title: Depressive symptoms and patterns of drug use among street youth.
abstract: OBJECTIVE
  Rates of depression among street youth are poorly characterized, particularly as they pertain to concurrent drug use. We sought to assess associations between drug type and degree of depression in this population.
  
  
  METHODS
  Between October 2005 and November 2007, data were collected from a cohort of street-recruited youth aged 14-26 residing in Vancouver, Canada, for the At-Risk Youth Study. Active drug users were classified by predominant substance of use: daily marijuana use, weekly cocaine/crack use, weekly crystal methamphetamine use, or weekly heroin use. Adjusted mean number of depressive symptoms (measured by the Center for Epidemiological Studies Depression [CES-D] scale) was compared among the four groups using multiple linear regression. Logistic regression was also used to assess adjusted odds of CES-D score ≥ 22.
  
  
  RESULTS
  Among 447 youth, mean CES-D score was the highest among heroin users (adjusted mean: 22.7; standard deviation [SD]:1.2), followed by crystal methamphetamine users (adjusted mean: 21.8; SD: 1.1), then cocaine and/or crack users (adjusted mean: 19.1; SD: 1.0), and finally, marijuana users (adjusted mean: 18.3; SD: 1.1), resulting in a difference that was significant among groups (p < .001). When compared with daily marijuana users, odds of CES-D score ≥ 22 were higher among heroin users (adjusted odds ratio [AOR]: 2.64; 95% confidence interval [CI]: 1.39-4.99) and crystal methamphetamine users (AOR: 1.88; 95% CI: 1.04-3.42), but not among cocaine/crack users (AOR: 1.41; 95% CI: .79-2.52).
  
  
  CONCLUSIONS
  To our knowledge, this is the first report of drug use typologies and depression among street youth. Policymakers might heed the apparent vulnerability of heroin and crystal methamphetamine users to even greater degrees of depression than their peers.
authors.affiliation: Department of Pediatrics, Boston Medical Center, Boston, Massachusetts, USA.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Hadland
authors.forename: Brandon D L
authors.initials: BD
authors.lastname: Marshall
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.forename: Jiezhi
authors.initials: J
authors.lastname: Qi
authors.forename: Julio S
authors.initials: JS
authors.lastname: Montaner
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D018453:Homeless Youth / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012931:Social Environment; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult