Risk/Protective Factors Associated with Substance Use Among Runaway/Homeless Youth Utilizing Emergency Shelter Services Nationwide

Abstract

Rates of alcohol, tobacco, and marijuana use among runaway/homeless youth are substantially higher than found among American high school students. To understand the risk and protective factors associated with substance use, this study (1) assessed cigarette, alcohol, and marijuana use among a national sample of runaway/homeless youth, (2) identified risk/protective factors associated with lifetime substance use, and (3) examined risk/protective factors associated with six month frequency of substance use. Unduplicated cases (n = 11,841) from the 1997 Runaway/Homeless Youth Management Information System (RHY MIS) were analyzed. Results showed that substance use levels are greater than previously reported for this population. Predictors of cigarette, alcohol, and marijuana use and frequency were predominately individual youth risk factors and demographics rather than family risk factors. Providers in emergency youth shelters are in a prime position to assess substance use behaviors, as well as the associated risk factors. Provision of appropriate screening and referral to other services is essential to meet the needs of these youth.     

A Comparison of Drug Use and Risk Behavior Profiles Among Younger and Older Street Youth

Among 559 street youth recruited between 2005 and 2007 in Vancouver, Canada, young drug users (<21 years of age) were compared with older drug users (≥21 years) with regard to recent drug use and sexual practices using multiple logistic regression. Older youth were more likely to be male and of Aboriginal ancestry, to have more significant depressive symptoms, to have recently engaged in crack smoking, and to have had a recent history of injection drug use. Young drug users, by contrast, were more likely to have engaged in recent binge alcohol use. Efforts to reduce drug use-related harm among street youth may be improved by considering the highly prevalent use of “harder” drugs and risk for depression among older youth.     

Influence of Risk and Protective Factors on Substance Use Outcomes Across Developmental Periods: A Comparison of Youth and Young Adults

Data were collected from samples of youth (ages 11–18; N = 38,268) and young 10 adults (ages 18–24; N = 602) across 30 Tennessee counties using surveys and telephone interviews conducted in 2006–2008. Data were analyzed using hierarchical nonlinear modeling to determine: (1) which risk and protective factors predicted alcohol and marijuana use, and (2) whether predictors differed as a function of developmental period. Findings provide preliminary evidence that prevention efforts need to take into consideration the changing environment and related influences as youth age, especially as they move from a more protected community environment to one where they live somewhat independently. Implications and limitations are discussed.     

Alcohol Use Severity and Sexual Risk Behavior Among Female Substance Users

Background: Substance use has been identified as one of the leading factors related to HIV transmission in the United States. The association of problematic drinking with sexual risk behavior puts individuals at greater risk for HIV transmission. This may be of particular concern for women given that approximately 66% of new HIV infections occurring through heterosexual transmission are female. Objectives: To investigate alcohol use severity and sexual risk behavior among females who use heavy, illicit drugs. Methods: Female substances users (N = 251; M_age = 31.90, SD = 7.67; 63.7% Black) self-reported past month alcohol use and lifetime sexual risk behaviors with both casual and steady sex partners. Results: Problematic alcohol users were more likely to use noninjection drugs and less likely to use injection drugs than abstainers and more likely than moderate alcohol users to use alcohol before/during sex with a steady partner. White problematic alcohol users were less likely to use injection drugs before/during sex with a steady partner than abstainers. Black problematic alcohol users were more likely to use non-injection and alcohol than moderate alcohol users before/during sex with steady partners. Conclusions: The current study extends the existing literature by taking a closer look at the role of alcohol use severity in sexual risk taking behavior of Black and White female substance users, a particularly vulnerable group for HIV transmission.     

The Dynamic Nature of Risk Factors for Substance Use Among Adolescents

ABSTRACT

Substance use is one of the major social problems facing youth today. The research on risk factors associated with onset and continuation of use is extensive. Typically, reviews of the literature categorize risk factors by environmental domain (i.e., family, peer relations, neighborhoods). This review extends this framework by examining studies that focus on the changing nature of risk factors for substance use among teenagers. The underlying assumption is that, especially during adolescence, these relations are dynamic and shift across time. Five time-related mechanisms are identified and used to describe the research. The article concludes with a discussion about the implications for future research.     

Protective and Risk Factors Associated with Drug Use Among Hispanic Youth

Analysis of data from a nationally representative sample of Hispanic youths age 12-17 and their parents was done to investigate the impact of a number of variables on youths' drug-using behavior. The significance of youth, household, and parental characteristics were tested using measures of youth drug use as dependent variables in regression models. Parents' attitudes and use of licit and illicit drugs were found to play an important role in their children's drug use behavior. The results also provide some support for theh hypothesis that Hispanic children whose parents are more acculturated into American society are at higher risk of using drugs. Youths of Mexican origin, youths living outside large metropolitan areas, and females were found to be more likely to use drugs. The results provide supportive evidence that for drug prevention education programs to be effective with Hispanic youths, they must be family oriented.     

