Changing how and when people who use drugs receive their income assistance payments could reduce escalations in drug use around government cheque day, however, changes could also have unintended consequences that increase individual drug-related harm.

Researchers with the BC Centre on Substance Use (BCCSU), which is co-hosted by UBC’s faculty of medicine, have been examining whether varying the timing and frequency of income assistance payments can mitigate drug-related harms linked to the existing once-monthly payment schedule, known as cheque day or “Welfare Wednesday.”

Based on preliminary findings, presented this week at Congress 2019, researchers are recommending the consideration of changes to the income assistance system that allow for individual choice about the timing and frequency of payments and avoid a one-size-fits-all approach.

“These complex findings signal the potential for the income assistance system to address the severe harm seen each month around payments,” says Lindsey Richardson, research scientist at BCCSU, associate professor at UBC and principal investigator of the study. “However, changes must accommodate the complexity of people’s lives by allowing for choice in preferred schedule, providing flexibility to change as life circumstances change, and focusing on the autonomy and dignity of recipients.”

Researchers at the BCCSU followed 194 participants, all people who use drugs, for six-month periods between 2015 and 2018 to evaluate the impact of alternative payment schedules, evaluating two interventions compared with the standard monthly cheque distribution: a staggered schedule where participants receive payments monthly on a day that does not fall during the week of synchronized government disbursement; and a split and staggered schedule, where participants receive semi-monthly payments two weeks apart on days that do not fall during the week of synchronized government disbursement.

The preliminary analysis found:

• Intervention participants were about one third as likely to increase their drug use on government payment days when they received their payments either desynchronized from government payments or desynchronized and in smaller increments, particularly in terms of the frequency of use and quantity of substances used.
• Intervention participants were about one-half as likely to increase their drug use on their individual payment days when they received their payments, although findings were not consistent in all analyses.
• Overall substance use showed significantly larger decreases in overall quantity of substances used, average daily frequency of drug use and number of drugs used among participants in the intervention arms.
• Study analyses also identified signals that participants may be more likely to experience some drug-related harms, including perpetration of and exposure to violence, negative police interactions, treatment interruption and overdose frequency.

Patterns of participation in the intervention provided insight into how distribution systems that do not involve personal choice can be problematic for people.

These complex findings signal the potential for the income assistance system to address the severe harm seen each month around payments.

Lindsey Richardson
Research scientist, BC Centre on Substance Use

 

Monthly synchronized income assistance payments have long been linked to considerable and costly increases in drug use and resulting harm, including overdose, hospital admission, treatment interruption and emergency service calls. The BC Coroners Service has further reported that fatal overdoses increase by 35 to 40 per cent in the five days after income assistance payments. However, the impact of potential changes to cheque day schedules had not been examined previously.

In addition to the formal research study, the BCCSU consulted with more than 500 individuals from more than 50 community organizations and service providers, first responders and residents from communities across BC, in order to explore stakeholder perspectives and understand concerns about potential changes.

“This project is part of a larger conversation around involving the community in shaping low-barrier financial institutions and harm reduction banking in general,” said Sharon Buchanan, manager of Pigeon Park Savings, a partnership between PHS community services and Vancity credit union. “We saw that staggering social assistance allowed some members to hit savings goals and monitor their finances more closely. However, it presented unique challenges to others who felt intimidated by creditors if they were not able to service their debts because of the new payment schedule. It’s clear there’s a need to balance the nuances of different schedules while meeting the need for an individualized approach.”

A summary of those consultations were published in a community impact statement, which included recommendations that changes must ensure consistent and equal access to income assistance regardless of individual drug use patterns. The summary noted that low rates of income assistance may exacerbate the problem. Many people shared how poverty contributes to the amount of substance use around cheque day.

Learn more about the Cheque Day Study.

This article originally appeared as a news release on the British Columbia Centre on Substance Use website.

View the full-list of media coverage on this new study here.