Push and Pull: Migration Patterns and Links to Harm Reduction Services Among People Who Use Drugs
Bibliographic record
Abstract
ABSTRACT Objectives: The role of migration among people who use drugs (PWUD) remains a complex topic that is often shaped by risk but also has the potential for protective health outcomes. This study examines migration trends and the effect of migration on the use of social support services for PWUD in Ottawa-Gatineau region. Methods: Respondent-driven sampling was used to recruit participants residing in Ottawa-Gatineau who were ≥18 years and used drugs in the preceding 6 months. Migration was defined as a permanent change in location after ≥3 months. Push factors (reasons for leaving previous residence) and pull factors that brought them to Ottawa were explored. Bivariable and multivariable logistic regressions were conducted using odds ratio (OR), adjusted odds ratio (AOR), and 95% confidence interval (CI), respectively, to investigate the effect of migration on shelter use and accessing harm reduction services. Results: Of 398, 358 (89.95%) migrated in their lifetime and 71 (17.83%) within the last 12 months. Our sample was 79.40% male and 22.86% identified as First Nations, Inuit, or Métis. Migratory push factors included getting away from drugs or harmful friends and pull factors included returning home for family. Recent migrants had higher odds of living in a shelter (AOR: 2.51, 95% CI: 1.37–4.61) and lower odds (AOR: 0.40, 95% CI: 0.19–0.82) of accessing harm reduction services. Conclusion: PWUD are a highly mobile group and despite being motivated to migrate to reconnect with family or social networks, a high prevalence of shelter use and low uptake of harm reduction services exists. Objectifs: Le rôle de la migration chez les personnes qui consomment des drogues (PWUD) demeure un sujet complexe qui est souvent façonné par le risque, mais qui a aussi un potentiel de protection pour la santé. Cette étude examine les tendances migratoires et l’effet de la migration sur l’utilisation des services de soutien social pour les PWUD dans la région d’Ottawa-Gatineau. Méthodes: L’échantillonnage dirigé par les répondants a été utilisé pour recruter des participants résidant à Ottawa-Gatineau âgés de 18 ans ou plus et ayant consommé de la drogue au cours des six mois précédents. La migration a été définie comme un changement permanent d’emplacement après ≥3 mois. Les facteurs d’incitation (raisons de quitter la résidence antérieure) et les facteurs d’attraction qui les ont amenés à Ottawa ont été explorés. Des régressions logistiques bi-variables et multi-variées ont été menées en utilisant les rapports de cotes (odds ratios-OR), les OR ajustés et les intervalles de confiance à 95% (IC) respectivement, pour étudier l’effet de la migration sur l’utilisation des abris et l’accès aux services de réduction des risques. Résultats: Sur 398, 358 (89,95%) ont migré au cours de leur vie et 71 (17,83%) au cours des 12 derniers mois. Notre échantillon comprenait 79,40% d’hommes et 22,86% de membres des Premières Nations, d’Inuits ou de Métis. Les facteurs d’incitation migratoires incluaient s’éloigner des drogues ou des amis nuisibles et des facteurs d’attraction incluaient rentrer à la maison pour la famille. Les migrants récents avaient des chances plus élevées de vivre dans un refuge (AOR: 2,51, IC à 95%: 1,37–4,61) et des probabilités plus faibles (AOR: 0,40, IC à 95%: 0,19–0,82) d’accéder aux services de réduction des risques. Conclusion: Les PWUD constituent un groupe très mobile et, bien qu’ils soient motivés à migrer pour se reconnecter avec les réseaux familiaux ou sociaux, il existe une forte prévalence ou utilisation de refuges et une faible utilisation des services de réduction des risques.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".