Social Estrangement Factors Associated with Alcohol or Drug Dependency among Homeless, Street-Involved Youth

Purpose:

Previous research shows substance abuse is highly prevalent among homeless youth. These youth live in unstable residences and engage in behaviors that alienate them from societal norms. Risky behaviors, such as substance use, criminal involvement, association with substance-using street peers, academic failure and victimization may lead to social estrangement. Thus, the purpose of this exploratory study was to apply a conceptual model of estrangement to understand youths' alcohol/drug dependency. The framework of societal estrangement includes domains of disaffiliation (from institutions and family), human capital (getting money/other economic resources), identification with homeless culture (associating with homeless peers and living on the streets), and psychological dysfunction (problems with mental illness). Variables measuring these four domains were tested to evaluate how these estrangement factors predict homeless youth's dependency on alcohol/drugs.

Methods:

Interviews using self-report instruments were conducted with 185 youth aged 18-23 years receiving homeless services from a community drop-in center and whose case managers identified them as drug/alcohol users. Youth completed standardized questionnaires querying variables representing social estrangement, including disaffiliation from family and criminal involvement, methods for obtaining money, street peer influence and the youth's affect. Alcohol/substance dependency was measured by completion of the structured Mini International Neuropsychiatric Interview that reliably assesses dependency based on DSM-IV criteria.

Participants averaged 21 years of age, were predominantly white (68%) and male (65%). Most were living in unstable/public places (61%), had not completed high school (54%), and had been in jail (75%). Most of these youth reported drinking alcohol (81%) and/or smoking marijuana (72%); 61% were identified as alcohol dependent and 55% as dependent on other drugs.

Results:

Logistic regression analyses indicated that disaffiliation and human capital variables accounted for 15% of the variance in alcohol dependence, but the addition of variables measuring identification with homeless culture increased the model R2 to .39 (model=79.3(df=17), p<.001). Analyses suggest that youth who had parents who used alcohol or marijuana, spent a great deal of time each day on the street, used other drugs and/or sold blood/plasma as a source of income were more likely to be alcohol dependent.

Similar analyses of drug dependence showed that disaffiliation and human capital accounted for 16% of the variance in drug dependency, but the addition of identification with homeless culture resulted in a model R2 of .35 (model=79.6(df=16),p<.001). Findings suggest that being alcohol dependent, using marijuana, obtaining money from friends, carrying a weapon, and/or experiencing greater numbers of violent offenses increased the odds of being drug dependent.

Conclusions:

This study confirms the magnitude of alcohol/drug dependence among homeless youth and demonstrates the varying predictors for alcohol and drug dependency. While school-based substance use intervention programs are available for adolescents, effective programs for homeless youth are nearly non-existent. Agencies providing care to these youth must recognize the societal estrangement factors that lead to or increase alcohol/drug dependency issues for these youth. Further research of brief interventions delivered in drop-in centers is needed as these are more likely to be more readily received by these youth.