@article{ref1,
title="Characteristic substance misuse profiles among youth entering an urban emergency department: neighborhood correlates and behavioral comorbidities",
journal="American journal of drug and alcohol abuse encompassing all addictive disorders",
year="2016",
author="Goldstick, Jason E. and Stoddard, Sarah A. and Carter, Patrick M. and Zimmerman, Marc A. and Walton, Maureen A. L. and Cunningham, Rebecca M.",
volume="42",
number="6",
pages="671-681",
abstract="BACKGROUND: Little is known about characteristic profiles of substance use - and their individual- and neighborhood-level correlates - among high-risk youth. <br><br>OBJECTIVES: To identify characteristic substance misuse profiles among youth entering an urban emergency department (ED) and explore how those profiles relate to individual- and community-level factors. <br><br>METHODS: Individual-level measures came from screening surveys administered to youth aged 14-24 at an ED in Flint, Michigan (n = 878); alcohol outlet and crime data came from public sources. Binary misuse indicators were generated by using previously established cut-points on scores of alcohol and drug use severity. Latent class analysis (LCA) identified classes of substance use; univariate tests and multinomial models identified correlates of class membership. <br><br>RESULTS: Excluding non-misusers (51.5%), LCA identified three classes: marijuana-only (27.9%), alcohol/marijuana (16.1%), and multiple substances (polysubstance) (4.6%). Moving from non-misusers to polysubstance misusers, there was an increasing trend in rates of: unprotected sex, motor vehicle crash, serious violence, weapon aggression, and victimization (all p <.001). Controlling for individual-level variables, polysubstance misusers lived near more on-premises alcohol outlets than non-misusers (RRR = 1.42, p =.01) and marijuana-only misusers (RRR = 1.31, p =.03). Alcohol/marijuana misusers were more likely to live near high violent crime density areas than non-misusers (RRR = 1.83, p =.01), and were also more likely than marijuana-only misusers to live in areas of high drug crime density (RRR = 1.98, p =.03). No other relationships were significant. <br><br>CONCLUSION: Substance-misusing youth seeking ED care have higher risk for other problem behaviors and neighborhood-level features display potential for distinguishing between use classes. Additional research to elucidate at-risk sub-populations/locales has potential to improve interventions for substance misuse by incorporating geographic information.  Keywords: Cannabis impaired driving; DUID; Ethanol impaired driving <p /> <p>Language: en</p>",
language="en",
issn="0095-2990",
doi="10.1080/00952990.2016.1174707",
url="http://dx.doi.org/10.1080/00952990.2016.1174707"
}