Methods. Data were derived from a population-based study (National Survey on Drug Use and Health) of youth ages 12-17 (n = 216,852) in the United States between 2002 and 2013. To examine involvement in violence, respondents were asked: “During the past 12 months, how many times have you attacked someone with the intent to seriously hurt them?” Multinomial regression was used to examine differences between youth reporting episodic (1-2 times, n = 13,091; 5.84%) and repeated violent attacks (3+ times, n = 1,819; 0.83%) in contrast with youth reporting no attacks. Additional analyses examined the association of sociodemographic, intrapersonal, and contextual factors with substance use disorders among the subset of youth reporting violent attacks.
Results. Substance use morbidity among youth with no attacks was only 6% as compared to 22% among episodic and 36% among repeatedly violent youth. Compared to those reporting no attacks, episodic and repeatedly violent youth were significantly more likely to report “enjoying” risky behavior as well as relatively easy access to illicit drugs and receipt of a recent drug offer. Violent youth were also significantly more likely to report past 12-month alcohol, cannabis, and other illicit drug use and to have met criteria for DSM-IV substance use disorders. Contrasting adolescents reporting episodic (1-2 episodes) and repeated (3 or more episodes) involvement in violent attacks revealed far greater substance use risk among the minority of youth involved repeated violent attacks.
Conclusions and Implications. Findings from the present study point to the importance of distinguishing between the various gradations of violence among youth in understanding the relationship between substance use and violence, as well as shed light on the intrapersonal and contextual factors that can help identify violent youth at greatest risk for substance use problems. Overall, this pattern of results points to the importance of targeted substance use prevention among serious and chronically violent youth and perhaps the development of intervention programs designed specifically for this subset of at-risk youth.