Pathways to High-Risk Drug Abuse among Urban Youth:

This four-year study was designed to identify the critical factors responsible for the transition from “soft” or “gateway” drug use (monthly use of alcohol/marijuana/tobacco) to “hard” drug use (weekly heroin and/or cocaine), including injection drug use, among multiethnic inner city young adults between the ages of 16 and 24 in Hartford, CT. The study tested the hypothesis that social networks are more influential than personal vulnerability (social, familial and personal risk and protective factors) in promoting hard drug use and the transition to injecting. A key component explored the ethics of doing research with drug-using adolescents. With a baseline sample of 401 participants, results from the study showed a difference in network relationships based upon ethnicity, and the association of drug use with improved sexual performance or enjoyment, potentially increasing the risk for HIV/STD transmission. Research results were used to develop a culturally and contextually appropriate intervention strategy to reduce health, mental health and sexual health risks associated with party drug use and sexually transmitted diseases.

Additional Information:

ICR
Jean J. Schensul, Ph.D.
Principal Investigator

Margaret R. Weeks, Ph.D.
Co-Principal Investigator

Raul Pino, M.D.,
Project Coordinator

Lorie Brumhall, Ph.D.,
Senior Ethnographer

Mariajose Romero, Ph.D.
Data Analyst

Mark Convey, B.A.,
Qualitative Data Research Assistant

Jeannie Ota, B.A.,
Data Entry

Bob Levine, M.D.,
Consultant, Yale University

Hispanic Health Council
Merrill Singer, Ph.D.,
Co-Principal Investigator

Scott Clair, Ph.D.,
Network Analyst

UMASS-Amherst
Edward Stanek, Ph.D.
Epidemiologist/Biostatician

The purpose of this four-year study was to identify the relative contributions of ecological and social network influences to transitioning from “soft” or “gateway” poly-drug use (monthly use of alcohol/marijuana) to “hard” drug use (weekly heroin and/or cocaine use) in urban youth and young adults between the ages of 16 and 24. The project challenged the idea that there is a single “pathway” to hard drug use by showing that youth develop different drug use sequences depending on exposure, networks, choices and other factors. The study used coordinated ethnographic, epidemiologic and network research methods to identify the histories, patterns and networks of high risk, drug-using youth and to identify the factors that impact the transition from gateway to hard drug use.

With a baseline sample of 401 participants, preliminary results from the study showed a difference in network relationships based upon ethnicity, and the association of drug use with improved sexual performance or enjoyment, potentially increasing the risk for HIV/STD transmission. Research results were used to develop a culturally and contextually appropriate intervention strategy to reduce health, mental health and sexual health risks associated with party drug use and sexually transmitted diseases.
Initial data gathered led to a supplemental grant, Minority Supplement to Pathways to High-Risk Drug Abuse Among Urban Youth, that examined the relationship between drug selling, the informal economy and drug use transitions in a predominantly Latino neighborhood in Hartford. Similarly, the discovery of ecstasy use and distribution, through the survey and through ethnography in local neighborhoods and with networks of youth, led to a second supplemental grant, Supplement to Pathways to High-Risk Drug Abuse Among Urban Youth: Club Drugs, that looked at the diffusion of ecstasy and other “club” drugs into the Hartford area, their relationship to drug use transitions, and associated sexual health risks.
Results from two ICR-sponsored conferences on ethical issues associated with conducting ethnographic, epidemiologic and intervention research with high-risk youth and adults in field settings are being used to develop a manual for use in other similar projects and for training, locally and through the Internet.

Identify drug use histories, patterns, interactions and settings among youth, ages 16-24.

Identify indigenous categories of youth networks, settings for observation of drug use, and adapt, expand, validate and pilot effective instruments for measuring predictors of drug use trajectories among drug-using youth ages 16-24.

Identify how factors such as age, gender, ethnicity and peer networks affect the transition from “soft” to “hard” drug use.

Identify appropriate intervention approaches, formats, messages and outreach strategies for preventing transition to hard drug use and related health risks amongst youth 16-24 years old.

Produce and disseminate a manual on ethical considerations in conducting research with young people involved in illicit or other illegal/risky behavior.

Schensul, Jean J., Huebner, C., Singer, M., Snow, M., Pino, R., Broomhall, L. The High, the Money and the Fame: Smoking Bud among Urban youth. Medical Anthropology, Spring 2000.
Broomhall, L., Convey, M., Romero, M. In the cuff: Gender, drug use and drug selling among inner city African American and Puerto Rican female adolescents. Paper presented at the 2000 Annual Meeting of the American Anthropological Association, Chicago, Illinois.
Huebner, C., Schensul, J. Romero, MJ, Singer, M. Los Jovenes de Hartford y el SIDA: Las Drogas en “la calle”, “la discoteca” y el alto riesgo del sexo. Paper presented at the International Conference on AIDS, Havana, Cuba, January 2000.
Pino, R., Schensul, J., Romero, MJ. Redes socials de alto riesgo en adolescents adictos en Hartford, CT. Paper presented at International Conference on AIDS, Havana, Cuba, January 2000.
Schensul, J., Heubner, C., Urban Youth and Club Drugs. Paper presented in an invited NIDA-sponsored panel entitled “Raves, Risks, Research: Update on Club Drugs, Washington, DC., December, 1999, in preparation for publication.
Broomhall, L., Convey, M., Pino, R. Hot tracks, fly gear and phat rides: the political economy of small-time drug dealing among inner city youth in Hartford. Paper presented at the 1999 Annual Meeting of the American Anthropological Association, Chicago, Illinois (in preparation for publication).

Pino, R., Broomhall, L., Schensul, J., Romero, M., Convey, M. The roles of cousins in the social networks of drug-using youth in Hartford, CT. Paper presented at the 1999 Annual Meeting of the American Anthropological Association, Chicago, Illinois in invited session on Social Networks in Place, Space and Time.
Huebner, C., Schensul, J. Constructing Social Networks for social and economic security in urban youth culture. Paper presented at the 1999 Annual Meeting of the American Anthropological Association, Chicago, Illinois in invited session on Social Networks in Place, Space and Time organized by J. Schensul and C. Huebner.
Schensul, J., Clair, S., Pino, R., Levitt, M. Methodological issues in the conduct of network research with substance abusing youth. Invited Oral/Panel presentation at AIDS Science Day, Yale Center for Interdisciplinary Research on AIDS, April, 1999.
Broomhall, L., Schensul, J., Pino, R., Convey, M., Heubner, C. Network effects on Pathways to High-risk drug use among urban youth. Paper presented at annual meeting of the Society for Applied Anthropology, Tucson, Arizona, spring, 1999 in invited session on Social Networks in Place, Space and Time.
Clair, Scott, Schensul, J., Pino, R., Levitt, M. Will you remember me in the morning: The dynamics of social networks examining risky behavior in urban adolescents and young adults. Paper presented at the annual conference of the Society for Chaos Theory in Psychology and the Life Sciences, Berkeley, CA, Spring, 1999, in preparation for publication in Connections.