Street children’s use of inhalants at 47%
According to the National Alliance to End Homelessness, homeless youth are 3 times more likely to use marijuana, and 18 times more likely to use crack cocaine than non-homeless youth; between 30 and 40 percent of homeless youth report alcohol problems in their lifetime, while 40 to 50 percent report other drug problems.
In the United States one out of 45 children become homeless each year or over 1.6 million. While homeless, they experience high rates of acute and chronic health problems, drug use is a common problem. It’s difficult to reduce drug use among street children without a good understanding of the problem, and up to now the research has been confined mainly to local studies with inconsistent results. A new review explores drug use among street children in a systemic review of 50 studies from 22 countries and reveals how large the problem really is along with the causes and health consequences among street children and areas where research is desperately in need.
Researchers from Moi University (Kenya), Indiana University (USA), Regenstrief Institute (USA) and University of Toronto (Canada), found that the influence of drugs among street children varies widely among countries, 14% in Nigeria and 92% in Honduras and Brazil.
The estimates in this review were several times higher than that of the World Health Organization’s estimates of drug use among non-street youth globally.
The Meta analysis revealed the most commonly used drug among street children was inhalants such as glue, acetone, gasoline, and paint thinner. An overall analysis revealed inhalant use at 47% as reported by street children. Following inhalant use was tobacco, alcohol and marijuana. Tobacco use measured in 28 studies from 14 countries yield an overall estimate of 44%. Marijuana use measured in 19 studies representing 10 countries in overall analysis revealed 31%. Fewer studies representing six countries measured cocaine use showing an estimate use of 7%. The majority of cocaine use was concentrated in five studies originating from Brazil (16%) with the remaining studies from Africa and Eurasia with a low rate at 2%.
The use of other psychoactive substances, including pharmaceuticals (six studies), and injection drugs (seven studies), were reported much less frequently.
Using substances was associated with participants who were older, male, classified as children of the street, those who had been street-involved for a greater duration, those without family contact, and those sleeping in public or communal places at night. In multivariate analysis, no consistent associations appeared, with the exception of age.
The most common reasons street children give for using drugs are peer pressure, escapism, pleasure, curiosity, and increasing courage and strength for life on the streets.
In their conclusion the researchers write “This review has identified key issues requiring urgent public health action. The widespread use of inhalants is particularly concerning due to legal availability and unrestricted sales to minors, as well as detrimental health effects, and should be a major concern for law and policymakers. It is likely that the use of inhalants could impact upon the ability of street children to be integrated into society and resume a normal life. While there is a need to investigate further the link between their substance use and health outcomes, we hypothesize that due to their drug use they are at higher risk of poor health outcomes, including HIV and mortality. Additional effort and collaboration between policymakers, communities and researchers is essential to understand and implement mechanisms to reduce the harms associated with using inhalants, while also preventing and stopping substance use among this vulnerable population.”
Dr. Paula Braitstein, PhD, MSc, College of Health Sciences, Department of Medicine, Moi University, Eldoret, Kenya, School of Medicine, Department of Medicine, Indiana University, Indianapolis, IN, USA Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada Regenstrief Institute, Inc., Indianapolis, IN, USA and senior author of this study had said the most valuable outcomes of this review is an understanding of what new research needs to be done.
“As a result of this review, we learned that we don’t really know what causes street children to start and stop using drugs. We also found that many studies of street children focus on boys, so we have even less information about girls’ drug use. Finally, 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”, Said Braitstein.
This review has been published in Addiction.