Characteristic substance misuse profiles among youth entering an urban emergency department: neighborhood correlates and behavioral comorbidities

Content Provider	Scilit
Author	Goldstick, Jason E. Stoddard, Sarah A. Carter, Patrick M. Zimmerman, Marc A. Walton, Maureen A. Cunningham, Rebecca M.
Copyright Year	2016
Abstract	Background: Little is known about characteristic profiles of substance use – and their individual- and neighborhood-level correlates – among high-risk youth. Objectives: To identify characteristic substance misuse profiles among youth entering an urban emergency department (ED) and explore how those profiles relate to individual- and community-level factors. Methods: Individual-level measures came from screening surveys administered to youth aged 14–24 at an ED in Flint, Michigan (n = 878); alcohol outlet and crime data came from public sources. Binary misuse indicators were generated by using previously established cut-points on scores of alcohol and drug use severity. Latent class analysis (LCA) identified classes of substance use; univariate tests and multinomial models identified correlates of class membership. Results: Excluding non-misusers (51.5%), LCA identified three classes: marijuana-only (27.9%), alcohol/marijuana (16.1%), and multiple substances (polysubstance) (4.6%). Moving from non-misusers to polysubstance misusers, there was an increasing trend in rates of: unprotected sex, motor vehicle crash, serious violence, weapon aggression, and victimization (all p < .001). Controlling for individual-level variables, polysubstance misusers lived near more on-premises alcohol outlets than non-misusers (RRR = 1.42, p = .01) and marijuana-only misusers (RRR = 1.31, p = .03). Alcohol/marijuana misusers were more likely to live near high violent crime density areas than non-misusers (RRR = 1.83, p = .01), and were also more likely than marijuana-only misusers to live in areas of high drug crime density (RRR = 1.98, p = .03). No other relationships were significant. Conclusion: Substance-misusing youth seeking ED care have higher risk for other problem behaviors and neighborhood-level features display potential for distinguishing between use classes. Additional research to elucidate at-risk sub-populations/locales has potential to improve interventions for substance misuse by incorporating geographic information.
Related Links	http://europepmc.org/articles/pmc5123591?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123591/pdf
Ending Page	681
Page Count	11
Starting Page	671
ISSN	00952990
e-ISSN	10979891
DOI	10.1080/00952990.2016.1174707
Journal	The American journal of drug and alcohol abuse
Issue Number	6
Volume Number	42
Language	English
Publisher	Informa UK Limited
Publisher Date	2016-06-17
Access Restriction	Open
Subject Keyword	Journal: The American Journal of Drug and Alcohol Abuse Substance Abuse Polysubstance Use Neighborhood Violence Problem Behaviors
Content Type	Text
Resource Type	Article
Subject	Clinical Psychology Psychiatry and Mental Health