Substance use among current and former foster youth: A systematic review

Substance use tends to escalate across adolescence and into young adulthood, and can be intensified by experiences with trauma and maltreatment, mental illness, and exposure to parental alcohol and drug use. Despite the disproportionately high levels of these variables among youth placed in the foster care system, relatively few studies have focused on the measurement of substance use in this vulnerable population. The current review summarizes the published literature on alcohol and drug outcomes for current and former foster youth. Specifically, prevalence of use and diagnoses are presented separately, as well as a review of risk and protective factors. Discussion of results addresses limitations and suggestions for improvement in the measurement of these outcome variables.

► Use of alcohol and marijuana may be similar among foster and non-foster youth.
► Use of hard drugs seems higher among foster youth than the general population.
► Prevalence of substance use disorders is markedly higher among youth in care.
► Similar patterns are seen among foster alumni, with the addition of more diagnoses.
► Substantial limitations in measurement hinder definitive conclusions.