Background: Research identifies the importance of social determinants of health for people who use drugs (PWUD), implicating social policy in the arena of “drug policy” requiring critical attention. Yet, little research focuses on policy dimensions that affect the participation of PWUD in employment opportunities.
Objectives: Given the importance of income generation to socioeconomically disadvantaged PWUD, we sought to assess participation, outcomes and experiences of social-policy-relevant barriers to low-threshold employment.
Methods: We employed a parallel explanatory mixed-methods design using data from the Assessing Economic Transitions (ASSET) Study, a Vancouver, Canada-based mixed-methods, longitudinal cohort involving quarterly interviews with 332 quantitative participants and annual interviews with 169 qualitative participants (2019-2023). Exploratory descriptive analyses, combined with thematic analyses of participant experiences, identified social policy dimensions impacting health, social and economic dynamics of economic engagement.
Results: Findings demonstrate that despite transformative impacts of economic engagement on participant health, social, and economic outcomes, (1) employment standards regulations that restrict drug use, periodic absences and skills development; and (2) income assistance policy that constrains earnings and ancillary benefit eligibility (e.g., substance use disorder treatment) are central barriers to economic engagement for PWUD engaged in low-threshold employment.
Implications: Social policy reform specifically designed to support economic engagement for PWUD could decrease policy and regulatory hurdles impacting economic opportunity development and labour market disengagement for PWUD. There is considerable opportunity to expand the scope, scale and benefits of meaningful, supportive economic engagement to reduce drug-related harm.
Lindsey Richardson is an Associate Professor of Sociology at the University of British Columbia, a Research Scientist at the British Columbia Centre on Substance Use, and holds the Canada Research Chair in Social Inclusion and Health Equity. Her research focuses on the dynamics and health consequences of poverty and socioeconomic disadvantage among people who use drugs, with a focus on public policy reform, community economic development and harm reduction.