Kipke M D, Montgomery S, MacKenzie R G
Division of Adolescent Medicine, Childrens Hospital Los Angeles, CA 90054-0700.
J Adolesc Health. 1993 Jun;14(4):289-94. doi: 10.1016/1054-139x(93)90176-p.
Despite recent surveys reporting a decline in adolescents' use of alcohol and other drugs in the general population, substance abuse may actually be increasing among particular subgroups of high-risk youth. This study examined the prevalence of alcohol and other drug use reported by 1121 youth, ages 12-24 years, seen for an initial medical visit at a free community-based primary health clinic. The clinic, located in the Hollywood/Wilshire area of Los Angeles, serves both homeless (62%) and non-homeless (38%) youth. Bivariate and multivariate analyses revealed that the homeless youth were significantly more likely to report use of alcohol and illicit drugs (marijuana, stimulants, hallucinogens, and narcotics) and prior involvement in injecting drug use (IDU). Variables found to be significantly associated with substance use among the homeless youth included length of time homeless, an attempted suicide, physical and sexual abuse, and involvement in survival sex/prostitution. Among the non-homeless youth, age of first intercourse, a previous suicide attempt, and a history of physical and sexual abuse were significantly associated with substance use. These findings suggest that rates of alcohol and other drug use may be higher among youth seen at community-based primary health clinics, particularly homeless youth underscoring the need for screening for these risk variables.
尽管最近的调查显示，普通人群中青少年饮酒和使用其他毒品的情况有所下降，但在高危青年的特定亚群体中，药物滥用实际上可能正在增加。本研究调查了1121名年龄在12至24岁之间、在一家免费的社区初级保健诊所进行首次就诊的青年报告的饮酒和使用其他毒品的情况。该诊所位于洛杉矶好莱坞/威尔希尔地区，为无家可归者（62%）和非无家可归者（38%）青年提供服务。双变量和多变量分析显示，无家可归青年报告饮酒和使用非法药物（大麻、兴奋剂、致幻剂和麻醉品）以及先前参与注射吸毒（IDU）的可能性显著更高。在无家可归青年中，发现与药物使用显著相关的变量包括无家可归的时间长度、自杀未遂、身体和性虐待以及参与生存性交易/卖淫。在非无家可归青年中，首次性交年龄、先前的自杀未遂以及身体和性虐待史与药物使用显著相关。这些发现表明，在社区初级保健诊所就诊的青年中，饮酒和使用其他毒品的比例可能更高，尤其是无家可归青年，这突出了对这些风险变量进行筛查的必要性。
