Lindsey Richardson is a medical sociologist whose research program is motivated by fundamental inequities in health that have social and institutional roots. Dr. Richardson links observational, intervention, and research participation studies in efforts to identify and address the causes and health consequences of socio-economic (in)security, with a specific focus on people who use illicit drugs.
Research Scientist, British Columbia Centre on Substance Use.
Associate Member, Division of Social Medicine, UBC Faculty of Medicine.
Affiliate Investigator, Vancouver Coastal Health Research Institute
Research Methods (SOCI 217)
Experimental and Mixed Methods (SOCI 381)
Sociology of Health and Illness (SOCI 384)
Drugs and Society (SOCI 387)
Health, Illness and Society (SOCI 584)
Sociology of health and illness; substance use; urban health; sociology of work and economic life; health disparities; research participation; research methods, especially longitudinal, experimental and mixed-methods research
Dr. Richardson’s current research focuses on three interrelated areas:
1. Observational studies on the dynamics and health consequences of poverty and socio-economic marginalization. This research is ongoing and to date has shown that despite a persistent relationship between unemployment and poor health, people who use illicit drugs face significant social-structural barriers to employment (e.g., treatment regulations, housing insecurity, opportunity gaps). As a result, they are commonly relegated to prohibited income generation (e.g., informal recycling, drug dealing) that, while allowing flexibility and individual agency, can carry further risk of harm. It also results in reliance on synchronized income assistance payments, which, while protecting against the effects of severe poverty are also linked to cyclical elevations in drug use and drug-related harm that coincide with once-monthly support payments. This work draws on data from longitudinal cohorts housed at the British Columbia Centre on Substance Use. It also includes several systematic reviews, for example on the relationship between socioeconomic marginalization and overdose. This research has appeared in venues such as Addiction, AIDS, Social Science & Medicine, Drug and Alcohol Dependence, Sociology of Health & Illness, and Social Indicators Research, among others
2. Applied studies that seek to identify modifiable aspects of upstream determinants of health. This second area translates findings from observational research into interventions. The first of these studies is a complex field experiment known as the Cheque Day Study that evaluates whether changing the socio-economic context by varying the timing and frequency of income assistance payments mitigates escalations in drug use and related harms that coincide with payments. Initial results from this study are published in The Lancet Public Health, and the extensive integrated knowledge translation undertaken alongside the experiment appears in BMC Public Health. Funded by the Canadian Institutions of Health Research, UBC’s Peter Wall Institute, the Michael Smith Foundation for Health Research, and the Providence Health Care Research Institute, the analysis of data from this study is ongoing.
A new study in this second area focuses on community-based innovative employment models and their effects on broadly defined well-being. The CIHR-funded (2021-2024) Assessing Economic Transitions (ASSET) Study is currently engaged in primary data collection and involves widespread community collaboration.
3. Critical studies of health research participation among marginalized populations, focusing on randomized controlled trials (RCTs). While RCTs are considered the gold standard in medicine, identifying how participant disadvantage influences RCT participation, trial effectiveness and generalizability in substance use RCTs is particularly salient given issues of poverty, criminalization and stigma for people who use drugs. This research investigates dynamics of RCT recruitment, retention, and protocol adherence. It has been published in Qualitative Health Research, Journal of Addiction Medicineand Substance Abuse Journal.
My research is currently supported by a five-year Canadian Institutes of Health Research Foundation Grant (2017-2022) and was a previously supported Michael Smith Foundation for Health Research Scholar (2014-2019) and Canadian Institutes of Health Research New Investigator (2015-2020) awards. Prior to my time in academia, I worked on social, health, and drug policy for the Government of Canada and the City of Vancouver, and my graduate and postgraduate training was supported by the Pierre Elliott Trudeau Foundation, the Canadian Social Sciences, and Humanities Research Council, Nuffield College as well as a University of Oxford Clarendon Scholarship.
*indicates supervised student co-author
*Jaffe, K., Korthuis, P.T., Richardson, L. (2021) Experimental (re)structuring: Shifting place, time, and social ties among medical research participants. Qualitative Health Research. 31(8): 1504-1517. doi: 10.1177/10497323211016408
*Jaffe, K., Korthuis, P.T., Richardson, L. (2021) “This could be my last chance”: Therapeutic optimism in an addictions randomized controlled trial. Sociology of Health and Illness. DOI: 10.1111/1467-9566.13297
Richardson, L., *Laing, A., Choi, J., Nosova, K., Milloy, M-J., Marshall, B., Singer, J., Wood, E., Kerr, T. (2021) Effect of alternative income assistance schedules on drug use and drug-related harm: a randomised controlled trial. The Lancet Public Health. 6: e324-34. Doi: 10.1016/S2468-2667(21)00023-2.
*Van Draanen, J., Hayashi, K., Milloy, M-J., Nosova, E., Shulha, H., Grant, C., Richardson, L. (2021)Material security as a measure of poverty: a validation study with people who use drugs. Social Indicators Research, 157: 501-521. doi: 10.1007/s11205-021-02663-1.
Mendell, J., Richardson, L. (2021) Integrated knowledge translation to strengthen public policy research: a case study from experimental research on income assistance receipt among people who use drugs. BMC Public Health. 21:153.
*Mohd Salleh, N.A., Voon, P., Karamouzian, M., Milloy, M-J., Richardson, L. (2021) Methadone maintenance therapy service components linked to improvements in HIV care cascade outcomes: A systematic review of trials and observational studies. Drug and Alcohol Dependence. 281(1): 108342.
*Van Draanen, J., Karamouzian, M., *Mitra, S., *Tsang, C., Richardson, L. (2020) Socio-economic Marginalization and Opioid Overdose: A Review of the Evidence. Drug and Alcohol Dependence. 214: 18127.
