Predictors of substance use among homeless youth in San Diego

High rates of homelessness among a cohort of street-involved youth

“…Moreover, homeless youth more commonly experience a whole host of difficulties rather than a single problem (Martijn and Sharpe, 2006), and generally face multiple barriers to service utilization making the treatment of various health concerns increasingly challenging (Nwakeze et al, 2003;Aidala et al, 2005;Carlson et al, 2006). Recent reports of rising injection drug use and high-risk behaviors among North American street youth highlight the growing risk of HIV transmission among younger age groups (Feldman and Middleman, 2003;Health Canada, 2003;Wood et al, 2006;Bousman et al, 2005). Furthermore, the literature consistently demonstrates that in excess of 50% of homeless youth have some drug-and alcohol-related problems (Goering et al, 2002;Klein et al, 2000), which often arise following the onset of homelessness (Martijn and Sharpe, 2006).…”

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“…Street youth are a heterogenic group with wide gender and ethnic variability. Minority groups such as gay, lesbian, bi-sexual and transvestites are particularly poorly understood [3,4,24,32].…”

“…Most studies used validated and reliable screening and diagnostic tools such as the MINI, international neuropsychiatric interview [2,5] and Form 90, from Project Match [1,23]. Computer assisted interviews were used, such as Audio-CASI, and computer assisted structured interviews were used [20,28,32]. The use of computerised interviews may have reduced social desirability bias and literacy issues in the studies.…”

“…The disaffiliation of emerging adults from social institutions and mainstream society is also a concern [1,21,31] while there are few effective interventions or policies to address this growing issue [21,32]. The major themes and implications for research and policy are detailed in Table 4.…”

“…Many studies identified high prevalence of psychosocial dysfunction and psychopathology within the homeless youth population, yet the temporal sequences and the interactions amongst the most significant factors leading to substance use in homelessness was less clear [19,32]. In a study of 302 homeless youth across 95 youth or homeless services in Melbourne, Australia, [18], where young people were asked about their leaving home story, the most prevalent pathway to homelessness (38%) involved the young person's drug or alcohol use as a source of family conflict that eventually led to the young person leaving home.…”