VANCOUVER—Changing when and how people get their monthly income-assistance payments could ease the spike in drug use that’s typically seen around “cheque day,” suggests a new study from the BC Centre on Substance Use (BCCSU).

The findings — which are being presented next week at the 2019 Congress of the Humanities and Social Sciences at the University of B.C. — also caution that such changes could actually increase drug-related harms, such as overdose frequency, police interaction or exposure to violence.

But while the data is less conclusive about how such harms might be linked to a change in payment schedules, a connection between substance use and “cheque day” schedules was clearly established, said Lindsey Richardson, research scientist with BCCSU and an associate professor of medical sociology at the University of B.C.

“What the drug use findings tell us is that when you modify people’s payment schedules, their drug use patterns change,” Richardson, who is also the lead investigator on the study, told Star Vancouver Sunday.

BCCSU’s study followed 194 individuals, all people who use drugs, over a period of six months total, between 2015 and 2018.

Currently, most of the roughly 190,000 B.C. residents on some form of income assistance receive their money in a single monthly payment, on the last Wednesday of the month — sometimes known as “cheque day” or “Welfare Wednesday.”

BCCSU researchers tracked the impact on participants of two separate payment schedules: the first where participants received their monthly payment on a day other than the last Wednesday of the month; and the second — a “split and staggered” schedule — where participants received smaller payments every two weeks, with neither payment falling on the last Wednesday of the month.

Participants in both groups were roughly one-third as likely to increase their drug use on cheque days, according to the study, particularly with regards to the frequency of drug use and the amount of drugs used.

Overall substance use — including quantity of drugs used, daily frequency of use and number of drugs used — also showed “significantly larger decreases,” according to the findings.

Past research by the BCCSU has shown a surge in drug-related harms around cheque day, including riskier drug use, more overdoses, more hospital visits, more police interaction and an increase in overall mortality rates.

The current study also cites BC Coroners Service data showing that fatal overdoses see a 35- to 40-per-cent jump in the days after income assistance payments.

In recent years, some overdose prevention sites in the city of Vancouver — including Insite — began offering 24 hour-a-day service during the week following cheque day, in response to the demonstrated increase in drug-related harms over that time period each month.

More than 1,500 people died in B.C. of illicit drug overdose in 2018 alone. While official nationwide data for the last three months of 2018 has not yet been released, overdose deaths in B.C. in the first nine months of last year account for well over a third of the national total

The discovery that drug-related harms sometimes increased with a change to payment schedule, however, was “a really unexpected finding,” said Richardson.

“You would expect that if you’re decreasing drug use or decreasing harmful patterns of drug use, that you’d see beneficial impacts (on drug-related harm statistics),” she said. An upcoming analysis of 120 interviews, conducted as part of the study, will likely shed some light on the connection between the two, she added.

The one conclusion that can be drawn, she said, is that any major changes to income assistance payment structures would have to be made carefully and with an eye to the potential for unintended consequences.

The BCCSU’s study also took in responses from more than 500 individuals from over 50 community organizations and service providers from across the province, as well as first responders and B.C. residents, to help identify additional points of concern.

Sharon Buchanan, manager at Pigeon Park Savings in Vancouver’s Downtown Eastside neighbourhood, said the impact of the experimental income assistance schedules on her clients’ personal finances was in some cases positive and in others more concerning.

“We saw that staggering social assistance allowed some members to hit savings goals and monitor their finances more closely,” Buchanan said in a statement.

“However, it presented unique challenges to others who felt intimidated by creditors if they were not able to service their debts because of the new payment schedule. It’s clear there’s a need to balance the nuances of different schedules while meeting the need for an individualized approach.”

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And given that such concerns reflect problems encountered by many people living with poverty — and not simply those who also use drugs — the need for a more flexible income assistance system, which can accommodate the specific needs of recipients is clear, Richardson said.

“The gist of what we’re trying to advocate for at this point is more agility within the system, and that could benefit people who use drugs, but it could also benefit anyone who receives income assistance,” she said.

“Financial management practices aren’t specific to people who use drugs. Everyone has a different way of approaching how they work with money, and having a system that is able to support that is worth figuring out.”

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