Kids and Drugs: Treatment Recognizes Link between Delinquency and Substance Abuse
Winters, Ken C., Corrections Today
American teen-agers have shown an increased involvement in substance use since 1992. According to a 1997 report by the National Institute on Drug Abuse (NIDA), 22 percent of eighth-graders, 39 percent of 10th-graders and 42 percent of 12th-graders reported using an illicit drug in the past year. This upward rate of illicit drug use is due primarily to an increase in marijuana use, which increased between 1992 and 1997 by more than 16 percentage points among 12th-graders and by more than 10 percentage points among eighth-graders. From a public health standpoint, adolescent drug abuse has far-reaching social and economic ramifications, particularly when its onset is early and when the disorder does not remit. Adverse consequences associated with problematic youth drug abuse include psychiatric co-morbidity and suicidality, mortality from drug-related traffic crashes, risky sexual practices and substantial direct health care costs.
Further disheartening news is that drug use continues to show increases among juvenile arrestees. Most of the 12 cities that report drug use forecasting data to the National Institute of Justice (NIJ) indicate that nearly half of juvenile arrestees report some recent drug use, the most commonly abused substance being marijuana.
Clearly, a striking consequence of drug use by young people is its association with violence and delinquency. Conduct problems and the related characteristics of the delinquency spectrum - used here to refer to the broad domain of undercontrolled antisocial behaviors observed among children and adolescents - have shown a deep, pervasive and long-standing association with youth drug involvement. This finding, that a syndrome of general deviance characterizes adolescents who abuse alcohol and other drugs, has been observed in numerous cross-sectional and longitudinal investigations based on clinical, community and school samples. Because studies indicate that conduct problems often precede the development of alcohol and drug problems, theorists have proposed that delinquency is either a key risk factor for adolescent substance use and abuse, or the relationship between the two is mediated by common personality characteristics, such as impulsivity and lack of behavioral inhibition.
Strength and Nature Of the Association
Several studies have reported that delinquency is common among adolescents treated for a substance use disorder (SUD), with the reported incidence of conduct disorder (CD) ranging between 40 and 57 percent. Large proportions of clinic-referred youth with CD, or those in juvenile justice settings (JJS), also reveal drug abuse behaviors. It is estimated that nearly 250,000 juvenile detainees are substance abusers, and reports of co-morbid SUD among youth with CD range between 29 and 59 percent.
An important question regarding the inter-relationship of drug use and antisocial behaviors concerns the etiological significance of each domain to each other. The nature of the inter-relationship of substance use and the manifestations of delinquency is complex. While the weight of evidence suggests that delinquency behaviors figure prominently in the onset and development of drug use behaviors among young people, the specific processes by which this psychopathology contributes to drug involvement and SUD have not been clearly articulated. Furthermore, given the co-morbidity of CD and SUD, it has been suggested that they share a common pathobiology, such as deficits in the neurotransmitter functioning of the central nervous system.
The best evidence that delinquency and related disruptive behaviors are etiologically linked to drug abuse is from studies that follow delinquent youth from childhood through adolescence. These studies generally indicate that manifestations of delinquency often precede the onset of drug use. For example, a prominent study of Colorado students found that the same behaviors of general deviance (e.g., rejecting conventional values, engaging in illegal behaviors, associating with delinquent peers) that were associated with drug use during high school were predictive of problem drinking seven years later. …