Danya Fast

(she/her)
BA, MA, PhD

Investigator, BC Children's Hospital
Scientist, Foundry

I am a social scientist who studies how young people and their caregivers navigate substance use and care in the context of multiple public health crises, including the overdose and housing crises.

Academic Affiliations

  • Associate Professor, Division of Social Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia
  • Research Theme: Evidence to Innovation
  • Research Group(s): Implementing Knowledge for Equity and System Change

Policing and access to harm reduction services among young people who use drugs and young Indigenous people who use drugs before and after the pilot implementation of decriminalization of personal possession

International Journal of Drug Policy

McAdam, E. and Milloy, M.-J. and Sayre, E.C. and Verdicchio, C. and Sedgemore, K.-O. and May, H. and Pranteau, S. and Corriveau, D. and Friesen, D. and Fleury, M. and Fast, D. and DeBeck, K.

DOI: 10.1016/j.drugpo.2025.105068

The stakes of stimulant use, psychosis, and antipsychotic treatment among youth who use drugs: A longitudinal qualitative study

Social Science and Medicine

Goodyear, T. and Thulien, M. and Anghel, A. and Slemon, A. and Jensen, M. and Ignaszewski, M.J. and Sassi, R. and Mathias, S. and Jenkins, E. and Knight, R. and Fast, D.

DOI: 10.1016/j.socscimed.2025.118701

Building Social Support into Mental Health and Substance Use Treatment Trajectories: Insights from a Longitudinal Qualitative and Ethnographic Study with Young People Experiencing Unstable Housing and Homelessness

Child and Youth Services

Lee, H. and Thulien, M. and Eekhoudt, C.R. and Friesen, D. and Manson, D. and Bagley, S. and Hadland, S. and Fast, D.

DOI: 10.1080/0145935X.2025.2468177

A Scoping Review of Evidence-Based Interventions and Health-Related Services for Youth Who Use Nonmedical Opioids in Canada and the United States

Journal of Adolescent Health

Marchand, K. and Turuba, R. and Hui, D. and Gunn, H. and Wright, M.D. and Marshall, T. and Fast, D. and Knight, R. and Marsh, D.C. and Sassi, R. and Mathias, S. and Barbic, S.

DOI: 10.1016/j.jadohealth.2024.07.013

Re-making selves and social worlds: Experiences of live-in substance use treatment among adolescents experiencing social structural marginalization in Vancouver

Ssm Qualitative Research in Health

Sandhu, M. and Thulien, M. and Eekhoudt, C.R. and Friesen, D. and Moore, E. and Ignaszewski, M. and Bagley, S. and Motta-Ochoa, R. and Jenkins, E. and Fast, D.

DOI: 10.1016/j.ssmqr.2025.100631

Making Homes in Un-Homelike Places among Young People in Vancouver: Implications for Homelessness Prevention

Youth

Daniel Manson and Danya Fast

DOI: 10.3390/youth4020057

06 / 2024

Navigating and negotiating outness among 2S/LGBTQ+ youth experiencing homelessness

Children and Youth Services Review

Goodyear, T. and Knight, R. and Fast, D. and Oliffe, J.L. and Jensen, M. and Kia, H. and Jenkins, E.

DOI: 10.1016/j.childyouth.2024.107830

Homes of substance: Drugs and the making of home/lessness for 2S/LGBTQ+ youth

Social Science and Medicine

Goodyear, T. and Jenkins, E. and Fast, D. and Oliffe, J.L. and Kia, H. and Katriana, I. and Knight, R.

DOI: 10.1016/j.socscimed.2024.117352

Intersecting transitions among 2S/LGBTQ+ youth experiencing homelessness: A scoping review

Children and Youth Services Review

Goodyear, T. and Chayama, K.L. and Oliffe, J.L. and Kia, H. and Fast, D. and Mniszak, C. and Knight, R. and Jenkins, E.

