Lindsey Richardson: Can staggering income-assistance cheques reduce overdose risk?

published on June 18, 2018 by Lindsey Richardson in Vancouver Sun

Earlier this month the B.C. Coroners Service released its latest report on overdose deaths in the province. Once again, the number of people who died as a result of an overdose is staggering — 124 in April, a figure that has tragically become the norm in the two years since the provincial public-health emergency was declared.

Also contained in the coroners’ report was this: over the past year an average of 5.6 fatal overdoses occurred over the five days beginning with monthly income-assistance payment days, compared with 3.5 deaths on all other days of the month. That’s a 60-per-cent increase in fatal overdoses during a single five-day period each month.

The data reflects a long-established relationship between synchronized, once-monthly provincial income-assistance payments — known as Cheque Day or “Welfare Wednesday” — and increases in drug and alcohol consumption. Scientific evidence provides a long and growing list of impacts linked to these synchronized monthly payments, ranging from fatal and non-fatal overdoses to the interruption of medical care and people being unable to access social, health and financial services that are either oversubscribed or closed for lack of use.

Research confirms what people have known for many years: that income-assistance payments — a critical component of the social safety net that reduces some of the health harms of poverty — are associated with increases in drug and alcohol use and overdose risk. The twin opioid and overdose epidemics have only magnified the harms that come alongside monthly spikes in consumption.

Not everyone receiving income assistance uses drugs, nor do all people who use drugs receive income assistance. However, people who use drugs who receive income assistance are often marginalized and vulnerable, facing both food and housing insecurity. Some have concurrent mental or physical health issues, and face a range of harms that are amplified by how income assistance is delivered.