Drug use among street children and adolescents: what helps?

Sexual Behaviors in Iranian Working Children and the Correlated Risk Factors: Result of the Large-Scale Rapid Assessment and Response (RAR) Survey

This study aimed to investigate the sexual behaviors among working children and the associated factors. This cross-sectional study was conducted on a sample of 1937 working children in the 10-18 age range in 15 provincial capitals in 2019-20 (Feb-May); the Response rate was 94.9%. Univariate and multivariable logistic regression was used to examine the variable of sexual behaviors. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) are reported. The prevalence of sexual behaviors in working children was 4.2%. The results showed a significant difference between those who reported sexual behaviors and those who did not in terms of age, identity document (ID), running away from home, alcohol use, and substance use. There was a statistically significant relationship between fathers' unemployment and sexual behaviors among working children. Furthermore, we found that having divorced parents could increase the odds of sexual behaviors by 3.74 times. The findings showed that related welfare and support organizations should design and implement effective and continuous training and interventions to raise awareness and reduce the prevalence of high-risk sexual behaviors in working children. They should also provide family counseling and promote parental supervision of children.

The global distribution and epidemiology of alcohol and drug use among street-involved children and youth: a meta-analysis

Background: Street-involved children and youth (SICY) who work and live on/of the streets are more likely to inject drugs and engage in psychoactive substance use.Objectives: The present study aimed to identify the prevalence, distribution, sociodemographic determinants, and risk-taking associated with alcohol and drug use among SICY.Methods: Studies published in English related to alcohol and drug use among SICY were searched for from December 1 1985 to July 1 2022, on PubMed, Scopus, Cochrane, and Web of Science.Results: After full-text paper evaluation, 73 studies were included in the meta-analysis. Results indicated that lifetime prevalence rates were 44% (alcohol), 44% (crack), 33% (inhalants), 44% (solvents), 16% (tranquilizer/sedatives), 22% (opioids), and 62% (polysubstance use). The current prevalence rates were 40% (alcohol), 21% (crack), 20% (inhalants), 11% (tranquilizer/sedatives), and 1% (opioids). Also, life-time and current prevalence of alcohol and crack use, current prevalence of tranquilizer/sedative use, and life-time prevalence of polysubstance use were higher among older age groups. Life-time prevalence of tranquilizer/sedative use was lower among older age groups.Conclusions: The high prevalence of using alcohol, crack, and inhalants is a major issue because they are used extensively among different age groups, including minors. Such findings are beneficial for policymakers, health authorities, and professionals in developing programs aimed at minimizing inhalant use and other types of substance use harms among this group. It is important to accurately monitor this risk-exposed population to understand the mechanisms that might help protect them from high-risk substance use.

The Global Distribution and Epidemiology of Psychoactive Substance Use and Injection Drug Use Among Street-Involved Children and Youth: A Meta-Analysis

Background: Globally, street-involved children and youth (SICY) who work and live on/of the streets are at higher risk of increased psychoactive substances and injecting drug use. Objectives: The present study aimed to identify the prevalence, distribution, sociodemographic factors, and risk-taking behaviors associated with psychoactive substances and injecting drug use among SICY. Methods: Studies in English published from December 1 1985 to July 1 2022, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on psychoactive substances and injecting drug use among SICY. The pooled-prevalence estimates were obtained using a robust fixed-effects model. Results: The most commonly reported life-time and current psychoactive substance was tobacco followed by cannabis, LSD/ecstasy, cocaine, methamphetamine, heroin and injection drug use. The results showed that life-time and current prevalence of methamphetamine and cannabis use, as well as life-time prevalence of cocaine, LSD/ecstasy, heroin, tobacco, and injecting drug use increased as age rose while current prevalence of cocaine and tobacco use decreased as age rose. SICY who were male, homeless, had parents who had died, had history of substance use among family members or best friends, had experienced violence, had casual sex partners, had a history of working in the sex trade, and had unprotected sex were all related to psychoactive substance use and injecting drug use. Conclusions: Research examining this population suffers from lack of studies, therefore, improving the knowledge for interventions aimed at reducing risk behaviors, particularly those related to the transmission of sexually transmitted infections such as HIV is of great importance.

