23, No. 2
Preventing Substance Use Among Youth in Foster Care
Youth in foster care have higher rates of substance use than youth in the general population (Kim, 2017; Braciszewski, 2012; Barn, 2015; Traube, 2012). Research has focused on understanding the variables that contribute to these higher rates. While there is still much debate on exact causes, there is agreement that certain risk and protective factors influence the likelihood of substance use among youth in foster care.
Risk and Protective Factors
Risk factors shown to have a higher relationship with future substance use are: school exclusion, involvement in the criminal justice system, association with deviant peers, a history of behavior problems, and co-morbid mental health diagnoses--specifically depression and conduct disorder (Kim, 2017; Babowich, 2016).
Two of the most discussed risks factors are poor relationships with primary caregivers and lack of caregiver supervision. Given that foster care is typically a result of unsafe parenting practices, it makes sense that youth in care would experience these two risk factors at higher rates (Kim, 2012; Traube, 2012).
Protective Factors. The most consistently discussed protective factors are positive relationships with caregivers and level of caregiver supervision (Kim, 2017; Braciszewski, 2012; Barn, 2015; Traube, 2012). This has implications for youth with multiple placements, since they may have a harder time connecting with caregivers.
Other protective factors include school engagement, problem-solving skills, and emotional regulation (Kim, 2017; Traube, 2012, Barn, 2015).
An example of this is KEEP SAFE, an intervention that works with caregivers and youth together and separately to build skills that support positive parenting, problem solving, and skills to address peer pressure. One recent study showed KEEP SAFE significantly reduced substance use in foster youth 18 months after participating in the program (Kim, 2017).
Prevention strategies also address the need for increased supervision, particularly for teens. Adolescent brain development puts teens at a higher risk for unsafe behavior because the part of the brain that supports risk taking develops before the part of the brain that supports problem solving and judgment. This means teens are particularly vulnerable to substance use and other risky behavior (Galvan, 2007). Supervision includes knowledge of where teens are and who they are with, building relationships with their peer groups, and paying attention to red flags of substance use.
Opioid Use Prevention
Many of the recommendations from SAMHSA and the U.S. Department of Health and Human Services reflect the protective factors mentioned above, particularly building strong relationships. Other key strategies for preventing teen opioid use are: