Experiencing violence and other predictors of within-person same-day use of multiple substances in youth: a longitudinal study in emergency settings

ABSTRACT

Background: Although experiencing violence is a risk factor for substance use among youth, its association with same-day use of multiple substances (a form of polysubstance use) and mitigating factors is less well understood.

Objectives: To identify whether prosocial factors modified the effect of experiencing violence on the frequency of same-day use, and examine gender-specific risk/protective factors for same-day use.

Methods: We analyzed longitudinal data from a cohort of youth who use drugs aged 14–24 (n = 599; 58% male) presenting to an urban emergency department between 2009–2011 and assessed biannually for two years. Using Poisson-generalized linear models with person-level fixed effects, we estimated within-person associations between self-reported experiencing violence and same-day use and analyzed gender and peer/parent support as effect modifiers. We adjusted for negative peer influence, parental drug and alcohol use, family conflict, anxiety and depression, and age.

Results: Overall, positive parental support corresponded to lower rates of same-day use (rate ratio [RR]:0.93, 95% CI:0.87–0.99) and experiencing violence was associated with higher rates of same-day use (RR:1.25, 95% CI:1.10–1.41). Violence exposure was a risk factor among males (RR:1.42, 95% CI:1.21–1.66), while negative peer influences and parental substance use were risk factors among females (RR:1.63, 95% CI:1.36–1.97 and RR:1.58, 95% CI:1.35–1.83, respectively). Positive peer support reduced the association between violence exposure and same-day use among males (RR:0.69, 95% CI:0.57–0.84, p < .05).

Conclusions: Tailored interventions may address gender differences in coping with experiencing violence – including interventions that promote parental support among males and reduce influence from parental substance use among females.

KEYWORDS:

• Adolescent
• substance-related disorders
• prevention & control

Acknowledgments

We would like to thank the study participants for their time and trust, as well as their participation during the study period. We additionally would like to thank study staff, without whom the study would not be possible.

Disclosure statement

The research presented in this paper is that of the authors and does not reflect the official policy of funders. Funders did not have any role in study design, collection, analysis, interpretation of data, writing of the report or the decision to submit for publication.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/00952990.2024.2307546

Additional information

Funding

Funding for this study was provided by NIDA [R01 024646] and the FACTS (Firearm-safety Among Children & Teens) Consortium [also known as “Building Research Capacity for Firearm Safety Among Children”], funded by the National Institutes of Health within the National Institute for Child Health and Human Development [NICHD, 1R24HD087149].