An Examination of High Risk Substance Use Behaviors Among Child Welfare Involved Runaway Youth

BACKGROUND AND PURPOSE:  Child welfare involved-youth who run away from home are more likely to use consume alcohol or use illegal substances (Tucker et al., 2011). However, studies have not controlled for key variables and little is known about the extent to which child welfare-involved runaway youth engage in high risk substance use behaviors.

Based on the population of all child welfare involved-youth, approximately 17.4% reported using illicit drugs (Traube et al., 2012) compared to 10.1% of youth in the general population (SAMHSA, 2012). Prior studies have found that associating with deviant peers (Ferguson & Meehan, 2011; Oxford et al., 2001), being older (Wallace et al. 2003), male (Aarons et al., 2008), and White have been linked to increased risk of adolescent substance use (Kilpatrick et al., 2000). Protective factors against substance use include future expectations (Sutherland & Shepherd, 2001) and school engagement (Yibling et al., 2011). The purpose of the study is to investigate whether child welfare-involved runaway youth experience high risk substance use behaviors after controlling for key risk and protective factors. 

METHODS:The sample included a subsample of 1,054 participants (11-17 years old) from Wave I (October 2008-September 2009) of the second National Survey of Child and Adolescent Well-Being (NSCAW II). The CRAFFT (Car, Relax, Alone, Forget, Friends, Trouble, 1999) is used as a brief screening instrument for adolescents to measure alcohol or substance use disorders. Scores of two or more indicate a need for further assessment. Thus, the CRAFFT score was dichotomized so that scores of 2 or more equal 1. Covariates included gender (Male =1), race (White =1), age, out-of-home care (yes =1), deviant peer affiliation (sum of 6 items assessing how many friends are deviant ranges from 6=none to 30=all), future expectations (averages 6 items ranging from 1=none to 5=it will happen to assess youths positive expectations for the future, such as, chances they will live to 35, graduate high school, or have a good job; AddHealth, n.d.), and school engagement (i.e., students’ emotional, behavioral, and academic engagement in school; Furlong & Christenson, 2008). In addition, the Severe Violence Subscale of the Violence Exposure Scale (VEX-R; Fox & Leavitt, 1995) is a dichotomous scale (yes=1) that captures whether youth have been exposed to community violence. Stata 13.1 was used for analyses. Logistic regression, which is used for modeling dichotomous outcome variables, was employed to investigate correlates of risky substance use.

RESULTS:  Findings indicate that child welfare involved runaways had more than triple the odds of high risk substance use behaviors (OR = 3.30, p< .01), even after controlling for other risk factors. The study also found that each unit increase in age (OR = 1.57, p< .001) and affiliation with deviant peers (OR=1.15, p< .001) increases the odds of risky substance use behaviors.

IMPLICATIONS FOR PRACTICE: Study results underscore the increased risk of substance use among runaway child welfare involved youth, the importance of peer relationships during adolescence, and the need for effective intervention strategies to prevent substance use risk behaviors among child welfare involved-youth.