Poly-Substance Use Among Male and Female Street Youth in Toronto, Canada

Öz

Street-involved youth experience high rates of alcohol and other drug use, which put them at risk for other health-related problems including substance dependence, infectious diseases, drug overdose and victimization. There is limited research on gender differences in poly-substance use among street-involved youth. In this study of 150 street youth in Toronto, Canada, we explore the effects of gender, health and social factors on alcohol and other drug use. Multivariate regression analyses were used to create models predicting the number of substances (alcohol and illicit drugs) used in the last 30 days before interview. The mean number of substances used by the female and male street youth was 2.1 and 2.5, respectively, with up to seven used in total. Multivariate analyses showed that different factors were associated with poly-substance use for female street youth compared to male street youth. These results highlight gender-specific factors to be considered in developing preventive approaches and supportive services for homeless youth with substance use problems.

Anahtar Kelimeler

• Alcohol and drug use, homelessness, gender, health, youth

Kaynakça

1. Adlaf, E.M., Begin, P., & Sawka, E. (Eds.) (2005). Canadian Addiction Survey (CAS): A National Survey of Canadian’s Use of Alcohol and Other Drugs. Ottawa: Canadian Centre on Substance Abuse.
2. Adlaf, E.M. & Zdanowicz, Y.M. (1999). A cluster-analytic study of substance problems and mental health among street youths. The American Journal of Drug and Alcohol Abuse, 25(4), 639-660.
3. Adlaf, E.M., Zdanowicz, Y.M., & Smart, R.G. (1996). Alcohol and other drug use among street-involved youth. Addiction Research & Theory, 4(1), 11-24.
4. Anderson, T. (Ed.). (2008). Neither Villain nor Victim: Empowerment and Agency among Women Substance Abusers. New Brunswick, NJ, Rutgers University Press.
5. Ballon, B., Kirst, M.J. & Smith, P. (2004). Youth help seeking expectancies and their relation to help seeking behaviors for substance use problems. Addiction Research & Theory, 12(3), 241-260.
6. Baron, S.W. (1999). Street youths and substance use: The role of background, street lifestyle, and economic factors. Youth & Society, 31(1), 3-26.
7. Baron, S. W. (2004). General strain, street youth and crime: A test of Agnew’s revised theory. Criminology, 42(2), 457-483.
8. Berkman, L. & Syme, L. (1979). Social networks, host resistance and mortality: a nine- year follow-up study of Alameda County residents. American Journal of Epidemiology ;109:186-204.

