Social Norms Regarding Prescription Drug Misuse Among Homeless Youth

Background and Purpose: Non-medical use of prescription drugs (NMUPD) among youth and young adults is a serious and growing public health concern. Homeless youth, in particular, are more likely to engage in NMUPD when compared to their housed counterparts. Extant research suggests that social network norms are highly associated with a range of substance use behaviors. However, there is a dearth of evidence pertaining to the relationship between network norms and NMUPD. The current study thus seeks to understand whether social norms regarding NMUPD are associated with engagement in NMUPD among a sample of homeless youth.

Methods: As part of a longitudinal social network panel study, homeless youth ages 13-24 (N = 1,046) were recruited from three drop-in centers in Los Angeles, CA, and were interviewed regarding their individual and social network characteristics. Multivariate logistic regression was employed to assess significant associations between social norms, including both descriptive norms (which indicate the perceived prevalence of a behavior in a group) as well as injunctive norms (which refer to perceived approval or disapproval of a behavior as endorsed by network members), and self-reported NMUPD.

Results: Both descriptive and injunctive norms were significantly associated with self-reported NMUPD among homeless youth. Youth, who perceived that at least one of their network members engaged in NMUPD, were 2.68 times more likely to report engaging in NMUPD themselves (p < .0001). Conversely, youth who perceived that at least one person in their network would object to them engaging in NMUPD were 41% less likely to engage in NMUPD themselves (p < .01).

Conclusions and Implications: Our findings suggest that, similar to other substance use behaviors, NMUPD may also be highly influenced by homeless youths’ perceptions of the behaviors of their social network members. Therefore, prevention and intervention-based programs developed with the intent of reducing NMUPD may benefit from taking a social network norms approach to modifying behaviors, particularly in the context of homeless and unstably housed youth populations.