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SUBSTANCE ABUSE & HOMELESS YOUTH
A study conducted by the Family and Youth Services Bureau of the United States Department of Health and Human Services (HHS) found that 56 percent of street youth and 75 percent of household youth with runaway experiences had never used a shelter. According to the report released by HHS:
The likely reason…is that young people's previous experiences in institutional settings, as well as strong bonds that they forge on the street in order to survive, can affect their willingness to enter shelters (HHS).
The major problem with homeless youth refusing to enter shelter, however, is that the longer a youth lives on the streets, the more attached he or she may become, further destabilizing his or her life (Kipke). Usually lacking life skills and a source of income, homeless youth, once they are on the streets, face serious challenges getting basic needs like shelter, clothing, and food. Many resort to theft, prostitution, or drug dealing in order to survive.
Most homeless youth originate from difficult family situations of veritable poverty, neglect, physical and/or sexual abuse, and substance abuse. Very few receive the same type of support and encouragement like that of their housed counterparts. While maintaining life on the streets, youth begin to bond with other homeless youth, and many begin to survive in the community of the streets as a “family,” and it is in this newfound supportive “family” that many youth prefer to live (Fest).
Being out on the streets for longer periods of time not only increases the probability that youth will be less able to transition to a stable living situation, but it increases the likelihood that they will begin using and abusing drugs and alcohol (HHS, Kipke). This is especially true among youth who have experienced multiple episodes of homelessness (Windle). In a national study conducted by the Research Triangle Institute, approximately 20 percent more street youth reported using illicit drugs than sheltered youth (Greene, et al.). And the same study indicates that substance use among street youth before leaving home was significantly higher for all drug types when compared to shelter youth before leaving home; and the percentage of youth using drugs after leaving home increased substantially in both populations (Green, et al.). The longer youth live away from home, the less likely they feel they could return home, and according to a sample survey of homeless youth in San Francisco, “Those who could not go home reported significantly more injection drug use” (Moon, et al.).
Reasons youth reported for taking drugs ranged from fitting in with peers to coping with problems to helping them stop feeling lonely or depressed (HHS), and youth with a history of sexual abuse were more likely to use alcohol and/or marijuana (Rew, et al.). It is widely believed that youth often use drugs to self-medicate or as an analgesic (HHS).
Issues that homeless youth have with alcohol and other drugs have a strong correlation with greater risk of contracting sexually transmitted infections [STIs] (Rew, et al), encountering sexual victimization (Greene, et al. & HHS), exhibiting suicidal ideation (Rew, et al.), attempting suicide (HHS), experiencing violent physical victimization (Greene, et al.), and engaging in incidences of delinquency (Greene, et al. & HHS). Many times, alcohol and drug abuse contribute to risk-taking behaviors: sharing needles for injecting drugs and receiving tattoos or piercings; participating in “survival sex” or theft in order to support a drug habit; or practicing unsafe sexual behaviors, which tend to co-occur with substance abuse (Lombardo & Toro).
As indicated by both the HHS & the Research Triangle Institute surveys, substance abuse treatment is widely underutilized by homeless youth, especially shelter youth. Twenty-one percent of street youth had received drug treatment while only 12 percent of shelter youth received treatment, and only 5 percent of youth from both sample populations were currently in treatment programs. When asked what kept them from opting for treatment, many youth suggested a lack of resources to pay and no knowledge of treatment facilities available. Not-for-profit and sliding scale substance abuse treatment programs, especially for youth, tend to be a needed service in many communities. The Department of Health and Human Services research team clarifies, “…it is critical that organizations serving these young people ensure that they have access to prevention and treatment either directly or by referral.”
Here in Texas, there is funding available for substance abuse treatment and prevention. In February, the Texas Commission on Alcohol and Drug Abuse (TCADA) released its request for proposals (RFP) announcement for applications for prevention, intervention, and treatment services for fiscal year 2005. This is a competitive grant review, and the deadline for applications is April 5, 2004. For the full RFP and for more information about this program, please visit the TCADA website at www.tcada.state.tx.us.
Sources:
Burt, Martha and Laudon Y. Aron. Helping America's Homeless. The Urban Institute, 2001.
Fest, Jerry. Street Culture: An Epistemology of Street-Dependent Youth, 1995.
Greene, Jody M., Ronaldo Iachan, Chris L. Ringwalt. "Substance Abuse Among Runaway and Homeless Youth." Research Triangle Institute, 1995.
Kipke, MD. "HIV and Substance Abuse Among Homeless Youth. Issues in Delivering Services to Homeless Persons." Presented at the annual National AIDS Demonstration Research Meeting, National Institute on Drug Abuse, Bethesda, MD, 1990.
Lombardo, Sylvie A. and Paul A. Toro. "Risky Sexual Behaviors and Substance Abuse Among Homeless and Other At-risk Adolescents" (unpublished report).
Moon, MW, D. Binson, K. Page-Shafer, and R. Diaz. "Correlates of HIV Risk in a Random Sample of Street Youths in San Francisco." Journal of the Association of Nurses in AIDS Care, 12:18-27, Nov-Dec 2001.
Rew, Lynn, Maggie Taylor-Seehafer, and ML Fitzgerald. "Sexual Abuse, Alcohol and Other Drug Use, and Suicidal Behaviors in Homeless Adolescents." Issues in Comprehensive Pediatric Nursing, 24:225-240, Oct-Dec 2001.
Rew, Lynn, Rachel T. Fouladi, and Ronald D. Yockey. "Sexual Health Practices of Homeless Youth." Journal of Nursing Scholarship, 34:139-145, 2002.
Windle, M. "Substance Use and Abuse Among Adolescent Runaways: A Four-Year Follow-Up Study." Journal of Youth and Adolescents. 18:331-344, 1989.
United States Department of Health and Human Services. "Youth with Runaway, Throwaway, and Homeless Experiences…Prevalence, Drug Use, and Other At-Risk Behaviors." http://www.ncfy.com/chapt2_youth_run.htm. October, 1995.
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