9. Bousman, C.A., Blumberg, E.J., Shillington, A.M., Hovell, M.F., Ji, M., Lehman, S. & Clapp, J. (2005). Predictors of substance use among homeless youth in San Diego. Addictive Behaviors, 30(6), 1100-1110.
10. Bruneau, J., Lamothe, F., Soto, J., Lachance, N., Vincelette, J., Vassal, A. & Franco, E. (2001). Sex-specific determinants of HIV infection among injection drug users in Montreal. Canadian Medical Association Journal, 164(6), 767-773.
11. Chen, X., Tyler, K.A., Whitbeck, L.B., & Hoyt, D.R. (2004). Early sexual abuse, street adversity, and drug use among female homeless and runaway adolescents in the midwest. Journal of Drug Issues, 34 (1), 1-21.
12. Children’s Aid Society of Toronto (2009). Retrieved February 26th 2009, from http://www.torontocas.ca/
13. Choi, S.Y.P., Cheung, Y.W., & Chen, K. (2006). Gender and HIV risk behavior among intravenous drug users in Sichuan Province, China. Social Science & Medicine, 62, 1684.
14. Daly, G. (1996). Homeless: Policies, Strategies and Lives on the Street. New York: Routledge.
15. Dematteo, D., Major, C., Block, B., Coates, R., Fearon, M., Goldberg, E., King, S, Millson, M., O’Shaugnessy, M., & Read, S. (1999). Toronto street youth and HIV/AIDS: Prevalence, demographics, and risks. Journal of Adolescent Health,25, 358
16. Ennett, S.T., Bailey, S.L., & Federman, E. (1999). Social network characteristics associated with risky behaviors among runaway and homeless youth. Journal of Health and Social Behavior, 40(1), 63-78.
17. Erickson, K. G., Crosnoe, R. & Dornbusch, R. (2000). A social process model of adolescent deviance: Combining social control and differential association perspectives. Journal of Youth and Adolescence, 29(4), 395-425.
18. Erickson, P.G., Butters, J., McGillicuddy, P., & Hallgren, A. (2000). Crack and prostitution: gender, myths and experiences. Journal of Drug Issues, 30(4), 767-788.
19. Erickson, P.G., & Butters, J.E. (2005). How does the Canadian juvenile justice system respond to detained youth with substance use associated-problems? Gaps, challenges and emerging issues. Substance Use & Misuse, 40(7), 953-973.
20. Flannery, D.J., Vazsonyi, A.T., Torquati, J., & Fridrich, A. (1994). Ethnic and gender differences in risk for early onset substance use. Journal of Youth and Adolescence, (2), 195-213.
21. Gaetz, S. (2004). Safe streets for whom? Homeless youth, social exclusion, and criminal victimization. Canadian Journal of Criminology and Criminal Justice, 46(July), 455.
22. Haley, N. & Roy, E. (1999). Canadian street youth: Who are they? What are their needs? Paediatric and Child Health, 4(6), 381-383.
23. Harrison, L. Erickson, P.G., Korf, D., Brochu, S. & Benschop, A. (2007). How much for a dime bag?An exploration of youth drug markets. Drug and Alcohol Dependence, 90S, S27-S39.
24. Health Canada (2002). Health Canada’s Gender-based Analysis Policy. http://www.hc-sc.gc.ca/english/women/gba_policy.htm
25. Johnson, K.D., Whitbeck, L.B. & Hoyt, D.R. (2005). Substance abuse disorders among homeless and runaway adolescents. Journal of Drug Issues, 35(4), 799-816.
26. Johnston, L.D., O’Malley, P.M., & Bachman, J.G. (2002). Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 2001. Bethesda, MD: National Institute on Drug Abuse.
27. Karabanow, J. (2003). Creating a culture of hope: Lessons from street kid agencies in Canada and Guatemala. International Journal of Social Work, 46(3), 369-386.
28. Kawachi, I. & Kennedy, B.P. (1997). Socioeconomic determinants of health: Health and social cohesion: why care about income inequality? British Medical Journal, 314,
29. Kipke, M.D., Montgomery, S.B., Simon, T.R., & Iverson, E.F. (1997). Substance abuse disorders among runaway and homeless youth. Substance Use & Misuse, 32 (7-8), 969
30. Kirst, M.J. (in press). Social capital and beyond: A qualitative analysis of social contextual and structural influences on drug use-related health behaviours. Journal of Drug Issues.
31. Krug, E., Mercy, J., Dahlberg, L. & Zwi, A. (2002). The world report on violence and health. The lancet, 360, 1083-1088.
32. McCaskill, P.A., Toro, P.A., & Wolfe, S.M. (1998). Homeless and matched housed adolescents: A comparative study of psychopathology. Journal of Clinical Child & Adolescent Psychology, 27(3), 306-319.
33. Nofzinger, S. & Lee, H.R. (2006). Differential associations and daily smoking of adolescents: The importance of same-sex models. Youth & Society, 37(4), 453-478.
34. O’Grady, B. & Gaetz, S. (2004). Homelessness, gender and subsistence: The case of Toronto street youth. Journal of Youth Studies, 7(4), 397-416.
35. Paterson, B. & Panessa, C. (2008). Engagement as an ethical imperative in harm reduction involving at-risk youth. International Journal of Drug Policy, 19(1), 24-32.
36. Riehman, K.S., Kral, A.H., Anderson, R., Flynn, N. & Bluthenthal, R.N. (2004). Sexual relationships, secondary syringe exchange, and gender differences in HIV risk among drug injectors. Journal of Urban Health, 81(2), 249-259.
37. Roy, E., Haley, N., Leclerc, P., Sochanski, B. Boudreau, J-F., & Boivin, J-F. (2004). Mortality in a cohort of street youth in Montreal. Journal of the American Medical Association, 292(5), 569-574.
38. Slesnick, N. & Kang, M.J. (2008). The impact of an integrated treatment on HIV risk behavior among homeless youth: A randomized control trial. Journal of Behavioral Medicine, 31(1), 45-59.
39. Smart, RG., Adlaf, E., Walsh, G., & Zdanowicz, Y. (1992). Drifting and Doing: Changes in Drug Use among Toronto Street Youth, 1990-1992. Research Report. Toronto: Addiction Research Foundation.
40. Spittal, P.M. & Schechter, M.T. (2001). Injection drug use and despair through the lens of gender. Canadian Medical Association Journal, 164(6), 802-3.
41. Strike, C., Myers, T., Calzavara, L., & Haubrich, D. (2001). Sexual coercion among young street-involved adults: Perpetrators’ and victims’ perspectives. Violence and Victims, 16(5), 537-551.
42. Sutherland, E. & Cressey, D. (1978). Criminology. Philadelphia: Lippincott.
43. Van Leeuwen, J.M., Hopfer, C., Hooks, S., White, R., Petersen, J. & Pirkopf, J. (2004). A snapshot of substance abuse among homeless and runaway youth in Denver, Colorado. Journal of Community Health, 29(3), 217-229.
44. Wade, T. & Brannigan, A. (1998). The genesis of adolescent risk-taking: Pathways through family, school and peers. Canadian Journal of Sociology, 23(1), 1-19.
45. Whitbeck, L.B., Hoyt, D.R., Yoder, K.A., Cauce, A.M, & Paradise, M. (2001). Deviant behavior and victimization among homeless and runaway adolescents. Journal of Interpersonal Violence, 16, 1175-1204.
46. Youthlink (2003). Inner City Hepatitis C Support Program: 12 month interim report. Toronto: Children’s Aid Society of Toronto.