DOI: 10.1016/j.childyouth.2023.107355

2S/LGBTQ+ youth substance use and pathways to homelessness: A photovoice study

International Journal of Drug Policy

Goodyear, T. and Jenkins, E. and Oliffe, J.L. and Fast, D. and Kia, H. and Knight, R.

DOI: 10.1016/j.drugpo.2024.104621

Road to Recovery: protocol for a mixed-methods prospective cohort study evaluating the impact of a new model of substance use care in a Canadian setting

BMJ Open

Dennis, B.B. and Bowles, J. and Johnson, C. and De Wolfe, T. and Mundel, E. and Fast, D. and Boyd, J. and Fleury, M. and Bach, P. and Fairbairn, N. and Socas, M.E. and Ti, L. and Hayashi, K. and DeBeck, K. and Milloy, M.J. and Felicella, G. and Morgan, J. and Eekhoudt, C.R. and McGrail, K. and Richardson, L. and Ryan, A. and Mbuagbaw, L. and Guyatt, G. and Nolan, S.

DOI: 10.1136/bmjopen-2024-090608

The war on drugs is a war on us: young people who use drugs and the fight for harm reduction in the Global South

Harm Reduction Journal

Stowe, M.-J. and Gatonye, R. and Maharjan, I. and Kehinde, S. and Arya, S. and Valderrbano, J.H. and Mcbride, A. and Scheibein, F. and Igonya, E.K. and Fast, D.

DOI: 10.1186/s12954-023-00914-7

Looking beyond drugs: A scoping review of recovery in the context of illicit substance use among adolescents and young adults

International Journal of Drug Policy

Eekhoudt, C.R. and Sandhu, M. and Mniszak, C. and Goodyear, T. and Turuba, R. and Marchand, K. and Barbic, S. and Fast, D.

DOI: 10.1016/j.drugpo.2024.104598

I turn to my closest friends for support: queer youth navigating mental health during COVID-19

Culture, Health and Sexuality

Stehr, R. and Fast, D. and Naepi, S. and Knight, R.

DOI: 10.1080/13691058.2023.2183263

Risk mitigation guidance and safer supply prescribing among young people who use drugs in the context of COVID-19 and overdose emergencies

International Journal of Drug Policy

Giang, K. and Charlesworth, R. and Thulien, M. and Mulholland, A. and Barker, B. and Brar, R. and Pauly, B. and Fast, D.

DOI: 10.1016/j.drugpo.2023.104023

Staying Together No Matter What: Becoming Young Parents on the Streets of Vancouver

Culture, Medicine and Psychiatry

Fast, D. and Charlesworth, R. and Thulien, M. and Kr{\"u}si, A. and Buxton, J. and West, S. and Chase, C. and Manson, D.

DOI: 10.1007/s11013-022-09813-1

Methadone Maintenance Treatment Discontinuation Among Young People who use Opioids in Vancouver, Canada,Cessation du traitement dentretien la mthadone chez les jeunes gens qui utilisent des opiodes Vancouver, Canada

Canadian Journal of Psychiatry

Pilarinos, A. and Kwa, Y. and Joe, R. and Dong, H. and Grant, C. and Fast, D. and Buxton, J.A. and DeBeck, K.

DOI: 10.1177/07067437221136468

Using photovoice to understand experiences of opioid use among sexual and gender minority youth in Vancouver, Canada

Culture, Health and Sexuality

Goodyear, T. and Ferlatte, O. and Fast, D. and Salway, T. and Jenkins, E. and Robinson, S. and Knight, R.

DOI: 10.1080/13691058.2022.2079153

They are always focusing on the person who is doing the worst: Exploring how crisis shapes young people's pathways in and out of supportive housing in Vancouver, Canada

Social Science and Medicine

Manson, D. and Fast, D.