Street and drug use experiences among sheltered children and adolescents in the Federal District of Brazil

PROBLEM

The use of drugs by street children and adolescents is a problem found in most large cities around the world.

METHODS

This is a cross-sectional study of street children and adolescents living in shelters in the Federal District, Brazil. An objective questionnaire was applied to 84 individuals from September 2016 to October 2017; 14 of them participated in the qualitative study.

FINDINGS

Most participants were adolescents (84.5%) and males (64.3%), with a history of abandonment, domestic violence, and family drug abuse. All spent some time on the street; boys had a higher chance of being behind the school level and using drugs than girls. Over 60% had used drugs in the previous year, mainly alcohol and marijuana. Over 70% understand the health consequences of this behavior, but most have never tried or failed to stop. About 40% consider themselves dependent on drugs.

CONCLUSIONS

The results showed that street-life experience, peer pressure, and exposure to drugs within the family had an important impact on respondent's drug use behavior, reinforcing the importance of education programs that focus on the family.

[Sexual exploitation of homeless children and adolescents living on the streets in Southern Brazil]

The scope of this study was to investigate the prevalence of sexual exploitation of homeless children and adolescents living on the streets, as well as characteristics associated with this outcome. In this cross-sectional investigation, carried out in the municipalities of Rio Grande and Porto Alegre-RS, data were collected through interviews, which were conducted by trained interviewers. The Respondent-Driven Sampling (RDS) strategy was adopted and statistical analyses were conducted using Poisson regression with robust adjustment of variance. The sample included 186 children and adolescents between 10 and 17 years of age, of which 8% reported having been subjected to sexual exploitation. Being 16 to 17 years old, having had forced sexual intercourse and not having bonds with school were characteristics independently associated with this outcome. It was observed that the lack of contact with school increased the probability 16-fold of having suffered sexual exploitation, being considered the main risk factor in this study. The proposition is that the inclusion and permanence of homeless children and adolescents living on the streets into schools might significantly reduce the risk of sexual exploitation of this population group.

Capturing the heterogeneity of life on the streets: A person-centered analysis of street histories and social connections of youth

INTRODUCTION

The heterogeneity of street-involved youth was examined using a person-centered approach. Youth were classified based on patterns of street involvement and the identified profiles compared to identify theoretically coherent and practically significant differences.

METHODS

Participants were 111 street-involved youth aged 9 to 18 (M age = 14.15 years; 81.1% male, 91.1% non-white) from three Brazilian cities. Youth completed a life history interview and structured assessment. Latent class analysis was used to identify three profiles of youth based on reasons for going to the street and connections to major developmental contexts (street, family, institutions). Profile comparisons on psychosocial variables (e.g., age, life events) and adjustment indicators (e.g., drug use, life satisfaction) were conducted using multinomial logistic regression.

RESULTS

The largest profile (48.6%) included youth drawn to the street by drug use or trafficking, who had moderate connections to street and family. Another group (40.5%) went to the street to escape family dysfunction, and the street represented their primary developmental context. These groups differed on some psychosocial indicators but had similar patterns of adjustment. The third group of youth (10.8%) had families with a history of street involvement and maintained strong ties to all three developmental contexts. These youth had generally better adjustment than their peers (e.g., less drug use, higher life satisfaction) but had higher levels of sexual risk related to the overrepresentation of girls.

CONCLUSIONS

Street involvement is a multidetermined phenomenon that may expose young people to distinct conditions of vulnerability. Findings have implications for research, practice, and policy.

Diversity in substance use behaviour among street children of Delhi under Bayesian paradigm

BACKGROUND

Shannon's index is one of the measures of biodiversity, which is intended to quantify both richness and evenness of the species/individuals in the ecosystem or community. However, application of Shannon's index in the field of substance use among the street children has not been done till date.

