Combining chain link sampling with a community-based participatory action study of people who smoke drugs in two cities in British Columbia, Canada

Abstract Background: The smoking of illicit drugs presents a serious social and economic burden in Canada. People who smoke drugs (PWSD) are at an increased risk of contracting multiple infections through risky drug practices. Peer-led harm reduction activities, and the resulting social networks that form around them, can potentially minimize the dangers associated with the smoking illicit drugs.Goal: The goal of this study is to examine the influence of peer-led harm reduction initiatives on drug behaviour by comparing the attributes and social networks of PWSD in two British Columbia cities with different harm reduction programs.Methods: Using community-based participatory action research (CBPAR) and respondent- driven sampling (RDS), individuals with lived drug experiences were employed from communities in Abbotsford and Vancouver as ‘peer researchers’ to interview ten contacts from their social networks. Contacts completed a questionnaire about their harm reduction networks.Results: We found that PWSD residing in Abbotsford were more likely to report engaging in harm-promoting behaviours, such as sharing, reusing, or borrowing crack pipes. However, PWSD in the Downtown Eastside Community (DTES) of Vancouver were more likely to report engaging in harm-reducing activities, such as being trained in naloxone use and CPR. These differences are likely linked to the greater availability of harm reduction programs in DTES compared to Abbotsford.