DOI: 10.1016/j.socscimed.2023.116091

Interest in using buprenorphine-naloxone among a prospective cohort of street-involved young people in Vancouver, Canada

Journal of Substance Use and Addiction Treatment

Pilarinos, A. and Bingham, B. and Kwa, Y. and Joe, R. and Grant, C. and Fast, D. and Buxton, J.A. and DeBeck, K.

DOI: 10.1016/j.josat.2023.209005

Autonomy and (In)Capacity to Consent in Adolescent Substance Use Treatment and Care

Journal of Adolescent Health

Goodyear, T. and Jenkins, E. and Knight, R. and Sedgemore, K.-O. and White, M. and Culham, T. and Fast, D.

DOI: 10.1016/j.jadohealth.2022.10.031

Initiation of opioid agonist treatment and subsequent substance use and other patterns among adolescents and young adults in Vancouver, Canada

Drug and Alcohol Dependence

Pilarinos, A. and Fast, D. and Nosova, E. and Kwa, Y. and Joe, R. and Buxton, J.A. and DeBeck, K.

DOI: 10.1016/j.drugalcdep.2022.109441

Harm reduction calls to action from young people who use drugs on the streets of Vancouver and Lisbon

Harm Reduction Journal

Can{\^e}do, J. and Sedgemore, K.-O. and Ebbert, K. and Anderson, H. and Dykeman, R. and Kincaid, K. and Dias, C. and Silva, D. and Charlesworth, R. and Knight, R. and Fast, D.

DOI: 10.1186/s12954-022-00607-7

Navigating Opioid Agonist Therapy among Young People who use Illicit Opioids in Vancouver, Canada

International Journal of Drug Policy

Pilarinos, A. and Kwa, Y. and Joe, R. and Thulien, M. and Buxton, J.A. and DeBeck, K. and Fast, D.

DOI: 10.1016/j.drugpo.2022.103773

Characterizing the Landscape of Service Provider Needs and Gaps in Services during the Canadian Youth Polysubstance Use Health Crisis

Canadian Journal of Addiction

Nairn, S.A. and Hawke, L.D. and Isaacs, J.Y. and Knight, R. and Stewart, S.H. and Henderson, J. and Haines-Saah, R. and Fast, D. and Lam, A. and Conrod, P.

DOI: 10.1097/CXA.0000000000000150

Interventions to Reduce Opioid Use in Youth At-Risk and in Treatment for Substance Use Disorders: A Scoping Review,Interventions pour rduire lutilisation dopiodes chez les jeunes risque et en traitement pour des troubles dutilisation de substances: Une revue de la porte

Canadian Journal of Psychiatry

Nairn, S.A. and Audet, M. and Stewart, S.H. and Hawke, L.D. and Isaacs, J.Y. and Henderson, J. and Saah, R. and Knight, R. and Fast, D. and Khan, F. and Lam, A. and Conrod, P.

DOI: 10.1177/07067437221089810

I'm just trying to stay: Experiences of temporal uncertainty in modular and supportive housing among young people who use drugs in Vancouver

International Journal of Drug Policy

Manson, D. and Kerr, T. and Fast, D.

DOI: 10.1016/j.drugpo.2022.103893

COVID-19 vaccine intention among young adults: Comparative results from a cross-sectional study in Canada and France

Vaccine

Coulaud, P.-J. and Ablona, A. and Bolduc, N. and Fast, D. and Bertrand, K. and Ward, J.K. and Greyson, D. and Jauffret-Roustide, M. and Knight, R.

DOI: 10.1016/j.vaccine.2022.02.085

Navigating Treatment in the Shadow of the Overdose Crisis: Perspectives of Youth Experiencing Street-Involvement Across British Columbia

Canadian Journal of Addiction

Thulien, M. and Charlesworth, R. and Anderson, H. and Dykeman, R. and Kincaid, K. and Sedgemore, K. and Knight, R. and Fast, D.