Sexual Minority Disparities in Substance Use Willingness Among Youth

Background: Disparities in substance use have been observed in sexual minority youth, but less is known about willingness to use substances, an important precursor to actual use. Objective: The goal of this study was to examine willingness to use cigarettes, alcohol, and marijuana among sexual minority youth compared to their non-sexual minority counterparts using both cross-sectional and longitudinal data. Methods: The present study drew on two waves (Times 1 and 2; 6 months apart) of data collected during high school as part of a prospective study of substance use initiation and progression in Rhode Island. At Time 1, participants (N = 443) ranged in age from 15 to 20 years (M age = 16.7 years, 26.6% sexual minority, 59.5% female, 72.0% White). Participants self-reported their sexual identity and attraction, lifetime use of alcohol, cigarettes and marijuana, and cigarette, alcohol, and marijuana use willingness (i.e., if offered by a best friend or group of friends). Results: In cross-sectional multivariate regression models, sexual minority youth were more likely to report willingness to use cigarettes (p <.05) and marijuana (p <.01) compared to their non-sexual minority counterparts. Longitudinal multivariate regression models revealed that sexual minorities were only significantly more likely to report cigarette willingness at Time 2 compared to their non-sexual minority counterparts (p <.01). There were no significant differences in alcohol use willingness in multivariable cross-sectional or longitudinal models by sexual minority status. Conclusions: Sexual minority youth reported more willingness than non-sexual minority youth to use substances offered by peers; however, longitudinal analyses revealed that peers appear to play a role only in willingness to smoke cigarettes for these youth, and thus peer influence may be a contributing factor in explaining tobacco-related disparities among sexual minority youth. Given that stigma and peer groups may a particular risk factor for tobacco among sexual minority youth, our findings highlight the importance of prevention programs such as social marketing approaches that correct social norms, reduce stigma, and provide refusal-skills training to reduce tobacco-related disparities among sexual minorities.     

Public Religiosity,Religious Importance,and Substance Use Among Latino Emerging Adults

Objective: This study examined the relationship between religiosity (religious importance and public religion) and substance use (binge drinking and marijuana use) among Latino emerging adults. Method: Study utilized data (N = 2,442; 51.9% male) from wave 3 of the National Longitudinal Study of Adolescent Health (Add Health). Results: Only public religion was found to be a protective factor for both binge drinking and marijuana use. Conclusion: The study results suggest the potential for public forms of religion, such as attendance to services and activities, to act as a protective factor for substance use.     

Youth and Familial Substance Use's Association with Suicide Attempts among Runaway and Homeless Youth

This study examined how youth suicide attempts are associated with youth and familial substance use among two samples of runaway and homeless youth (RHY): (a) a nationally representative sample of RHY residing in shelters, and (b) a multicity, purposive sample of RHY found on the street. Data were collected using personal interviews from 640 shelter youth and 600 street youth in 1992. Logistic regression analyses revealed that, after controlling for key demographic characteristics, youth who had used substances (particularly sedatives, hallucinogens, and inhalants) were much more likely than those who had not used substances to have ever attempted suicide. In addition, after controlling for their own substance use, youth with family members who had used substances were twice as likely as those without such family members to have ever attempted suicide. This study suggests the importance of developing and focusing suicide prevention efforts on RHY known to have used (or are using) substances and to have substance-using family members.     

Drug Use,Needle Sharing,and HIV Risk among Injection Drug-Using Street Youth

Injection drug use is the second most common HIV risk behavior in the United States, but little is known about injection drug use and needle-sharing behavior among street youth, a group at high risk for HIV infection. This study investigates the drug use histories, injection drug use behaviors, and needle-sharing practices of 106 injection drug using youth in Los Angeles, California. Respondents report high rates of injection drug use and needle sharing, indicating that these youth are at particularly high risk for HIV infection. Results suggest a need for outreach services tailored to the unique needs of injection drug-using adolescents.

El uso de la droga por injeccion es el segundo comportamiento de riesgo de VIH en los Estados Unidos, pero poco se conoce acerca de la utilizacion de la droga por injeccion y del compartir de aguijas hypodermicas por los jovenes drogadictos callejeros, que constituyen un grupo de alto riesgo de infection del VIH. Este estudio investiga la historia del uso de la droga, el comportamiento del compartir de agujas hypodermicas de 106 jovenes que utilizan droga en Los Angeles. Sujetos reportan un alto número de uso droga por injeccion y por compartir agujas hypodérmicas, indicando que estos jovenes estan en alto riesgo de infeccion del VIH. Los resultados de este estudio indican la necesidad de servicios sociales adaptados a las necesidades particulares de estos jovenes que utilizan drogas.

L'utilisation de la drogue par injection est le deuxième comportement de risque de VIH aux États-Unis, mais on n'a que très peu d'informations sur l'utilisation de la drogue par injection et le partage d'aiguilles hypodermiques parmi les jeunes drogués de la rue, lesquels constituent un groupe à haut risque d'infection VIH. Nous avons étudié les histoires et comportements, y compris les comportements de parage de seringues, de 106 jeunes utilisateurs de drogue à Los Angeles. Les sondés ont fait état d'un taux élevé d'utilisation de la drogue par injection et de partage de seringues, ce qui laisserait croire que ces jeunes courent un risque élevé d'infection VIH. Les résultats de cette étude indiquent la nécessité de services sociaux adaptés aux besoins particuliers des drogués adolescents.     

Family Factors of Low-Income African-American Youth Associated with Substance Use

Abstract

Objectives: An extensive body of literature has identified several risk and protective factors for adolescent substance use. Several facets of family relationships have been identified in the general adolescent and African-American adolescent substance use literature. There are gaps in the knowledge base for African-American rural youth living in poverty and would benefit from further exploration. It is possible that this unique population may exhibit trends not seen in the general population or urban African-American adolescents.

Method: A sample of 826 African-American adolescents, living in rural low-income areas and ranging in age from 14 to 19 years old were given a survey of 294 questions. Topics of the survey ranged from school attendance and attitudinal questions to queries concerning risk behaviors such as gang activity and substance use. Only variables concerning the family of the adolescent were used in this analysis. An exploratory analysis was performed to determine the relationship of family relationship variables to African-American rural adolescent substance use.

Results: The results suggest that several factors, namely existence of family rules and parental monitoring, are significant factors in buffering adolescent substance use for alcohol, marijuana and cocaine. These factors proved to be significant across gender.

Conclusions: The parent-adolescent relationship is an important factor influencing adolescent substance use. Also, the quality and type of parental/adolescent relationship is important. This relationship should also be targeted when considering any intervention for treating these adolescents. Further research should be conducted in this domain.     

Knowledge,Attitudes, and Substance Use Practices Among Street Children in Western Kenya

The study describes the knowledge of and attitudes toward substance use among street-involved youth in Kenya, and how they relate to their substance use practices. In 2011, 146 children and youth ages 10–19 years, classified as either children on the street or children of the street were recruited to participate in a cross-sectional survey in Eldoret, Kenya. Bivariate analysis using χ² or Fisher's Exact Test was used to test the associations between variables, and multiple logistic regression analysis was used to identify independent covariates associated with lifetime and current drug use. The study's limitations and source of funding are noted.     

The Link Between Substance Use and Reproductive Health Service Utilization Among Young US Women

ABSTRACT. Background: The authors sought to investigate associations between young women's use of alcohol and other substances and their sexual and reproductive health (SRH) service utilization. Methods: The authors used data from 4421 young women aged 15–24 years in the nationally representative study, National Survey of Family Growth, 2002–2008. The authors examined associations between frequency of tobacco, alcohol, marijuana, and illicit drug use and SRH service use in the past year using logistic regression. Results: Over half (59%) of the young women used SRH services, including contraception (48%), gynecological examination (47%), and sexually transmitted infection (STI) testing/treatment (17%) services. Proportions of SRH service use increased with higher frequencies of substance use (all P values <.001); service use was particularly common among daily substance users (range: 72% of daily marijuana users to 83% of daily binge drinkers). In multivariable analyses, associations between substance and SRH service use varied by substance and service type: weekly marijuana (odds ratio [OR] = 2.5, 95% confidence interval [95% CI] = 1.4, 4.3, P = .002) and alcohol (OR = 1.7, 95% CI = 1.1, 2.4, P = .01) use were positively associated with gynecological service use. All substances were positively associated with STI service use. However, daily smoking was negatively associated with contraceptive service use (OR = 0.6, 95% CI = 0.4, 0.8, P = .001). Conclusion: SRH service use was common among women reporting frequent substance use. SRH settings provide an opportunity to deliver substance use screening and preventive care to young women.     

Personal Values as a Mediator of Relations Between Perceived Parental Support and Control and Youth Substance Use

Background: Tobacco and marijuana smoking are very popular in adolescence and there is a high rate of comorbidity between them, even in young adulthood. Parental support and control may hinder involvement in the use of these substances by promoting conventional values among adolescents. Objectives: The present study investigates the relations between family functioning (parental support and control) and psychoactive substance use (tobacco and marijuana smoking) and determines whether these relationships are mediated by personal values (in terms of disapproval of deviance and beliefs about the importance of school, health and religion). Methods: 175 Italian late adolescents (17 to 20 years old) participated in this two-wave longitudinal study. Data were collected at school through an anonymous questionnaire. Results: Greater parental control and support were directly associated with lower adolescent tobacco and marijuana use; adolescent acceptance of conventional values mediated the association between parenting and adolescent marijuana use. Conclusion: Findings emphasize the influence of family relationships throughout adolescence. The transmission of conventional values to adolescents may be a critical mechanism through which parenting protects adolescents from substance use, especially marijuana use.     