METHODS

This paper is concerned with methods of estimating Shannon's diversity index (SDI), which can be used to capture the variation in the population due to certain characteristics. Under the consideration that the probability of abundance, based on certain characteristics in the population, is a random phenomenon, we derive a Bayesian estimate in connection with Shannon's information measure and their properties (mean and variance), by using a probability matching prior, through simulation and compared it with those of the classical estimates of Shannon. The theoretical framework has been applied to the primary survey data of substance use among the street children in Delhi, collected during 2015. The measure of diversity was estimated across different age profiles and districts.

RESULTS

The results unrevealing the diversity estimate for street children corresponding to each region of Delhi, under both the classical and Bayesian paradigms. Although the estimates were close to one another, a striking difference was noted in the age profile of children.

CONCLUSIONS

The Bayesian methodology provided evidence for a greater likelihood of finding substance-using street children, belonging to the lower age group (7-10, maximum Bayesian entropy-3.73), followed by the middle (11-14) and upper age group (15-18). Moreover, the estimated variance under the Bayesian paradigm was lesser than that of the classical estimate. There is ample scope for further refinement in these estimates, by considering more covariates that may have a possible role in initiating substance use among street children in developing countries like India.

High risky behavior and HIV/AIDS knowledge amongst street children in Shiraz, Iran

Background: Street children around the world are accompanying a wide range of risky behaviors. The most common ones include risky sexual behavior, substance and alcohol abuse, and violence. This study aimed to assess risk behaviors and HIV knowledge of street children in Shiraz. Methods: A total of 329 street children (7-18 years of age who spend days or nights on streets with or without their family for earning money) were interviewed through 2014-2016 in Shiraz. Data were collected through a structured interview about high-risk behaviors and HIV/AIDS Knowledge based on a form and questionnaire. Street children were asked to identify HIV/AIDS mode of transmission. All correct answers were scored as one (1), and incorrect, "don't know" responses and no responses scored as zero. The data were analyzed by SPSS software 16 (SPSS, Inc. Chicago, USA) using the Independent t-test and chi-square test, and Pearson's correlation test. P value< 0.05 was considered as statistically significant Results: The mean ± SD age was 13.46±3.09. A total of 86.6% of them were boys. A total of 97.6% of them reported staying with their parents. Street children reported sleeping place as follow: with their parents (n=312, 94.8%), sharing accommodation with other kids (n=13, %4), sleeping in parks (n=2, 7%), and one with relatives. The frequency of smoking, alcohol drinking, and drug abuse were 35 (10.6%), 47 (14. 3%), and 6 (1.8%) respectively. A total of 43 (13.1%) street children reported sexual activity, among them 30 (9.1%) had sexual activity without a condom. Mean ± SD HIV/AIDS knowledge scoring of street children was, 4.1±3.9. Conclusion: Special programs should be implemented in order to reduce high-risk behavior among street children. Intervention should include increasing awareness about alcohol and drug abuse, HIV/AIDS knowledge, sexual and verbal abuse through an organized system with the help of peer education.

Substance abuse among children

Substance abuse (SA) among children is a recognized challenge for policymakers and law enforcement and has life-threatening consequences owing to the impact on the children's development and the consequent increase in vulnerability. This work outlines several important issues related to SA among children: (1) SA prevalence including onset, common examples, extent, and spectrum of SA; (2) the presence of new psychoactive substances, which are rapidly spreading worldwide with limitations regarding their prevalence, detection, and interventions; (3) street children and their recruitment in drug supply; (4) SA and substance use disorder pathways, risk and protective factors for the development of SA; (5) SA consequences in the case of early initiation, including deaths; and (6) current preventive interventions for the pediatric population. In conclusion, this challenge requires consistent and unremitting attention in order to execute effective prevention programs with continuous re-evaluation of the situation.

