Predictors of addiction to alcohol and drugs among street youth in three U.S. cities

Purpose: Previous research documents disproportionate rates of substance abuse among homeless youth and demonstrates significant population differences based on the region in which services are received. This study identified predictors of street youths' addiction in three U.S. cities on: 1) institutional disaffiliation, 2) human capital, 3) psychological dysfunction and 4) homeless culture.

Methods: A cross-sectional study of 146 homeless youth (ages 18-24) from Los Angeles (n=50), Austin (n=50) and St. Louis (n=46) were recruited from shelters, drop-in centers and street locations using convenience sampling. Using a retrospective event-history instrument and standardized measures, youth were interviewed concerning institutional disaffiliation (school status, criminal histories, lack of family connection), human capital (locating resources/money, social support), psychological dysfunction (depression, PTSD), and homeless culture (transience, substances used). Logistic regression models predicted youths' addiction to alcohol and drugs.

Results: Findings demonstrated that variables measuring psychological dysfunction predicted alcohol addiction, while institutional disaffiliation and homeless culture predicted drug addiction. Specifically, the greater the number of substances used and having PTSD symptoms increased the likelihood of alcohol addiction (model chi-square=47.1 [df=17], p<.001). However, greater numbers of substances used, being arrested for vandalism and status offenses but not arrested for alcohol-related activities increased the likelihood of drug addiction (model chi-square=55.4 [df=17], p<.001).

Implications: Findings affirm distinct patterns of addiction for alcohol compared to drugs. Understanding these features and the heterogeneity of this population has strong potential for providing national mental health responses as well as information unique to substance use treatment for this underserved population.