Research Update: Youth Who Use Drugs Who Cannot Access Addiction Treatment Are Twice as Likely to Start Injecting

February 6, 2017

A Vancouver study1 investigated the relationship between the accessibility of addiction treatment and the initiation of injection drug use among at-risk youth. This study found that youth who used drugs -- cocaine, crack, heroin or methamphetamines -- but who had never injected were twice as likely to start injecting after being unable to access addiction treatment.

The findings are from a cohort study of street-involved youth (aged 14-26) in Vancouver who had used drugs in the past six months. Participants had to have never injected drugs at study enrollment and to have at least one follow-up visit to be included in this study. Between September 2005 and May 2014, 462 participants met these criteria. Over the course of the study:

  • 21% of participants disclosed that they had injected drugs for the first time (97 participants)
  • 28% of participants disclosed that they had tried but were unable to access addiction treatment (129 participants)

Of the participants who were unable to access addiction treatment, 41% tried to access detox services, 35% treatment centres, 10% recovery houses, and 4% counsellors. Waiting lists were the most frequent barrier to treatment (66%); 18% of participants cited logistical barriers including location, hours and documentation requirements as barriers; and 6% for behavioural issues. Seventeen percent of participants were rejected by treatment programs for unspecified reasons and 6% for behavioural issues.

The results of this study suggest that reducing barriers to treatment for youth who use drugs but who have never injected may reduce the likelihood that they will transition to injection drug use. This will avoid missed opportunities to prevent injection initiation and help to reduce drug-related harms like overdose and infection with HIV and hepatitis C.

Logan Broeckaert holds a Master's degree in History and is currently a researcher/writer at CATIE. Before joining CATIE, Logan worked on provincial and national research and knowledge exchange projects for the Canadian AIDS Society and the Ontario Public Health Association.


  1. DeBeck K, Kerr T, Nolan S, et al. Inability to access addiction treatment predicts injection initiation among street-involved youth in a Canadian setting. Substance Abuse Treatment, Prevention, and Policy. 2016 Dec;11(1). Available from:

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This article was provided by Canadian AIDS Treatment Information Exchange. It is a part of the publication Prevention in Focus: Spotlight on Programming and Research. Visit CATIE's Web site to find out more about their activities, publications and services.

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