Brittany Barker1, Jean Shoveller2, Cameron Grant3, Thomas Kerr4, Kora DeBeck5. 1. B.C. Centre on Substance Use, 1045 Howe St., Vancouver, B.C., V6Z 2A9 Canada; Department of Medicine, University of British Columbia, 2775 Laurel Street, 10th Floor, Vancouver, B.C., V5Z 1M9 Canada. Electronic address: bccsu-bb@bccsu.ubc.ca. 2. B.C. Centre on Substance Use, 1045 Howe St., Vancouver, B.C., V6Z 2A9 Canada; School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, B.C., V6T 1Z3 Canada. 3. B.C. Centre on Substance Use, 1045 Howe St., Vancouver, B.C., V6Z 2A9 Canada. 4. B.C. Centre on Substance Use, 1045 Howe St., Vancouver, B.C., V6Z 2A9 Canada; Department of Medicine, University of British Columbia, 2775 Laurel Street, 10th Floor, Vancouver, B.C., V5Z 1M9 Canada. 5. B.C. Centre on Substance Use, 1045 Howe St., Vancouver, B.C., V6Z 2A9 Canada; School of Public Policy, Simon Fraser University, 515 W Hastings St., Vancouver, B.C., V6B 5K3 Canada.
Abstract
BACKGROUND: Youth aging-out of the child welfare system (CWS) experience numerous vulnerabilities including, elevated rates of substance use and substance use disorders. Calls to improve services to transition youth to independence are common; however, evidence of the long-term impacts associated with transitional service utilization is scarce. Further, existing services frequently lack appropriate supports for substance using youth and it is unknown if youth are able to access such services. In the present study, we assess the relationship between transitional service utilization and health and social outcomes among a cohort of people who use drugs (PWUD) that aged-out of the CWS. METHODS: Data were obtained from two harmonized cohorts of PWUD in Vancouver, Canada. Those who reported aging-out were asked about service utilization, availability, barriers, and interest across seven categories of transitional services. Multivariable logistic regression analyses were conducted to assess the relationship between having previously utilized transitional services and current health and social outcomes. RESULTS: Between December 2014 and November 2017, 217 PWUD reported having previously aged-out of the CWS. Across service categories, reported service utilization prevalence ranged from 16.6-61.8% while unmet demand ranged from 64.8-78.4%. In multivariable analyses, compared to individuals who utilized ≤1 service while aging-out, having utilized 4-7 services was significantly associated with reduced odds of current homelessness (adjusted odds ratio [AOR]=0.29) and engaging in daily drug use (AOR=0.35) (both p<0.05). CONCLUSION: Findings suggest that this understudied high-risk population of PWUD and aged-out of the CWS experience long-term benefits associated with transitional service utilization and are interested and willing to engage in these services. However, given high unmet demand, findings also highlight considerable gaps in service delivery and support calls for extending the age of emancipation for all youth in the CWS and in particular, for additional harm reduction and substance use supports embedded into service models.
BACKGROUND: Youth aging-out of the child welfare system (CWS) experience numerous vulnerabilities including, elevated rates of substance use and substance use disorders. Calls to improve services to transition youth to independence are common; however, evidence of the long-term impacts associated with transitional service utilization is scarce. Further, existing services frequently lack appropriate supports for substance using youth and it is unknown if youth are able to access such services. In the present study, we assess the relationship between transitional service utilization and health and social outcomes among a cohort of people who use drugs (PWUD) that aged-out of the CWS. METHODS: Data were obtained from two harmonized cohorts of PWUD in Vancouver, Canada. Those who reported aging-out were asked about service utilization, availability, barriers, and interest across seven categories of transitional services. Multivariable logistic regression analyses were conducted to assess the relationship between having previously utilized transitional services and current health and social outcomes. RESULTS: Between December 2014 and November 2017, 217 PWUD reported having previously aged-out of the CWS. Across service categories, reported service utilization prevalence ranged from 16.6-61.8% while unmet demand ranged from 64.8-78.4%. In multivariable analyses, compared to individuals who utilized ≤1 service while aging-out, having utilized 4-7 services was significantly associated with reduced odds of current homelessness (adjusted odds ratio [AOR]=0.29) and engaging in daily drug use (AOR=0.35) (both p<0.05). CONCLUSION: Findings suggest that this understudied high-risk population of PWUD and aged-out of the CWS experience long-term benefits associated with transitional service utilization and are interested and willing to engage in these services. However, given high unmet demand, findings also highlight considerable gaps in service delivery and support calls for extending the age of emancipation for all youth in the CWS and in particular, for additional harm reduction and substance use supports embedded into service models.
Authors: Kora DeBeck; Thomas Kerr; Calvin Lai; Jane Buxton; Julio Montaner; Evan Wood Journal: Am J Drug Alcohol Abuse Date: 2011-08-11 Impact factor: 3.829
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