DOI: 10.1097/CXA.0000000000000146

Lessons Learned from "a Day for Youth Voices on the Opioid Overdose Crisis" and Future Directions for Research on the Youth Polysubstance Use Emergency in Canada

Canadian Journal of Addiction

Nairn, S.A. and Isaacs, J.Y. and Stewart, S.H. and Hawke, L.D. and Thulien, M. and Fast, D. and Knight, R. and Conrod, P. and Henderson, J. and Khan, F. and Lam, A. and Haines-Saah, R.J.

DOI: 10.1097/CXA.0000000000000151

The generative potential of mess in community-based participatory research with young people who use(d) drugs in Vancouver

Harm Reduction Journal

Thulien, M. and Anderson, H. and Douglas, S. and Dykeman, R. and Horne, A. and Howard, B. and Sedgemore, K. and Charlesworth, R. and Fast, D.

DOI: 10.1186/s12954-022-00615-7

Going Nowhere: Ambivalence about Drug Treatment during an Overdose Public Health Emergency in Vancouver

Medical Anthropology Quarterly

Danya Fast

DOI: 10.1111/maq.12638

06 / 2021

The sexualised use of cannabis among young sexual minority men: Im actually enjoying this for the first time

Culture, Health and Sexuality

Parent, N. and Ferlatte, O. and Milloy, M.-J. and Fast, D. and Knight, R.

DOI: 10.1080/13691058.2020.1736634

Poppers, queer sex and a Canadian crackdown: Examining the experiences of alkyl nitrite use among young sexual minority men

International Journal of Drug Policy

Cameron Schwartz and Danya Fast and Rod Knight

DOI: 10.1016/j.drugpo.2020.102670

03 / 2020

Opioid agonist therapy trajectories among street entrenched youth in the context of a public health crisis

SSM - Population Health

Giang, V. and Thulien, M. and McNeil, R. and Sedgemore, K. and Anderson, H. and Fast, D.

DOI: 10.1016/j.ssmph.2020.100609

Something that actually works: Cannabis use among young people in the context of street entrenchment

PLoS ONE

Paul, B. and Thulien, M. and Knight, R. and Milloy, M.J. and Howard, B. and Nelson, S. and Fast, D.

DOI: 10.1371/journal.pone.0236243

The knife's edge: Masculinities and precarity in East Africa

Social Science and Medicine

Fast, D. and Bukusi, D. and Moyer, E.

DOI: 10.1016/j.socscimed.2020.113097

Erratum to Poppers, queer sex and a Canadian crackdown: Examining the experiences of alkyl nitrite use among young sexual minority men [International Journal of Drug Policy 77 (2020) 102670] (International Journal of Drug Policy (2020) 77, (S0955395920300116), (10.1016/j.drugpo.2020.102670))

International Journal of Drug Policy

Schwartz, C. and Fast, D. and Knight, R.

DOI: 10.1016/j.drugpo.2020.102882

"am i gonna get in trouble for acknowledging my will to be safe?": Identifying the experiences of young sexual minority men and substance use in the context of an opioid overdose crisis

Harm Reduction Journal

Goodyear, T. and Mniszak, C. and Jenkins, E. and Fast, D. and Knight, R.

DOI: 10.1186/s12954-020-00365-4

The authors respond to comments on the use of secure care in youth

CMAJ

DeBeck, K. and Kendall, P. and Fast, D. and Pilarinos, A.

DOI: 10.1503/cmaj.71589

Prevalence and correlates of selling illicit cannabis among people who use drugs in Vancouver, Canada: A ten-year prospective cohort study

International Journal of Drug Policy

Reddon, H. and Fast, D. and DeBeck, K. and Werb, D. and Hayashi, K. and Wood, E. and Milloy, M.-J.

DOI: 10.1016/j.drugpo.2019.02.006

Interventions to address substance use and sexual risk among gay, bisexual and other men who have sex with men who use methamphetamine: A systematic review

Drug and Alcohol Dependence

Knight, R. and Karamouzian, M. and Carson, A. and Edward, J. and Carrieri, P. and Shoveller, J. and Fairbairn, N. and Wood, E. and Fast, D.

