55. Relationship Between Living Situation and Substance Use in an Urban Adolescent Population

Abstract

PurposeSubstance abuse in adolescence is related to many psychosocial and environmental factors, family structure being one that has received considerable attention. However, little data exists about how living arrangements may be related to substance use. This study sought to examine the relationship between living situation and substance use in an urban adolescent population.MethodsData for this study was obtained from evaluation survey of the largest freestanding comprehensive-care adolescent health center in the world, conducted by an independent agency (ICF International). The Mount Sinai Adolescent Health Center (MSAHC) sees nearly 12,000 patients a year, of whom > 95% were minority and approximately 65% low socioeconomic status. The sample in this study had a total of 1368 male and female adolescents. Of the total sample, 702 were current MSAHC patients and 700 were non-MSAHC patients recruited from the local community and matched for age and gender. Data was collapsed across these groups and enrollment group was included as a control variable in all analyses. The mean sample age was 19.5 ± 2.2 [SD] years. 47.3% of the sample was Hispanic, 54.4% was African American. Survey data was gathered via a self-reported, 20-minute phone survey for all participants. We performed a cross-sectional analysis of baseline data. Multinomial logistic regressions were performed, controlling for age, recruitment group, gender, and zip code.Results1099 (80.3%) patients reported living in their parents' home, 190 (13.9%) reported living in another person's home, and 79 (5.8%) reported living in their own place. Eighty-four (6.1%) of patients reported that they had ever used illegal drugs or pills without a prescription. Of the prior 30 days, patients reported smoking cigarettes on 2.5 ± 7.5 days, drinking 5 or more drinks of alcohol 1.0 ± 3.0 days, and using marijuana 3.3 ± 8.1 times. Regression analyses indicated that adolescents who have their own place vs. living with their parents were at 0.75 increased log odds of having (ever) abused prescription drugs Exp(B) = 2.12, p = 0.048. However, living in their own place or in another person's home relative to with parents was not associated with increased odds of smoking cigarettes, excessive alcohol use, or marijuana use (all p's > 0.13). A post hoc power analyses revealed power > 0.9 to detect even a small effect.ConclusionsLiving situation in an urban adolescent population significantly affects illegal prescription drug abuse. This information may be useful to aid providers in targeting counseling to more vulnerable patients.Sources of SupportBoot, et al. “Consumption of tobacco, alcohol and recreational drugs in university students in Belgium and the Netherlands: The role of living situation.” Int J Adolesc Med Health 2010; 22(4): 527-534. Harrell et al. “Racial/ethnic differences in correlates of prescription drug misuse among young adults” Drug and Alcohol Dependence 104 (2009) 268–271 Schepis, et al. “Characterizing Adolescent Prescription Misusers: A Population-Based Study.” J. Am. Aacad. CHILD ADOLESC. PSYCHIATRY, 47:7, JULY 2008. PurposeSubstance abuse in adolescence is related to many psychosocial and environmental factors, family structure being one that has received considerable attention. However, little data exists about how living arrangements may be related to substance use. This study sought to examine the relationship between living situation and substance use in an urban adolescent population. Substance abuse in adolescence is related to many psychosocial and environmental factors, family structure being one that has received considerable attention. However, little data exists about how living arrangements may be related to substance use. This study sought to examine the relationship between living situation and substance use in an urban adolescent population. MethodsData for this study was obtained from evaluation survey of the largest freestanding comprehensive-care adolescent health center in the world, conducted by an independent agency (ICF International). The Mount Sinai Adolescent Health Center (MSAHC) sees nearly 12,000 patients a year, of whom > 95% were minority and approximately 65% low socioeconomic status. The sample in this study had a total of 1368 male and female adolescents. Of the total sample, 702 were current MSAHC patients and 700 were non-MSAHC patients recruited from the local community and matched for age and gender. Data was collapsed across these groups and enrollment group was included as a control variable in all analyses. The mean sample age was 19.5 ± 2.2 [SD] years. 47.3% of the sample was Hispanic, 54.4% was African American. Survey data was gathered via a self-reported, 20-minute phone survey for all participants. We performed a cross-sectional analysis of baseline data. Multinomial logistic regressions were performed, controlling for age, recruitment group, gender, and zip code. Data for this study was obtained from evaluation survey of the largest freestanding comprehensive-care adolescent health center in the world, conducted by an independent agency (ICF International). The Mount Sinai Adolescent Health Center (MSAHC) sees nearly 12,000 patients a year, of whom > 95% were minority and approximately 65% low socioeconomic status. The sample in this study had a total of 1368 male and female adolescents. Of the total sample, 702 were current MSAHC patients and 700 were non-MSAHC patients recruited from the local community and matched for age and gender. Data was collapsed across these groups and enrollment group was included as a control variable in all analyses. The mean sample age was 19.5 ± 2.2 [SD] years. 47.3% of the sample was Hispanic, 54.4% was African American. Survey data was gathered via a self-reported, 20-minute phone survey for all participants. We performed a cross-sectional analysis of baseline data. Multinomial logistic regressions were performed, controlling for age, recruitment group, gender, and zip code. Results1099 (80.3%) patients reported living in their parents' home, 190 (13.9%) reported living in another person's home, and 79 (5.8%) reported living in their own place. Eighty-four (6.1%) of patients reported that they had ever used illegal drugs or pills without a prescription. Of the prior 30 days, patients reported smoking cigarettes on 2.5 ± 7.5 days, drinking 5 or more drinks of alcohol 1.0 ± 3.0 days, and using marijuana 3.3 ± 8.1 times. Regression analyses indicated that adolescents who have their own place vs. living with their parents were at 0.75 increased log odds of having (ever) abused prescription drugs Exp(B) = 2.12, p = 0.048. However, living in their own place or in another person's home relative to with parents was not associated with increased odds of smoking cigarettes, excessive alcohol use, or marijuana use (all p's > 0.13). A post hoc power analyses revealed power > 0.9 to detect even a small effect. 1099 (80.3%) patients reported living in their parents' home, 190 (13.9%) reported living in another person's home, and 79 (5.8%) reported living in their own place. Eighty-four (6.1%) of patients reported that they had ever used illegal drugs or pills without a prescription. Of the prior 30 days, patients reported smoking cigarettes on 2.5 ± 7.5 days, drinking 5 or more drinks of alcohol 1.0 ± 3.0 days, and using marijuana 3.3 ± 8.1 times. Regression analyses indicated that adolescents who have their own place vs. living with their parents were at 0.75 increased log odds of having (ever) abused prescription drugs Exp(B) = 2.12, p = 0.048. However, living in their own place or in another person's home relative to with parents was not associated with increased odds of smoking cigarettes, excessive alcohol use, or marijuana use (all p's > 0.13). A post hoc power analyses revealed power > 0.9 to detect even a small effect. ConclusionsLiving situation in an urban adolescent population significantly affects illegal prescription drug abuse. This information may be useful to aid providers in targeting counseling to more vulnerable patients. Living situation in an urban adolescent population significantly affects illegal prescription drug abuse. This information may be useful to aid providers in targeting counseling to more vulnerable patients.