Early Sexual Abuse, Street Adversity, and Drug Use among Female Homeless and Runaway Adolescents in the Midwest

Research on homeless and runaway adolescents has shown that this population is at high risk for illicit drug use. Though sexual abuse has been widely considered in the etiology of illicit drug use, we know less about how early sexual abuse affects young people’s decisions to run away, to use drugs, and to engage in other deviant behavior on the streets. Based on interviews with 361 female homeless and runaway adolescents in four midwestern states, the current study revealed a high prevalence of drug use, especially use of cocaine among youths with sexual abuse histories. Path analyses showed that early sexual abuse indirectly affected drug use on the streets via running away at an earlier age, spending more time on the street, and use of deviant strategies to survive (e.g., affiliation with deviant peers, trading sex, and use of nonsexual deviant subsistence strategies). Research on homeless and runaway adolescents has shown that this population is at high risk for illicit drug use (such as marijuana, speed, LSD, cocaine, inhalants, and mushrooms), and other deviant behavior (Greenblatt & Robertson, 1993; Hagan & McCarthy, 1997; Kipke, Montgomery, & Mackenzie, 1993; Koopman, Rosario, & Rotheram-Borus, 1994; Whitbeck & Hoyt, 1999). Compared with the general adolescent population, rates 1 Xiaojin Chen, Ph.D., is an assistant professor in sociology at Tulane University in New Orleans, Louisiana. His current research interests include sociological methodology and deviance among homeless and runaway adolescents. Kimberly A. Tyler, Ph.D., is an assistant professor in sociology at the University of Nebraska-Lincoln. Her research interests include sexual risk taking behaviors, sexual abuse, and sexual victimization among homeless and runaway adolescents. Les B. Whitbeck is professor of sociology at the University of Nebraska-Lincoln. His research focus is adolescent risk and resilience. He is conducting a longitudinal study of homelessness and runaway adolescents. Dan R. Hoyt is a professor of sociology and head of the Bureau of Social Research at the University of NebraskaLincoln. His current research focuses on risk, deviance, and mental health among high risk populations. 2 Ch e n, Ty l e r , Wh i T b e C k, & hoy T i n Jo u r n a l o f Dr u g I s s u e s 34 (2004) of drug use among homeless and runaway adolescents have been found to be substantially higher (Windle, 1989; Yates, Mackenzie, Pennbridge, & Cohen, 1988). For example, Stiffman, Earls, Powell, and Robins (1987) reported the rate of drug use among homeless groups to be five times higher than their home-based peers (Stiffman et al.) High rates of early childhood sexual abuse have also been found among homeless and runaway adolescents (McCormack, Janus, & Burgess, 1986; Silbert & Pines, 1981; Tyler, Hoyt, Whitbeck, & Cauce, 2001). Sexual abuse has been widely considered in the etiology of illicit drug use among both the general population and among homeless and runaway adolescents (Finkelhor, Hotaling, Lewis, & Smith, 1990; Rotheram-Borus et al., 1992; Widom & Ames, 1994). Compared with other coping strategies, self-medication through illicit drug use may be more immediately effective and available to address the negative emotional effects associated with sexual abuse histories (Rutter, 1989). Although it has been established that homeless and runaway adolescents who have experienced sexual abuse have high rates of drug use, less is known about the indirect effects and their influence on drug use. In other words, does sexual abuse directly affect drug use or are the effects indirect through other street variables? The current study investigates the negative developmental effects of early sexual abuse on adolescent drug use, via running away, risky sexual activity, deviant subsistence strategies, and affiliation with deviant peers among 361 female homeless and runaway adolescents in the Midwest. Since the rate of sexual abuse is approximately two to three times higher among females compared to males (Finkelhor, 1993; McCormack et al.; Sedlak & Broadhurst, 1996), females are the focus of this study. Childhood Sexual Abuse and Drug Use Research has shown that a large number of children, especially girls, suffer from sexual abuse each year (Finkelhor, 1984; Finkelhor, 1993; Finkelhor & Browne, 1988; Finkelhor et al., 1990). For example, Finkelhor (1993) estimated that about 25% of girls and 10% of boys suffer victimization before age 18 years. These estimates, however, vary from study to study depending on the definition of sexual abuse and the sampling methods used by researchers. The most recent research shows a range from 20% (Fleming, Mullen, & Bammer, 1997) to 60% (Peters, 1988). Numerous clinical studies have found a positive association between childhood sexual abuse and substance use (Burgess & Holmstrom, 1979; Rohsenow, Corbett, & Devine, 1988; Straus, 1979). For example, Singer, Petchers and Hussey (1989) found that adolescents with a sexual abuse history were more likely to use cocaine, stimulants, and other drugs regularly than the matched group without a sexual abuse history. In a longitudinal Dru g us e a m o n g Fe m a l e ho m e l e s s aD o l e s C e n T s 3 study of juvenile detainees, Dembo et al. (1992) found early sexual victimization predicted use of marijuana/hashish. Whitmire and Harlow (1996) also found a positive association between child sexual abuse and hard drug use among college students. Large community sample surveys also provide additional evidence in support of this relationship (Burnam et al., 1988; Finkelhor et al, 1990; Kilpatrick, Edmunds, & Seymour, 1992; Stein, Golding, Siegei, Burnham, & Sorenson, 1988; Winfield, George, Swartz, & Blazer, 1990). Adolescents with histories of sexual abuse were more likely to be multiple substance users (Harrison, Fulkerson, & Beebe, 1997). In addition, similar to the general population, females with a history of childhood sexual abuse were also at higher risk of substance use and abuse (Browne & Finkelhor, 1986). Runaway and Homeless Youth It has been well documented that the rates of childhood sexual abuse are much higher among runaway and homeless adolescents (Janus, Burgess, & McCormack, 1987; McCormack et al., 1986). Compared with their home-based peers, homeless and runaway adolescents are more likely to come from dysfunctional families, for example, families characterized by physical abuse, sexual exploitation, neglect, and abandonment (Bucy & Obolensky, 1990). Jencks (1994) found that 70% of homeless adolescents were physically or sexually abused while they were at home. Considering the high rates of sexual abuse, it is no surprise that many runaway adolescents rank sexual abuse as one of the most important reasons for running away (Fleming, 1991; Garbarino, Schellenbach, & Sebes, 1987). Similar to the general adolescent population, female runaway and homeless adolescents reported higher rates of childhood sexual abuse compared to their male counterparts (Finkelhor, 1993). For example, McCormack et al. (1986) showed that 73% of female homeless and runaways suffered sexual abuse, while 38% of males were sexually abused while at home. High rates of substance abuse, especially drag and alcohol use, have been found among homeless and runaway youth (Hagan & McCarthy, 1997; Whitbeck & Hoyt, 1999). Kipke and colleagues found that 71% of homeless adolescents in Southern California met DSM-III criteria for substance abuse (Kipke, Simon, Montgomery, Unger, & Iverson, 1997). Other studies also reported elevated levels of alcohol and drug use among runaway and homeless adolescents (Koopman et al., 1994). Compared with their home-based peers, drug and alcohol use was considerably higher among the homeless and runaway adolescent population (Stiffman et al., 1987; Windle, 1989; Yates et al., 1988). For example, Stiffman and colleagues (1987) reported the rate of drug use among homeless groups was five times higher than their home-based peers. 4 Ch e n, Ty l e r , Wh i T b e C k, & hoy T i n Jo u r n a l o f Dr u g I s s u e s 34 (2004)