*Mohd Salleh, N.A., Nosova, E., Milloy, M-J., Richardson, L.. (2020) Material security and adherence to antiretroviral therapy (ART) among HIV-positive people who use illicit drugs. AIDS. 34(7):1037–1045.
Richardson, L., *Mammel, M., Milloy, M-J, Hayashi, K. (2019) Employment cessation, long term labour market engagement and HIV infection risk among people who inject drugs in an urban Canadian setting. AIDS and Behavior. 23(12): 3267-3276.
*Jaffe, K., Dong, H., Godefroy, A., Boutang, D., Hayashi, K., Milloy, M-J, Kerr, T., Richardson, L.. (2018) Informal recycling, income generation and risk: health and social harms among people who use drugs. International Journal of Drug Policy.60, 40-46.
Boyd, J., Richardson, L., Anderson, S., Kerr, T., Small, W., McNeil, R. (2018). Transitions in illegal income generation among people who use drugs: A qualitative study on recycling and vulnerability to violence. International Journal of Drug Policy. 59, 36-43.
Conyers, L., Richardson, L., Datti, P., Koch, L., Misrock, M. (2017)
A critical review of health, social, and prevention outcomes associated with employment for people living with HIV. AIDS Education and Prevention 29(5), 475-490.
Krebs, E., Wang, L., Olding, M., DeBeck, K., Hayashi, K., Milloy, M-J., Wood, E., Nosyk, B., Richardson, L. (2016) Increased drug use and the timing of social assistance receipt among people who use illicit drugs. Social Science & Medicine 171, 94-102.
Richardson, L., Laing, A., Milloy, M-J., Maynard, R., Nosyk, B., Marshall, B., Grafstein, E., Daly, P., Wood, E., Montaner, J., Kerr, T. (2016) Protocol of The Impact of Alternative Social Assistance Disbursement on Drug-Related Harm (TASA) Study: A randomized controlled trial to evaluate changes to payment timing and frequency among people who use illicit drugs. BMC Public Health 16(668), 1-16.
Otterstatter, M.C., Amlani, A., Guan, H., Richardson, L., Buxton, J.A. (2016) Illicit drug overdose deaths resulting from income assistance payments: Analysis of the ‘check effect’ using daily mortality data. International Journal of Drug Policy 33, 83–87.
Richardson, L., Kerr, T., Dobrer, S., Puskas, C., Guillemi, S., Montaner, J., Wood, E., Milloy, M-J. (2015) “Socio-economic marginalization and plasma HIV-1 RNA non-detectability among individuals who use illicit drugs in a Canadian setting.” AIDS 29(18), 2487-95.
*Uhlmann, S., Milloy, M-J., Ahamad, K., Nguyen, P., Kerr, T., Wood, E., Richardson, L. (2015) “Factors associated with willingness to participate in a pharmacologic addiction treatment clinical trial among illicit drug users.” American Journal on Addictions 24(4): 368-373.
Richardson, L., *Long, C., DeBeck, K., Milloy, M-J., Wood, E., Kerr, T. (2015) “Socioeconomic marginalisation in the structural production of vulnerability to violence among people who use illicit drugs.” Journal of Epidemiology and Community Health 69(7): 686-692.
Nachega, J., Uthman, O., Peltzer, K., Richardson, L., Mills, E., Amekudzi, K., Ouédraogo, A. (2015) “The association of antiretroviral therapy adherence and employment status: systematic review and meta-analysis.” Bulletin of the World Health Organization, 93(1): 29-41.
Richardson, L., DeBeck, K., Feng, C., Kerr, T. and Wood, E. (2014) Employment and risk of injection drug use initiation among street involved youth in Canadian setting. Preventive Medicine, 66: 56-59.
Zlotorzynska, M., Milloy, M.J., Richardson, L., Montaner, J, Wood, E., Kerr, T. (2014) Timing of social assistance payment and overdose patterns at a Canadian supervised injection facility. International Journal of Drug Policy, 25 (4): 736-739.
Richardson, L., Milloy, M-J., Kerr, T., Parashar, S., Montaner, J.S.G. & Wood, E. (2014) Employment predicts decreased mortality among HIV-seropositive illicit drug users in a setting of universal HIV care. Journal of Epidemiology and Community Health, 68: 93-96.
Richardson, L., Wood, E. and Kerr, T. (2013) The impact of social, structural and physical environmental factors on transitions into employment among people who inject drugs. Social Science & Medicine, 76: 126-133.
Richardson, L., Wood, E., Montaner, J. and Kerr, T. (2012) Addiction treatment-related employment barriers: The impact of methadone maintenance. Journal of Substance Abuse Treatment, 43(3): 276-284.
Richardson, L., Wood, E., Li, K., Kerr, T. (2010) Factors associated with employment among a cohort of injection drug users. Drug and Alcohol Review, 29(3): 293–300.
Richardson, L., Sherman, S., and Kerr, T. (2012) Employment among people who use drugs: A new arena for research and intervention?International Journal of Drug Policy, 23: 3-5.
Richardson, L., Wood, E., Zhang, R., Montaner, J., Tyndall, M., Kerr, T. (2008) Employment among users of a medically supervised safer injection facility. American Journal of Drug and Alcohol Abuse, 34(5):519-25.
Dr. Richardson is currently recruiting MA/PhD students in the area of substance use, socio-economic well-being and health. Potential dissertation projects could examine innovative labour market models and economic inclusion, social policy and health, or the financial management practices of people who use drugs and their well-being. Supervision will offer opportunities to gain valuable research experience with ongoing and emerging studies as well as work with existing data and/or gather new qualitative and quantitative data. Expressions of interest can be sent to Dr. Richardson directly at email@example.com.