Methamphetamine Use and
Rates of Incarceration Among
Street-Involved Youth in a
Canadian Setting: A Cross-
Sectional Analysis
M-J. Milloy, omas Kerr, Jane Buxton,
Julio Montaner and Evan Wood
Given concerns over rising use of methamphetamine, especially among street-
involved youth, and the links between exposure to the correctional system and
the production of drug-related harm, we sought to assess the relationship be-
tween ever using methamphetamine and reporting ever being incarcerated in
the At-Risk Youth Survey (ARYS) in Vancouver, Canada.
M U  R  I 29
e relationship between ever being imprisoned and ever using methamphet-
amine was estimated using a multivariate logistic regression analysis while
also considering potentially confounding secondary demographic, social and
behavioural variables.
Of the 478 youth recruited into ARYS between September 2005 and October
2006, 385 (80.5%) reported ever being incarcerated overnight or longer. In
the multivariate model, methamphetamine use was independently associated
with ever being incarcerated (Adjusted Odds Ratio: 1.79, 95% Condence
Interval [CI]: 1.03–3.13).
Incarceration was very common in this cohort and strongly linked with ever
using methamphetamine. is nding is of concern and, along with the pre-
viously identied risks of drug-related harm associated with incarceration,
supports the development of novel public policy, such as community-based
drug treatment, to address the use of methamphetamine among street youth.
e use of methamphetamine in Western settings is of increasing concern [1,2],
especially among street-involved youth [3,4], a vulnerable population already
burdened by high levels of morbidity and mortality [5,6]. According to the Unit-
ed Nations Oce on Drugs and Crime, methamphetamine now constitutes the
second most commonly used illicit drug internationally, second only to marijuana
For older drug users, especially those who use injection drugs (IDU), the dy-
namics linking drug use, marginalisation and imprisonment are well described
[8-10]. Arrest and imprisonment is a common experience, with a history of incar-
ceration reported by at least 75% of participants in community-recruited samples
of IDU in Europe [11], ailand [12] and the United States [13]. Incarceration
may be a risk factor for drug related harm among IDU, since exposure to correc-
tional environments has consistently been associated with an increased likelihood
of HIV risk behavior and HIV infection [14,15] as well as increased risk of fatal
overdose upon release [16].
Sparked by the growing use of methamphetamine and concerns over links to
initiation of injection drug use [17], we have previously reported that over 75%
of participants in a local cohort of street-involved youth said they had previously

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