Recent substance use & mental disorder symptoms among homeless youth

Background: Substance use and mental disorder are prevalent among homeless youth. The complex set of vulnerabilities posed by life on the street and emerging adulthood may mean that substance use/mental disorder comorbidity in this population is associated with increased mental and physical health consequences. Methods: As part of a longitudinal study of homeless youth utilizing drop-in centers in Los Angeles, 652 youth (ages 14-25) completed a self-administered questionnaire. In addition to demographic and housing characteristics, youth reported on substance use and mental health. Multivariate models controlling for demographic characteristics (gender, education, age, race, and duration of homelessness) assessed associations between substance use (past 30 day use of marijuana, methamphetamine, prescription drug misuse (PDM), cocaine, and heroin) and mental health (past year suicide attempt, 30-day symptoms of PTSD, and current significant depressive symptoms). Results: Respondents reported high rates of substance use: 74% used marijuana, 25% meth, 20% PDM, 15% cocaine, and 10% heroin. Past year suicide attempts were reported by 13% of youth, 30% had symptoms indicating PTSD, and 56% had significant depressive symptoms. Having a past year suicide attempt was associated with PDM (OR=2.62; CI: 1.36-5.03), cocaine (OR=2.02; CI: 1.21-4.00), and heroin (OR=6.73; CI 3.34-13.57). Significant depressive symptoms were associated with marijuana (OR=1.07; CI: 1.00-1.14). PTSD symptoms were associated with meth use (OR=2.39; CI: 1.15-4.95). Discussion: Prevention programs should take into account the significant levels of substance use/mental disorder comorbidity among homeless youth. Further research is needed to examine how self-medication for mental health symptoms may contribute to this comorbidity.