July 16, 2013
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Substance use highly problematic among homeless youth

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Researchers observed a high prevalence of lifetime substance use among street children, according to a recent review and meta-analysis published in the journal Addiction.

"The most important conclusion to draw from this large number of studies is not only is substance abuse by street children highly prevalent in low-income countries; it is largely ignored," study researcher Paula Braitstein, PhD, associate research professor of medicine at Indiana University School of Medicine, said in a press release. "These children are often malnourished, have significant health problems and a lack of education. This poses a massive public health problem in terms of their future need for health care as well as potential for future productivity and/or re-integration back into society for countries with limited resources."

Paula Braitstein, PhD 

Paula Braitstein

Braitstein and colleagues looked at 50 studies on substance use among street children and youth aged 0 to 24 years living in "resource-constrained settings" from 22 countries. Analysis of combined lifetime substance use in 27 of those studies yielded an overall prevalence of drug use of approximately 60% (95% CI, 51-69). Inhalants — such as glue, paint thinner and acetone — accounted for nearly half (47%; 95% CI, 36-58) of drug use, likely because they are inexpensive and legal, according to Braitstein.

The prevalence of lifetime substance use varied widely from country to country, from 14% in Nigeria to 92% in Honduras and Brazil, the researchers said.

Braitstein and colleagues identified several research gaps, specifically data on physical and mental health outcomes, HIV and mortality associated with substance use.

"As a result of this review, we learned that we don't really know enough about what causes street children to start and stop using drugs," Braitstein said. "We also found that many studies of street children focus on boys, so we have even less information about girls' drug use. Although we know that some street children exchange sex for drugs or have sex while under the influence of drugs, little else is known about the link between drug use and risky sex behavior. There are several critical gaps in our knowledge that we need to fill."

Disclosure: The researchers report no relevant financial disclosures.