Ethnic Differences in the Salience of Risk and Protective Factors for Alcohol and Marijuana

ABSTRACT

The purpose of the study was to distinguish risk and protective factors that predict adolescent alcohol and marijuana use across all ethnic backgrounds from those that predict use for particular ethnic groups. Analysis of data from the 2000 Florida Youth Substance Abuse Survey was conducted separately for the three major ethnic groups- Whites, Blacks, and Hispanics. The outcome measures were 30-day use of alcohol and marijuana and twenty-eight risk and protective factors were considered for inclusion into two logistic regression models as independent variables. Six variables were associated with all three ethnic groups' alcohol use, two with Whites and Blacks, one with Whites and Hispanics, four with Whites only, and one with Hispanics' use only. For marijuana, five variables were significant for all three ethnic groups, one for Whites and Blacks, one for Whites and Hispanics, and three for Whites only. These findings can be used to tailor adolescent drug preventive programs to specific groups, which should increase their impact.     

Understanding Daily Depression,Drinking, and Marijuana Use Among Homeless Youth Using Short Message Service Surveying

Abstract

We used short message service surveying (SMS) with 150 homeless youths to examine the time ordering of feeling depressed with drinking alcohol, using marijuana, and using substances with friends. Multilevel binary logistic regression results revealed that youths who were depressed earlier in the day were more likely to drink alcohol later that day. Among depressed youths, heterosexual youths were less likely to drink alcohol than lesbian, gay, and bisexual (LGB) youths. Depressed youths had increased odds of using marijuana by a factor of 1.6, while heterosexual youths, compared to LGB youths, were 80% less likely to use marijuana. Females were 82% less likely and heterosexual youths 75% less likely to use substances with friends compared to males and LGB youths, respectively. These findings improve upon prior retrospective studies by using SMS to understand time ordering between feeling depressed and substance use in the same day.     

Transition to Independent Living and Substance Involvement of Treated and High Risk Youth

ABSTRACT

National studies indicate that alcohol and drug involvement increases during transition from adolescence to young adulthood. The present study evaluated change in alcohol and drug use as youth move from living with their family of origin to independent living environments. Two samples of youth, those who had previously been treated for alcohol and drug problems (n = 102), and a sample of non-abusing youth (n = 70) with comparable socioeconomic backgrounds and family history of alcohol dependence, were compared as they transitioned into their first independent living environment. There was a 35% increase in the number of monthly drinking episodes across this transition to independent living, and a 46% increase in number of drinks per week. Drug involvement was less affected by this developmental transition, however a larger proportion of teens with a history of substance problems reported use of drugs (31% vs. 48%) following transition to independent living. Both level of exposure to substances in the new environment and peer substance use were significant predictors of post-transition substance involvement. Findings highlight significant changes in alcohol involvement in relation to this critical developmental transition of late adolescence and young adulthood.     

Revisiting the Concepts of Risk and Protective Factors for Understanding the Etiology and Development of Substance Use and Substance Use Disorders: Implications for Prevention

Over the past 20 years we have accumulated a greater knowledge and understanding of the genetic, neurobiological, and behavioral factors that may be associated with young people initiating the use of drugs and other substances and to progressing from use to abuse and dependence. This knowledge suggests that individuals may be “predisposed” to substance use disorders (SUD) and that the actual engagement in these behaviors depends on their environmental experiences from micro to macro levels. This paper summarizes this knowledge base and supports a developmental framework that examines the interaction of posited genetic, psychological, and neurobiological “predispositions” to SUD and those environmental influences that exacerbate this vulnerability.     

Nontobacco Substance Use,Sexual Abuse,HIV, and Sexually Transmitted Infection Among Street Children in Kolkata,India

A community-based cross-sectional study among 554 Kolkata city street children assessed nontobacco substance use and sexual abuses along with human immunodeficiency virus (HIV)/ sexually transmitted infections (STIs) during 2007, using conventional cluster sampling technique for “hard-to-reach population” with a field-tested questionnaire and the collection of a blood sample for HIV and syphilis serology testing as a composite indicator of STIs. The reported prevalence of nontobacco substance use was 30%; 9% reported having been sexually abused. Some factors (age, lack of contact with family, orphan children, night stay at public place, etc.) were documented to be associated with substance use and sexual abuses. Seroprevalence of HIV was found to be 1% and that of STIs was 4%. This 1% HIV seroprevalence in street children is a matter of concern. Community-based intervention is necessary for them. The study's limitations are noted.