Push and Pull: Migration Patterns and Links to Harm Reduction Services Among People Who Use Drugs

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The role of migration among people who use drugs (PWUD) remains a complex topic that is often shaped by risk but also has the potential for protective health outcomes. This study examines migration trends and the effect of migration on the use of social support services for PWUD in Ottawa-Gatineau region.


Respondent-driven sampling was used to recruit participants residing in Ottawa-Gatineau who were ≥18 years and used drugs in the preceding 6 months. Migration was defined as a permanent change in location after ≥3 months. Push factors (reasons for leaving previous residence) and pull factors that brought them to Ottawa were explored. Bivariable and multivariable logistic regressions were conducted using odds ratio (OR), adjusted odds ratio (AOR), and 95% confidence interval (CI), respectively, to investigate the effect of migration on shelter use and accessing harm reduction services.


Of 398, 358 (89.95%) migrated in their lifetime and 71 (17.83%) within the last 12 months. Our sample was 79.40% male and 22.86% identified as First Nations, Inuit, or Métis. Migratory push factors included getting away from drugs or harmful friends and pull factors included returning home for family. Recent migrants had higher odds of living in a shelter (AOR: 2.51, 95% CI: 1.37–4.61) and lower odds (AOR: 0.40, 95% CI: 0.19–0.82) of accessing harm reduction services.


PWUD are a highly mobile group and despite being motivated to migrate to reconnect with family or social networks, a high prevalence of shelter use and low uptake of harm reduction services exists.

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