DOI: 10.1016/j.drugalcdep.2018.09.023

Becoming and coming undone on the streets of Dar es Salaam

Africa Today

Fast, D. and Moyer, E.

DOI: 10.2979/africatoday.64.3.01

We Dont Belong There: New Geographies of Homelessness, Addiction, and Social Control in Vancouvers Inner City

City and Society

Fast, D. and Cunningham, D.

DOI: 10.1111/ciso.12177

Secure care: More harm than good

CMAJ

Pilarinos, A. and Kendall, P. and Fast, D. and Debeck, K.

DOI: 10.1503/cmaj.180700

Criminalization of HIV non-disclosure: Narratives from young men living in vancouver, Canada

PLoS ONE

Knight, R. and Kr{\"u}si, A. and Carson, A. and Fast, D. and Shannon, K. and Shoveller, J.

DOI: 10.1371/journal.pone.0201110

Still at risk: An examination of how street-involved young people understand, experience, and engage with harm reduction in Vancouver's inner city

International Journal of Drug Policy

Bozinoff, N. and Small, W. and Long, C. and DeBeck, K. and Fast, D.

DOI: 10.1016/j.drugpo.2017.05.006

The material, moral, and affective worlds of dealing and crime among young men entrenched in an inner city drug scene

International Journal of Drug Policy

Fast, D. and Shoveller, J. and Kerr, T.

DOI: 10.1016/j.drugpo.2017.01.003

Dream homes and dead ends in the city: a photo essay experiment

Sociology of Health and Illness

Fast, D.

DOI: 10.1111/1467-9566.12563

Getting out of downtown: a longitudinal study of how street-entrenched youth attempt to exit an inner city drug scene

BMC Public Health

Knight, R. and Fast, D. and DeBeck, K. and Shoveller, J. and Small, W.

DOI: 10.1186/s12889-017-4313-9

Social-structural factors influencing periods of injection cessation among marginalized youth who inject drugs in Vancouver, Canada: An ethno-epidemiological study

Harm Reduction Journal

Boyd, J. and Fast, D. and Hobbins, M. and McNeil, R. and Small, W.

DOI: 10.1186/s12954-017-0159-9

Perceptions of a drug prevention public service announcement campaign among street-involved youth in Vancouver, Canada: A qualitative study

Harm Reduction Journal

Ti, L. and Fast, D. and Small, W. and Kerr, T.

DOI: 10.1186/s12954-017-0132-7

Pathways to criminalization for street-involved youth who use illicit substances

Critical Public Health

Boyd, J. and Fast, D. and Small, W.

DOI: 10.1080/09581596.2015.1110564

The multiple truths about crystal meth among young people entrenched in an urban drug scene: A longitudinal ethnographic investigation

Social Science and Medicine

Fast, D. and Kerr, T. and Wood, E. and Small, W.

DOI: 10.1016/j.socscimed.2014.03.029

Did Somebody Say Community? Young People's Critiques of Conventional Community Narratives in the Context of a Local Drug Scene

Human Organization

Fast, D. and Shoveller, J. and Small, W. and Kerr, T.

DOI: 10.17730/humo.72.2.86005462778382u2

Drug-related risks among street youth in two neighborhoods in a Canadian setting

Health and Place

Werb, D. and Kerr, T. and Fast, D. and Qi, J. and Montaner, J.S.G. and Wood, E.

DOI: 10.1016/j.healthplace.2010.06.009

Safety and danger in downtown Vancouver: Understandings of place among young people entrenched in an urban drug scene

Health and Place

Fast, D. and Shoveller, J. and Shannon, K. and Kerr, T.

DOI: 10.1016/j.healthplace.2009.07.004

Social and structural barriers to housing among street-involved youth who use illicit drugs

Health and Social Care in the Community

Kr{\"u}si, A. and Fast, D. and Small, W. and Wood, E. and Kerr, T.

