Access to drug and alcohol treatment among a cohort of street-involved youth

BackgroundA number of options for treatment are available to young drug users, but little is known about the youth who actually attempt to access such services. Here we identify characteristics of a cohort of street-involved youth and highlight commonly encountered barriers.MethodsFrom September 2005 to July 2007, data were collected from the At-Risk Youth Study (ARYS), a prospective cohort of 529 drug users aged 14–26 living in Vancouver, Canada. Participants who attempted to access any addiction services in the 6 months prior to enrollment were compared in univariate analyses and multiple logistic regression modeling of socio-demographic and drug-related factors.ResultsFactors positively associated with attempting to access services included Aboriginal ethnicity (adjusted odds ratio [AOR] = 1.66 [1.05–2.62]), high school education (AOR = 1.66 [1.09–2.55]), mental illness (AOR = 2.25 [1.50–3.38]), non-injection crack use (AOR = 2.93 [1.76–4.89]), and spending >$50 on drugs per day (AOR = 2.13 [1.41–3.22]). Among those who experienced difficulty-accessing services, the most commonly identified barrier was excessively long waiting lists. In a subgroup analysis comparing those who tried to access services but were unsuccessful to those who were successful, risk factors positively associated with failure included drug bingeing (odds ratio [OR] = 2.86 [1.22–6.76]) and homelessness (OR = 3.86 [1.11–13.4]).ConclusionsIn light of accumulating evidence that drug use among street youth is associated with risky health-related behaviors, improving access to treatment and other addiction services should remain an important public health priority.