258 participants included in this study, 328 (10.1%) reported selling illicit cannabis at baseline, and 46 (5.1%) initiated cannabis selling over the study period. In the multivariable analysis of the whole sample, factors significantly associated with selling cannabis included cannabis use (Adjusted Odds Ratio [AOR] = 4.05), dealing other drugs (AOR = 3.87), being male (AOR = 1.83), experiencing violence (AOR = 1.40), non-medical prescription opioid use (AOR = 1.32), non-custodial involvement in the criminal justice system (AOR = 1.31), being stopped by police (AOR = 1.30), crack use (AOR = 1.25), homelessness (AOR = 1.23), age (AOR = 0.96 per year) and participation in sex work (AOR = 0.67) (all p < 0.05). The subanalyses indicated that dealing drugs other than cannabis, cannabis use, and non-custodial involvement in the criminal justice system were the only factors significantly associated with selling cannabis in all four subgroups.
These findings support existing evidence indicating that selling illicit cannabis is often a survival-driven strategy to support the basic needs and substance use of some PWUD. Our findings suggest jurisdictions with planned or impending cannabis legalization and regulation should consider the vulnerability of PWUD when seeking to eradicate illicit cannabis markets, for example, in setting criminal penalties for selling cannabis outside of regulatory frameworks.
非法销售和使用大麻在边缘化的吸毒者（PWUD）中很普遍。鉴于参与非法毒品市场以前与一系列健康和社会危害有关，我们试图在加拿大温哥华研究在计划实施包括规范现有非法市场措施的非医用大麻合法化之前，与 PWUD 销售大麻相关的预测因素，该城市存在事实上的合法化大麻市场。
使用多变量广义估计方程（GEE）逻辑回归分析 2005 年 9 月至 2015 年 5 月期间三个前瞻性 PWUD 队列中与非法销售大麻相关的纵向因素。
在这项研究的 3258 名参与者中，328 人（10.1%）在基线时报告销售非法大麻，46 人（5.1%）在研究期间开始销售大麻。在全样本的多变量分析中，与销售大麻显著相关的因素包括大麻使用（调整后的优势比 [AOR] = 4.05）、贩卖其他毒品（AOR = 3.87）、男性（AOR = 1.83）、经历暴力（AOR = 1.40）、非医用处方类阿片类药物使用（AOR = 1.32）、非监禁性刑事司法系统参与（AOR = 1.31）、被警察拦截（AOR = 1.30）、快克使用（AOR = 1.25）、无家可归（AOR = 1.23）、年龄（AOR = 每年 0.96）和参与性工作（AOR = 0.67）（均 P < 0.05）。亚组分析表明，贩卖大麻以外的其他毒品、大麻使用和非监禁性刑事司法系统参与是所有四个亚组中与销售大麻唯一显著相关的因素。
这些发现支持现有的证据，表明非法销售大麻通常是支持一些吸毒者基本需求和药物使用的生存驱动策略。我们的研究结果表明，计划或即将实施大麻合法化和监管的司法管辖区在试图消除非法大麻市场时，应考虑到 PWUD 的脆弱性，例如在为在监管框架之外销售大麻设定刑事处罚时。
