Gender differences in the association between housing status and violence among people who report exposure to benzodiazepines.

BACKGROUND

Benzodiazepine exposure through the contaminated unregulated drug supply is associated with heightened risk of violent victimization, particularly for women. It is critical to identify the structural factors that intersect with drug toxicity and condition vulnerability to violence. As such, we conducted a gender-based analysis of the impacts of stable housing on violence among a sample of people exposed to benzodiazepines.

METHODS

Using data from 724 participants who reported suspected exposure to benzodiazepines (SEB) from three prospective cohorts of people who use drugs in Vancouver, B.C. in 2021-2023, we employed logistic regression analysis with generalized estimating equations to examine the association between stable housing and experiences of violence.

RESULTS

At baseline, 96 (31.7%) of 303 women and 115 (27.3%) of 421 men had stable housing; and 73 (24.1%) women and 112 (26.6%) men reported experiencing violence. Stable housing was significantly associated with lower odds of experiencing violence (Adjusted Odds Ratio [AOR]=0.70; 95% confidence interval [CI]: 0.51-0.95). However, in gender-stratified analyses, stable housing remained negatively associated with experiencing violence among men (AOR=0.60; 95% CI: 0.40-0.92) but not among women (AOR=0.81; 95% CI: 0.51-1.31).

DISCUSSION: Stable housing was associated with significantly lower odds of experiencing violence among men with SEB but not for women with SEB. Our results may highlight how violence is deeply entrenched in the daily lives of women who use drugs, with limited opportunities for physical refuge, and a broader need to urgently scale up affordable housing for people who use drugs and are at risk of experiencing violence.