Abstract
Background and aimsThe literature base on substance use among adolescents who receive interventions from child welfare services (CWS) in Nordic countries is limited. The purpose of this study was to investigate whether Norwegian adolescents in contact with CWS are at higher risk for substance-related problems (SRP) compared with the general adolescent population, and to what extent those in foster care (FC) differ from those receiving in-home services (IHS). MethodsThe data set comprise 9785 individuals aged 16–19 years who participated in the cross-sectional, population-based youth@hordaland-survey, of whom 141 (1.4%) received IHS from the CWS, while 155 (1.6%) lived in FC. The primary outcomes were indicators of self-reported SRP. Regression analyses were used to explore the association between IHS/FC and SRP with a reference group from the general population. Potential confounding variables included age, sex, ethnicity, and internalizing- and externalizing mental health problems. FindingsCompared with the general population, adolescents receiving IHS had a robust and consistent increased odds of SRP across multiple indicators compared to the general population, even after adjustment for confounding variables (adjusted odds ratios [AORs] ranging from 1.81 to 3.04, all p < 0.05; adjusted mean difference = 1.49, p < 0.01). Adolescents living in FC had a higher total degree of SRP (AOR = 1.51, p < 0.05), as well as higher illicit drug use (AOR = 1.75, p < 0.05), compared with the general adolescent population. The IHS-group had higher total degree of SRP (OR = 2.08, p < 0.01) compared with the FC-group. ConclusionsAdolescents receiving IHS and adolescents in FC had a significantly heightened risk for SRP, compared with the general population. The risk for SRP was higher among adolescents receiving IHS compared with those living in FC. These findings indicate that prevention efforts of SRP in CWS-populations during adolescence are needed.
Highlights
The use of alcohol and illicit drugs affects a large proportion of adolescents in Western countries and remain an important public health concern
This study is the first Norwegian population-based investigation on Substance-related problems (SRP) that distinguishes between those living in foster care (FC) and adolescents receiving in-home services (IHS)
The risk was somewhat higher in adolescents living in FC compared with the general population, the highest risk for SRP was among the adolescents receiving IHS
Summary
The use of alcohol and illicit drugs affects a large proportion of adolescents in Western countries and remain an important public health concern. Individuals receiving interventions from child welfare services (CWS) are subject to increased risk of negative life experiences such as maltreatment and living with parents with SRP or mental illness (Ruffolo et al, 2003; Havnen et al, 2009; Lehmann et al, 2020). These risk indicators are predictors of SRP (Shin et al, 2013). The purpose of this study was to investigate whether Norwegian adolescents in contact with CWS are at higher risk for substance-related problems (SRP) compared with the general adolescent population, and to what extent those in foster care (FC) differ from those receiving in-home services (IHS). These findings indicate that prevention efforts of SRP in CWS-populations during adolescence are needed
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