Substance use and victimization: Street-involved youths' perspectives and service implications

Homeless youths' use of substances is highly related to experiences of trauma and the development of posttraumatic stress symptoms. The current study approached homeless young people to elicit their perspectives regarding how their substance use and trauma experiences are interrelated. Recruited from a homeless youth service settings, youth (n = 50) participated in qualitative, semi-structured, face-to-face interviews that queried youth on two broad topics: how substances might place youth at risk for victimization and how substances may be used as a coping strategy. Youth identified several ways substance use placed them at further risk (e.g., decreasing awareness of potential danger, increasing physical risk through overdose or addiction, disconnecting them from support systems, and increasing risk for violence related to criminal behavior). They also described multiple ways in which substances temporarily helped them cope with past trauma (e.g., escaping difficult thoughts, improving negative moods, relaxing, and socializing with others). Many youth (68%) described using substances as a “temporary fix” or “band-aid” to cope with memories of past trauma that eventually placed them at higher risk for further victimization. Adaptations to existing prevention services that incorporate the interconnectedness between substance use and trauma are suggested.

► We qualitatively examine the interconnectedness of substance use and victimization.
► Substances are used to escape negative moods and thoughts related to past trauma.
► Substance use reduces youths' abilities to detect risk, leading to victimization.
► Substance use reduces motivation to leave the streets, increasing risk for trauma.