Canadian Street Youth and Substance Use

Executive Summary Key Findings Introduction Purpose Methods Analysis Analysis Terms Laboratory Methods Limitations Demographic Profile of E-SYS Participants Substance Use Smoking Alcohol Use Recent Alcohol Intoxication General Drug Use Patterns Non-Injection Drug Use Injection Drug Use Injection Drug Use and Hepatitis C Sexual Behaviours and STIs Implications Conclusions References

Findings from Enhanced Surveillance
of Canadian Street Youth, 1999-2003
(November 2007)

6. Implications

The results from this study have significant implications for intervention in the street youth population. Street youth reported use of substances such as cigarettes, alcohol and several drugs. The rates of non-injection and injection drug use among street youth make it clear that actions are needed to reduce the rates of substance abuse and lessen the impact of social and physical harms associated with use of these substances.

Harm reduction approaches — including providing information about safe drug use and safe sexual behaviours, facilitating a return to school or encouraging alternative education programs — also need to be available to street youth. There is also a need to work with the education system to identify youth who are at high risk of becoming street-involved and to offer preventive interventions.

A number of factors are associated with smoking in youth, including age, absence from school and exposure to smoking at home and among peers.³³ E-SYS confirms this among street youth. Public health interventions aimed at reducing smoking in society, such as banning smoking in bars/restaurants/workplaces, may be less likely to reach street youth. Even broad-reaching media campaigns may be ineffective with this population, depending on how they are delivered, since TV commercials and newspaper ads may not reach street youth as they would the general population. Effective interventions need to be developed to target this section of the nation’s youth.

Alcohol, the most widely used and abused drug among youth, presents an interesting and unique challenge. Unlike other psychoactive substances, alcohol use is thoroughly integrated into the social customs and commerce of society.²⁰ As such, initiatives aimed at preventing or reducing alcohol abuse in marginalized populations such as street youth need to be cognizant of their unique circumstances and modify them accordingly. Designing messages that are sensitive to street-life culture and subcultures with practical information or alternative solutions to meeting basic daily needs may be beneficial. The same street youth–centred approach could be used with respect to drug use in general.

An integrated approach to developing and implementing intervention programs for the street youth population would ensure that they are able to get the help they need in different areas. A multifaceted, gender-based approach addressing broader determinants of health is needed, as single-issue public health interventions are unlikely to address the root causes of risk behaviours. For example, street youth who have experienced family problems and abuse may require protection and mental health services as opposed to correctional services when they come in contact with the judicial system.

Findings from E-SYS show that overall, more than 20% of street youth reported injection drug use in all survey years. Infections such as hepatitis C most often occur as a direct result of injection drug use among street youth, caused by sharing needles. For instance, in 2003, only youth who used drugs by means of injection reported ever having hepatitis C infection.

This presents an opportunity for informative and preventive measures to reduce hepatitis C infection. Making treatment available and accessible to street youth and establishing educational preventive initiatives and programs on the risks associated with injection drug use in major urban centres may be useful in dealing with the issue.

Approximately one-fifth of street youth reported injecting drugs, such as cocaine, heroin or crystal methamphetamine. Injection drug use is often associated with other high-risk behaviours, such as involvement in the sex trade, criminal activity, unsafe sex and sharing needles. The amount of time spent on the street may be linked to the likelihood of youth using drugs by means of injection; early multifaceted interventions for street youth about the dangers of injection drug use and addiction could help prevent youth from beginning injection drug use. Finally, there is a need for continued research on Canada’s street youth to provide more detailed information regarding the most appropriate programs and acceptable method of delivery for this diverse group.