Karen Ward, 46, has lived in Vancouver's Downtown Eastside for 12 years. She began using cocaine about three years before that, and continues to smoke "rock."

Ward doesn't get welfare, but she is on disability assistance while working part-time for the City of Vancouver. She says when cheque issue day — or "welfare Wednesday" — rolls around, the entire neighbourhood goes crazy; the chaos even starts a day early in anticipation.

"People are getting loans. People are getting fronts — it's mayhem," said Ward. "Everyone finally has a little bit of money to spend. These people are so poor for so long ... They spend it right away; they spend it recklessly."

Karen Ward describes cheque issue day, or 'welfare Wednesday,' as chaos in Vancouver's Downtown Eastside, when everyone has a little bit of money and there are debts to settle. (Rafferty Baker/CBC)

Cheque issue day has long been tied to spikes in overdoses, taxing first responders and emergency rooms. According to the B.C. Coroners Service, fatal overdoses increase by 35 to 40 per cent in the five days after income assistance payments.

Officials have called for changes to reduce the harm, hoping to save some of the hundreds of lives lost in the province to overdoses each year.

But new research shows that the issue isn't so simple.

Lindsey Richardson is a researcher with the B.C. Centre on Substance Use and an associate professor at the University of British Columbia. Since 2015, she's been carrying out a study on the effects of changing assistance cheque schedules for people who use drugs.

Richardson recruited 194 volunteers — mostly based in Vancouver's Downtown Eastside — who participated for six months each.

They were randomly split into three groups: a control group that kept the regular assistance schedule, a group that received assistance once a month, but on a staggered schedule, and a group that received assistance split into two separate cheques over the course of the month.

Lindsey Richardson is a researcher with the B.C. Centre on Substance Use and an associate professor in UBC's sociology department. (Rafferty Baker/CBC)

Richardson found that those who were taken off the regular government schedule were significantly less likely to increase their drug use on the government payment days, and were about half as likely to increase their drug use on their own payment days.

People with altered payment schedules showed much larger decreases in overall quantity and frequency of drug use than the volunteers whose assistance cheques remained on the regular schedule.

Negative effects

But, according to Richardson, there was a downside for people who were out of sync with welfare Wednesday in their neighbourhood. Some people experienced more drug-related harm, including violence, negative interactions with police, overdose frequency, and interruption of health treatments.

"What might be happening is when you pull people out of [the] predictable regular scheduled system you're disrupting social relationships — you're disrupting economic relationships," said Richardson.

"We know that cheque day is one of the days in which people often settle their drug debts," she said. "What could potentially happen if a drug dealer goes to a person who holds a debt with them and says, 'It's time to pay up,' and that person says, 'Oh but I'm not being paid until two weeks from now,' that could potentially put that person at risk."

The 'Zero Block' of East Hastings Street in Vancouver, between Columbia and Carrall streets, teems with people selling their wares, meeting with friends, or just passing through. (Rafferty Baker/CBC)

Richardson also said that the randomized selection for how and when people received assistance may have been difficult on some participants.

"Changes to the income assistance system really could produce changes to drug use patterns," she said. "However, there is a strong potential for unintended consequences."

Richardson said the study revealed that a "one size fits all" cheque payment schedule is likely to increase harms, while flexibility could help reduce negative impact.

According to Ward, reducing poverty would go a long way toward reducing many of the harms drug users in the Downtown Eastside experience.

She said disrupting entrenched routines like when people get their cheques could be risky, but if people have choice about the issue, it could improve the situation.

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