Grant: Foundation Grant

Socioeconomic marginalization (SEM) is a key driver of drug use and drug-related harm, resulting in excess morbidity and mortality among people who use drugs and a significant social and economic burden in Canada and internationally. However, key dimensions of SEM and their health impacts are not fully understood and interventions that address drug use and related harm by targeting SEM are urgently needed. Further, research has shown that there is a strong link between understanding how SEM impacts individual outcomes and the generation of evidence-based strategies to reduce health inequity. My proposed program builds on my previous research in this field, and includes an established network of local, national and international collaborators, a growing training platform, and an integrated knowledge translation (iKT) strategy. My overall goal is to reduce drug use and related harm through effective interventions that address SEM among people who use illicit drugs. Using linked observational, intervention and randomized controlled trial (RCT) evaluation studies, the specific objectives of my CIHR Foundation program are to: 1) Conduct observational research that identifies elements of SEM to be targeted via social and structural interventions; 2) Implement social and structural RCTs that test public health solutions targeting SEM; and 3) Evaluate how social and structural drivers of SEM affect addictions RCT recruitment, retention and experiences from local and comparative national perspectives. Through qualitative, quantitative, experimental and mixed-methods approaches, this work will yield a robust evidence base for strategies to reduce drug use and drug-related harm driven by SEM. Parallel iKT initiatives will promote the integration of public health objectives into social and welfare policy, thereby reducing the human and health system costs of SEM among people who use drugs.