Drug dealing cessation among a cohort of drug users in Vancouver, Canada

Introduction: Drug dealing among drug users has been associated with elevated risk-taking and negative health outcomes. However, little is known about the cessation of drug dealing among this population. Methods: We assessed time to cessation of drug dealing using Cox regression. We also used generalized estimating equation (GEE) analysis and chi-square analysis to examine factors associated with willingness to cease drug dealing. Results: In total, 868 participants reported drug dealing between November 2005 and March 2009. Among 381 participants dealing drugs at baseline, 194 (51%) ceased dealing. Incidence of dealing cessation was positively associated with spending less than $50 per day on drugs (Adjusted Hazard Ratio [AHR] = 1.88, 95% confidence interval [CI]: 1.14-3.10) and negatively associated with buying drugs from the same source (AHR = 0.60, 95% CI: 0.37-0.98). In a GEE analysis, willingness to cease dealing was positively associated with older age (Adjusted Odds Ratio [AOR] = 1.02, 95% CI: 1.01-1.03), crack use (AOR = 2.00, 95% CI: 1.44-2.79), public injecting (AOR = 1.95, 95% CI: 1.55-2.43), and reporting that police presence affects drug purchases (AOR = 1.53, 95% CI: 1.22-1.91), and negatively associated with crystal methamphetamine injection (AOR = 0.62, 95% CI: 0.47-0.83). Discussion: Intensity of drug use and acquisition method were predictive of dealing cessation. Willingness to cease dealing was associated with a range of risky drug-related activities. Interventions to reduce drug dealing should be conceived in tandem with addiction treatment strategies.