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)

1. Introduction

Experimenting with tobacco, alcohol and drugs may be part of the transition to adulthood for some youth, but for others, particularly street youth, experimentation often leads to substance use problems over time, possibly due to a perceived need for substance use to cope with life on the street.

Many studies have examined substance use and risky sexual behaviours and their impact on the health of street youth,^1-8 and they have all shown that substance use is more prevalent among street youth than it is in the general youth population.^1-8 A myriad of constantly changing factors, including parental abuse, peer and social pressures, curiosity, genetic vulnerability, individual personality characteristics, environmental stressors and others have been suggested as reasons for substance use.¹

Drug-using populations may have a higher risk of contracting and transmitting both sexually transmitted infections (STIs) and blood-borne infections (BBIs), as they tend to engage in high-risk sexual behaviours due to the influence of the substances they use.^{9, 10} It has been argued that drug use is often an important determinant or correlate of sexual risk behaviours.

The short- and long-term health, psychological and social consequences of substance use are many and may include higher morbidity and premature death due to the presence of chronic conditions such as hepatitis C or HIV/AIDS, as well as increased prevalence of injuries, suicidal tendencies, psychosis, theft and violent crime. The costs associated with health care utilization and the criminal justice system are other important societal burdens.

Information regarding substance use patterns of Canadian youth often relies on student surveys, but while these surveys can provide a general overview of youth substance use patterns, they often do not include youth who are in institutions or have dropped out of school, or those who are at high risk or already involved in substance use.¹

Available information shows that compared to youth in the general population, street youth are 11 times more likely to die of drug overdose and suicide.⁶ Another study in Montreal found that almost half (45.8%) of the street youth in that city had injected drugs.⁷ Clearly the youth populations most at risk of substance use may be missed by population-based telephone surveys or school-based student drug use surveys. Enhanced Surveillance of Canadian Street Youth (E-SYS) is attempting to reach this population and obtain information about street youth to complement the general portrait of youth substance use in Canada.

1.1 Purpose

The information presented in this report is based on E-SYS. It is hoped that the insights garnered will help in attaining the following goals:

• Identifying trends in substance use among street youth.
• Identifying the demographic and social factors associated with substance use among street youth.
• Identifying potential risk factors associated with substance use among street youth