Research Roundup: What Can We Do To Reduce Substance Use Among Homeless Youth?

A group of teens.

Homeless young people use and abuse drugs and alcohol at alarming rates, perhaps as high as 50 to 84 percent, according to some studies. Beyond the obvious fact that using substances is bad for young people’s health, researchers say that drug and alcohol abuse can pull homeless youth farther and farther away from family, friends, school and other positive support systems. Interventions to get young people to stop using substances (or never use them in the first place) are crucial. But to date, we know very little about what works to help homeless young people get off and stay off drugs and alcohol.

Understanding the Abuse

A new study in the journal, Children and Youth Services Review, explores why homeless youth use substances in order to better understand how to help. The researchers asked 50 street youth, ages 18-24, to think of a time when they or someone they knew experienced a traumatic event. Then they asked how using substances might help or hurt in that situation.

The homeless youth said that substances helped them improve their emotions or moods, relax, escape distressing thoughts and find support from peers on the street. At the same time, they said that substance abuse had a host of negative consequences. They said it broke down their relationships with people who weren’t on the street, made them easier targets for victimization, and might even lead to death. Still, youth said substance abuse made them feel so isolated from others that knowing the negative consequences was not enough to get them to quit.

Exploring Motivation

So what might motivate homeless youth to change their alcohol and drug use? Researchers at the Ohio State University recently surveyed 200 youth at a drop-in center in Columbus to find out which of a list of factors might lead to behavior change. The list included demographics, history of depression, and involvement in the juvenile justice or child welfare systems, among other things.

Homeless youth who used alcohol were more likely to want to change their behavior if they were older, drank more frequently or had a history of childhood sexual abuse. Youth who had experienced more negative consequences of using drugs were more likely to say they wanted to quit. But many of the factors the researchers asked about didn’t affect young people’s desire to change. Which means, the researchers say, we need to look at other factors to find out what does motivate youth to change.

What Works?

The short answer is we’re still figuring that out. A researcher at the University of Illinois, Urbana-Champaign, recently looked at all of the evidence on programs specifically aimed at getting homeless youth off drugs and alcohol. She found only 15 published studies, and none of them met the standards for “good” research quality. She also found that the interventions studied – brief motivational intervention, community reinforcement approach, knowledge and skills training, case management, peer support intervention, family therapy, shelter services, and supportive housing – showed limited effects on substance use over time for homeless youth in general.

These three articles reach similar conclusions about what we need to do to help more homeless young people avoid or quit substance use:

  • Researchers and service providers need to explore the links between substance abuse and trauma and design programs that give youth better ways to cope.
  • Interventions need to be tailored to different groups of homeless youth, taking into account gender, race and ethnicity, age, sexual orientation, time on the street and other factors.
  • Researchers and service providers need to ask homeless young people about their treatment experiences and how good or bad experiences influence how well the treatment works.

Read the Articles

A Review of Interventions for Substance Use Among Homeless Youth (abstract). Research on Social Work Practice, Vol. 23, No. 1 (March 2013).

Factors Associated With Motivation to Change HIV Risk and Substance Use Behaviors Among Homeless Youth. Journal of Social Work Practice in the Addictions, Vol. 11, No. 2 (2011).

Substance use and victimization: Street-involved youths' perspectives and service implications (abstract). Children and Youth Services Review, Vol. 34, No. 12 (December 2012).

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