Prevalence and factors associated with substance use among street children in Jimma town, Oromiya national regional state, Ethiopia: a community based cross-sectional study

BACKGROUND

Street children constitute a marginalized population in most urban centers of the world. According to UN sources, there are up to 150 million street children in the world today. The estimated number of children who live on the streets in Ethiopia was 150,000, of which about 60,000 of them in Addis Ababa. However, aid agencies estimate that the problem may be far more serious, with nearly 600,000 street children country-wide and over 100,000 in Addis Ababa. World Health Organization estimates that globally, 25-90% of street children indulge in substance use. Even if substance use has become a common problem in Ethiopia, most of the studies done mainly focused among schools, college and university students. Research on street children and their substance use habits in Ethiopia was limited and specifically non in Jimma town.

OBJECTIVES

To assess the prevalence and factors associated with substance use among street children in Jimma town of Ethiopia in 2019.

METHODS

Cross sectional study was undertaken from March 1-31, 2019. Complete enumeration of study subjects was done and all 312 children of the streets were included. Interviewer administered structured questionnaires was used to collect the data. Bivariable logistic regression was carried out to select candidate for multiple logistic regression analysis with p-value < 0.25 at 95% confidence. Multiple logistic regression was carried out with those candidate variables using backward method and the associations predictors to the response variable was declared with p value of < 0.05 at 95% confidence level.

RESULT

Three hundred twelve street children were included in the study. The prevalence of substance use was 30.8% with 95% CI [25-36.2]. Age > 14 [AOR: 1.97 95%CI:1.00-3.889], attending grade 1-4th [AOR: 0.33 95%CI:0.151-0.737], attending 5th grade and above [AOR: 0.27 CI:0.093-0.756], child whose mother used substances [AOR: 7.78 95%CI:3.00-20.11], child did not know his maternal substance use status [AOR:5.1 95%CI: 2.19-11.81], child whose sibling use substance [AOR: 2.23 95%CI:1.254-5.63], best friend substance use [AOR: 11.01 95%CI:5.47-25.04] and staying 12-60 months on the street [AOR:3.00 95%CI:1.511-5.96] and staying > 5 years on the street [AOR:4.6 95%CI:1.06-19.7] were significantly associated with substance use.

CONCLUSION AND RECOMMENDATION

The prevalence of substance use among street children in Jimma town was high. Mothers and siblings have crucial roles in determining substance use behavior of the children. Stakeholders who are working on the improvement in the life of children of the street should try to satisfy the need of the children by intervening at individual level, at family or community level and at levels beyond community to lessen the problem to some extent. Researchers should do similar researches in more detail on these vulnerable but neglected groups of children to fully understand about the problem so the findings will be used as inputs for concerned bodies.

Violent language in the environment of street children singer-beggars

Background

Street children singer-beggars are differently treated psychologically and socially by many people on the street since they are considered to disturb the environment. They grow up with different perspectives from children of their age and social interactions unsuitable for their growth. Abusive language, repeated acts of violence, and antisocial attitudes have shaped their different personalities and characteristics in accordance with their age.

Objective

This study was conducted to observe the lives of street children singer-beggars through their understanding of adult communication and explain their verbal language and its meaning in their communication.

Participants

and Setting: The participants were 15 singer-beggars as informants who spent 8 h or more on the streets. They were selected through interview and observation in eight months based on the following characteristics as criteria:(1) having an age range between 12 and 17 years old, (2) having been in elementary school, (3) spending more than 8 h on the streets and having been taken to the streets on average three years, and (4) coming from very poor families. In addition to singing in the streets, they were working as porters and junk collectors and sellers. All of them smoke, enjoy alcoholic beverages, and inhale toxic materials (rubber cement glue). Researchers engaged in their daily lives intensively like playing music on the bus and in crowds.

Method

The study employs social phenomenology approach seeking to explore and describe the life experiences of street children who make a living by singing and begging.

Results

Result showed that all children (100%) reported that their communication pattern was conducted with four dominant groups, namely, parents, fellow singers, security officers, and street thugs. Furthermore, 80% of key informants said that communication occurred between setting and omission of verbal and nonverbal violence and physical violence. All key informants constructed 18 phrases related to violence or conflicts on the streets, seven phrases for calling people, 14 phrases related to deviant actions, and 24 phrases for begging or singing on the street.

