Thread by @lndsyrchrdsn

I’m really proud to share a just-published article in @TheLancetPH about our #ChequeDayStudy. It is the culmination of years of work and input from community. I hope it informs policy to improve the lives of PWUD in BC & beyond 1/13 thelancet.com/journals/lanpu…

Monthly synchronized income assistance payments have long been linked in past research to considerable and costly increases in drug use and drug-related harm, including overdose, hospital admission, treatment interruption, and emergency service calls. 2/13

This research suggests an individual signal for increased use from payments themselves and social signals from everyone being paid at the same time, producing calls to vary payment timing and frequency. 3/13 doi.org/10.1111/add.15…

We tested if that would work. Consulting with pple w/ lived and living experience, service providers, first responders and policy makers, we partnered with @PHScss @Vancity Pigeon Park Savings & worked with ~200 study volunteers. 4/13 bccsu.ca/cheque-day-stu…

We examine if changing the timing & frequency of income assistance payments reduces clustered drug use and drug related harm. In @TheLancetPH we report results for our primary and some secondary outcomes. The results are complex. 5/13

There’s strong evidence that alternative schedules lower drug use frequency and quantity & weaker but significant evidence that violence increased for some participants. We can use the #socialsupport system to change drug use but there may be unexpected consequences. 6/13

The study points to the need to look #upstream as well as #downstream to address the #ODcrisis. Ongoing #qual work will center the experience of pple who use drugs. It emphasizes the importance of testing proposed policy changes to explore potential unintended consequences. 7/13

This #RCT was complex: we had to figure out how to transition pple to new schedules; we talked to folks every 2 weeks to get detailed drug use info, etc. We focused a lot on participant safety with the help of an external monitoring committee. 8/13

It was also really hard: RCTs among marginalized pops still have stringent protocols, getting a representative sample took a ton of work, a public health emergency was declared after 6 months of data collection & we lost participants to #OD (not b/c they were in the study) 9/13

I’m still glad we did it. It upped the evidence (from observational to experimental) we provide to policy makers. It got people talking. Widespread consultation made it better. 10/13 bccsu.ca/wp-content/upl…

It also points to how sociological knowledge and ways of thinking can be applied not just to identify but also to address real world problems, and the importance of #PublicSociology & #MedSoc in linking social policy to health outcomes. #SDOH #socialpolicyisdrugpolicy. 11/13

We shared preliminary findings of the research and community consultation in 2019. We’ve been meeting with policymakers and community reps since then to talk about how a system grounded in dignity and individual choice could look in practice. 12/13

Many years in & the work feels as important as ever. Deep thanks to participants, rsch team (Allison Laing, @joannamendell @mjmilloy @pph_collective et al); funders @CIHR @PWI @PHCRI @MSFHR & everyone who gave advice. Been a long road & still feels like just the beginning. 13/13