title: Access to drug and alcohol treatment among a cohort of street-involved youth.
abstract: BACKGROUND
  A number of options for treatment are available to young drug users, but little is known about the youth who actually attempt to access such services. Here we identify characteristics of a cohort of street-involved youth and highlight commonly encountered barriers.
  
  
  METHODS
  From September 2005 to July 2007, data were collected from the At-Risk Youth Study (ARYS), a prospective cohort of 529 drug users aged 14-26 living in Vancouver, Canada. Participants who attempted to access any addiction services in the 6 months prior to enrollment were compared in univariate analyses and multiple logistic regression modeling of socio-demographic and drug-related factors.
  
  
  RESULTS
  Factors positively associated with attempting to access services included Aboriginal ethnicity (adjusted odds ratio [AOR]=1.66 [1.05-2.62]), high school education (AOR=1.66 [1.09-2.55]), mental illness (AOR=2.25 [1.50-3.38]), non-injection crack use (AOR=2.93 [1.76-4.89]), and spending >$50 on drugs per day (AOR=2.13 [1.41-3.22]). Among those who experienced difficulty-accessing services, the most commonly identified barrier was excessively long waiting lists. In a subgroup analysis comparing those who tried to access services but were unsuccessful to those who were successful, risk factors positively associated with failure included drug bingeing (odds ratio [OR]=2.86 [1.22-6.76]) and homelessness (OR=3.86 [1.11-13.4]).
  
  
  CONCLUSIONS
  In light of accumulating evidence that drug use among street youth is associated with risky health-related behaviors, improving access to treatment and other addiction services should remain an important public health priority.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Hadland
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.forename: Kathy
authors.initials: K
authors.lastname: Li
authors.forename: Julio S
authors.initials: JS
authors.lastname: Montaner
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D000437:Alcoholism / Q000534:rehabilitation*; D001955:British Columbia; D015331:Cohort Studies; D005260:Female; D015438:Health Behavior; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D018453:Homeless Youth / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015233:Models, Statistical; D012307:Risk Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D016896:Treatment Outcome; D014850:Waiting Lists; D055815:Young Adult