DOI: 10.1111/j.1365-2524.2009.00901.x

'I guess my own fancy screwed me over': Transitions in drug use and the context of choice among young people entrenched in an open drug scene

BMC Public Health

Fast, D. and Small, W. and Kr{\"u}si, A. and Wood, E. and Kerr, T.

DOI: 10.1186/1471-2458-10-126

Coming 'down here': Young people's reflections on becoming entrenched in a local drug scene

Social Science and Medicine

Fast, D. and Small, W. and Wood, E. and Kerr, T.

DOI: 10.1016/j.socscimed.2009.07.024

Social influences upon injection initiation among street-involved youth in Vancouver, Canada: A qualitative study

Substance Abuse: Treatment, Prevention, and Policy

Small, W. and Fast, D. and Krusi, A. and Wood, E. and Kerr, T.

DOI: 10.1186/1747-597X-4-8

The perspectives of injection drug users regarding safer injecting education delivered through a supervised injecting facility

Harm Reduction Journal

Fast, D. and Small, W. and Wood, E. and Kerr, T.

DOI: 10.1186/1477-7517-5-32

Care Pathways Study

Evidence-informed substance use services are a cornerstone of the response to substance use among youth. Research suggests that the sooner substance use care is initiated, the shorter the duration and impact of substance use disorders. However, numerous gaps and barriers exist in the provision of substance use services for youth, which for youth experiencing street-entrenchment are often compounded by complex institutional trajectories that include pediatric care, mental health care, foster care, criminal justice and frontline service (e.g., shelter) systems.

The Care Pathways Study focuses on the experiences of younger youth (ages 11-18) as they simultaneously navigate multiple systems of care and supervision, including the substance use service, criminal justice, government care, and mental health care systems. Through qualitative interviews and ethnographic fieldwork, we are documenting the evolving experiences of these young people and their caregivers and service providers over time. Our goal is to create new knowledge that can directly inform ongoing efforts to deliver innovative substance use services to youth, including at BC Children’s Hospital.

The objectives of the study are to:

1. Characterize the individual, social, structural and environmental contexts that shape youth’s engagement with various substance use services, including harm reduction services, detoxification and treatment, inpatient and outpatient programs, and opioid agonist therapy (OAT);
2. Describe how youth’s engagement with substance use services are shaped by responses from the other systems in which they are immersed, including the primary pediatric care, mental health care, foster care, criminal justice and frontline service systems; and
3. Identify critical gaps and opportunities for improvement in the delivery of substance use services for vulnerable youth, and their onward impact on key health outcomes.

This study is co-led by Family Services of Greater Vancouver-Directions Youth Services. Throughout all stages of the research, are working closely with the Youth Health Advisory Council.

Grants

Reimagining recovery with young people who use(d) drugs and their caregivers, Canadian Institutes of Health Research Project Scheme Grant, PI

Mobilizing Knowledge with Young People Who Use Drugs, Caregivers, and Providers: Informing Improved Youth Mental Health and Substance Use Services, Canadian Institutes of Health Research – Catalyst Grant, PI

Between homelessness and care (and back again): Navigating complex institutional trajectories among young people who use drugs in Metro Vancouver, Making the Shift, PI

Side-by-side: Improving the care system to improve health and well-being of youth who use crystal meth, Vancouver Foundation, Participatory Action Research Investigate Grant, PI

Side by side: Identifying strategies to address the health and social needs of youth who use stimulants, Canadian Institutes of Health Research Project Scheme Grant, PI

Substance use and addiction services engagement among vulnerable youth: An ethno-epidemiological study, Canadian Institutes of Health Research /SickKids – New Investigator Research Grant, PI

Substance use and addiction services engagement among vulnerable youth, Vancouver Foundation –Participatory Action Research Investigate Grant, PI

Honours & Awards

Michael Smith Health Research BC Scholar Award

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