Introduction: Research suggests by age sixteen half of all adolescents use alcohol regularly and the pervasiveness of substance abuse is higher among youth who engage in high-risk behaviors. Youth that runaway from their parental homes are particularly susceptible to alcohol abuse. Therefore, identification of risk factors associated with alcohol use is needed to improve services to this youth population. Understanding the differential impact of individual and family risk/protective factors on runaway/homeless youths' alcohol use could assist in developing more effective interventions to reduce these challenges. This study assessed alcohol use among a national sample of runaway/homeless youth, identified risk/protective factors associated with lifetime and six month frequency rates of alcohol consumption, and examined factors associated with heavy alcohol use among these youth.

Methods: The study utilized data from the Runaway/Homeless Youth Management Information System (RHYMIS), a national database that is required in all homeless youth shelters receiving federal funding. Data were collected from 332 federally-funded youth shelters nationwide and included a sample of 11,841 youth, age 12-17. Data were gathered by shelter personnel through the youths' stay at the emergency shelter, including: demographics (e.g. age, ethnicity, gender, residence before admission), individual youth characteristics (e.g. runaway behavior, employment and school status, juvenile justice issues, drug and alcohol use, gang involvement), and family/household problems (e.g. parent's unemployment, abuse or neglect of child/ren).

Results: The sample averaged 16 years of age, were predominantly white (60.3%), female (62.5%), and living at home prior to seeking shelter services (75.6%). Descriptive results indicated that 76.2% of these youth reported ever drinking alcohol. Of those ever drinking, 83.1% drank at least once, 20% drank more than 30 times, and 46.8% drank heavily (more than five drinks consecutively) during the six months before shelter admission. Logistic regression analyses indicated predictors of alcohol use/non-use were predominately individual youth risk factors and demographics rather than family factors (X²=425.1, p<.001). Multiple regression analyses to predict frequency of alcohol use indicated that greater number of ‘days on the run', living in numerous residences, school dropout, gang involvement, selling drugs, marijuana use, and physical abuse predicted greater alcohol use during the previous six months (F=122.7, p<.001, R²=.31). Predictors of heavy drinking indicated a similar set of predictors (F=55.9, p<011, R²=.24).

Discussion: Although rates of substance use among runaway youth have been shown to be nearly double that of housed youths attending school, this study is the first to confirm the magnitude of substance use problems among runaway/homeless youth on a national scale. Results indicated that substance use levels are greater than previously reported for this population and those who experience a number of other risk factors, including using other substances, victimization, and lengthy periods of unstable housing, are at increased risk for high levels of alcohol use. This study highlights the need to assess alcohol use issues among runaway/homeless youths, especially in emergency shelters where these youth seek basic services. Although treatment is not feasible in these agencies, policy decisions must focus on requiring assessment/referral for alcohol/substance use issues among these youth.