Conclusion

Communication acts of street children singer-beggars happened dynamically, specifically, and purposively. They formed communication patterns by constructing a language that showed suffering, brutality, attack, seduction, survival effort, and unity of groups and languages. This experience needed to be considered in helping children return to their families and child protection homes and schools for their welfare. Results showed that protection of children from the streets by government protection agencies must be conducted based on street children's point of view that allows them to get out of the streets.

Estimating the size of substance using street children in Delhi using Respondent-Driven Sampling (RDS)

Street children as a population sub-group exist in significant numbers in the developing world and have been reported to be vulnerable to adverse health and risk behaviours that include physical and sexual risk behaviour. However, the estimation of prevalence for various psychoactive substances among the street children in a representative sample has not been attempted in the developing country like India. This is challenging due to the absence of an appropriate sampling frame, the population living in isolation, hiding their identity and concealing their behaviour. Use of psychoactive substances in street children is riddled with these challenges. The present investigation describes the findings from size estimation study on a representative sample of street child (n = 766) in Delhi, by implementing the Respondent Driven Sampling Methodology (RDS). The weighted prevalence for three commonest substances was found as Tobacco (31.1 %), alcohol (13.5 %) and inhalants (11.3 %) used during the last one year with the estimated number as -Tobacco (21,770), Alcohol (9450) and Inhalants (5600). Almost one third of street children were using some substance. Also, a large majority of ever users were also using substances currently. The study demonstrates successfully the implementation of RDS for the estimation of the prevalence of psychoactive substances in a representative manner. A large majority of street children use psychoactive substances, and there is a need for more of such studies in other metropolitan cities so that local level interventions and planning can be done for treatment and prevention of psychoactive substances among the street children. The important public health implications had been discussed.

How far can you go? Association between illicit drug use and academic migration

ABSTRACT Objective: To measure the prevalence of illicit drugs use in the lifetime, last year and last month, as well as the factors associated to the last year's use and its association with academic migration, among undergraduate students of a university in southern Brazil. Methods: In this cross-sectional study, data were collected through self-administered questionnaire. It was conducted a clustered systematic sampling. For multivariate analyses, it was used Poisson regression. Results: 1,423 students participated. The prevalence of illicit drug use in the lifetime, last year and last month were 42.4%, 25.5% and 17.7%, respectively. Regarding illicit substances, marijuana use was the most prevalent. The variables independently associated with illicit drugs use in the last year were academic migration, being male, younger, single, high parent's educational level, living with peers, tobacco use in the last year, and having friend and relative that have used illicit drugs. Religious practice had a protective effect. Conclusion: Individuals who migrated from their cities to study at the university are more exposed to the main risk factors pointed out by this research and hence to the use of illicit drugs. Based on these results, we suggest that universities develop evaluation, prevention, treatment or referral strategies considering specific needs of this population

[A Street Clinic in a state capital in Northeast Brazil from the perspective of homeless people]

The objective of this study was to evaluate the Street Clinic strategy in Maceió, Alagoas State, Brazil, from the perspective of its users. This was a qualitative study in coverage areas of the Street Clinic in Maceió. Research subjects were 18 homeless individuals assisted by the clinic (10 men and 8 women), ranging from 20 to 40 years of age. Data were collected from September 2014 to February 2015 using a semi-structured interview. Content analysis was applied to the data and identified two categories: the first, the Street Clinic as such, revealed the strategy's critical points, challenges, and potentialities; the second showed the Street Clinic as social support, affect, and hope for change for the homeless. The strategy was rated positively by users, providing social support on health problems and other daily issues.

Características de Crianças Usuárias de Substâncias Psicoativas Descritas pela Própria Criança

RESUMO No Brasil, há uma população de crianças que faz uso de drogas. No entanto, são raras as pesquisas que tratam desse tema. Este estudo objetiva caracterizar a criança que faz uso de substâncias psicoativas atendida na Unidade de Tratamento à Criança e ao Adolescente Usuário de Álcool e Outras Drogas (UTCA) a partir dos relatos da própria criança. A UTCA é um serviço hospitalar da rede de saúde mental do estado do Espírito Santo. Os dados foram coletados a partir de entrevistas com três crianças e foram analisados por meio de análise de conteúdo. Os resultados indicam a frequência do consumo entre as crianças participantes, os fatores associados ao consumo e como a criança descreve o serviço oferecido pela UTCA.

Substance Abuse amongst the Street-children in Guwahati City, Assam

BACKGROUND

The nature of continuous exposure to the street and its associated life-styles make street children vulnerable to the use of psychoactive substances.

AIMS

The aim of the present study is to study some social factors of street children in Guwahati city and to ascertain the substance use behavior of the street children.

SUBJECTS AND METHODS

A population based cross-sectional study conducted during September 2008 to August 2009 among 215 street children between the ages of 5 and 18 years of Guwahati City Assam. The main outcome measures were substance use and its related risk factors prevalent among street children. The data collected were analyzed in Microsoft Office and percentages and Chi-square tests were used to analyze the variables.

RESULTS

Around 174/215 (80.9%) of study participants were substance abusers. It is noteworthy that as the age increases substance use was more common when compared to younger age group. The risk of substance abuse was 1.26 times relatively higher among those who had never been to school and 1.12 times more common in those from a joint family when compared to others. However the correlations were not found to be statistically significant. Substance abuse was 1.19 times more common in case of deaths of both parents and the association was found to be statistically significant (P = 0.02). Presence of step parents and substance use in the family was seen to be a risk factor for substance abuse and the association was highly significant (P < 0.001). The association of substance abuse with duration of street life was found to be highly significant. Majority of the substance users 152/174 (87.4%) were in the habit of sniffing glue and this was followed by smoking 147/174 (84.5%).

CONCLUSION

Substance abuse is an important concern affecting street children. Street and its associated life-styles make street children vulnerable to the use of psychoactive substances. Non- government organizations and Government should come forward to curb this problem and save millions of vulnerable lives.

Nonprescribed use of tranquilizers and use of other drugs among Brazilian students

OBJECTIVES

To describe patterns of nonprescribed use of tranquilizers by students aged 10 to 18 years and assess the sociodemographic characteristics of these adolescents and their use of other substances.

METHODS

A randomized and stratified sample of 47,979 students from state and private schools of the 27 Brazilian state capitals completed a self-report questionnaire. Poisson regression was used to estimate the associations between tranquilizer use and sociodemographic factors, as well as the use of other psychotropic substances.

RESULTS

The lifetime prevalence of nonprescribed use of tranquilizers was 3.9%. Use was most common among girls, wealthier adolescents, and those from private schools. An association was found between use of tranquilizers and lifetime use of alcohol (prevalence ratio [PR] = 3.15; 95% confidence intervals [95%CI] 2.58-3.85), tobacco (PR = 2.61; 95%CI 2.31-2.95), illicit drugs (PR = 3.70; 95%CI 3.19-4.29), and other prescription drugs (PR = 7.03; 95%CI 6.18-7.99). As the number of substances adolescents reported having used increased, so did the nonprescribed use of tranquilizers.

CONCLUSIONS

Nonprescribed use of tranquilizers by adolescents might indicate the use of other substances, including high-risk combinations such as tranquilizers and alcohol. The risks of this association should be addressed during the early stages of drug prevention programs.

Use of psychoactive substances by adolescents: current panorama

Adolescence is a period of vulnerability to substance use disorders (SUDs). Epidemiological studies indicate that about 23% of Brazilian adolescents use drugs, with alcohol being the most widely consumed substance. The etiology of SUDs is complex, influenced by an interaction of genetic risk, individual development, environmental factors, context of use, and substance used. Clinicians should consider diagnostic criteria and be aware of behavioral changes that may indicate drug use and its consequences in various aspects of adolescent life. Identification and treatment of comorbid conditions is critical to the management of SUDs in this age group. Interventions should restrict access to drugs and facilitate prompt recognition of initial use, preventing progression to serious patterns of abuse or dependence. Intervention should be broad, including academic and occupational activities as well as social relationships and leisure, which are critical to the reestablishment of normal adolescent development.