Alcohol and Drug Use Among Gang Members

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be much higher among gang members than non-gang .... witnessed drug deals in their neighborhood. ... reports of group fighting by self or peers or witnessing.
RESEARCH ARTICLE

Alcohol and Drug Use Among Gang Members: Experiences of Adolescents Who Attend School

MONICA H. SWAHN, PhDa ROBERT M. BOSSARTE, PhDb BETHANY WEST, MPHc VOLKAN TOPALLI, PhDd

ABSTRACT BACKGROUND: Problems related to gangs have been noted in large cities and in many schools across the United States. This study examined the patterns of alcohol, drug use, and related exposures among male and female high school students who were gang members. METHODS: Analyses were based on the Youth Violence Survey, conducted in 2004, and administered to over 80% of eligible public school students in grades 7, 9, 11, and 12 (N = 4131) in a high-risk, urban school district. The self-administered survey, completed during a class period, included measures of alcohol and drug use and related exposures. Tests of associations were determined using chi-square tests and logistic regression analyses. RESULTS: In this study, 8.8% of students reported gang membership. Students who initiated alcohol use prior to age 13 (OR = 4.90; 95% CI: 3.65-6.58), who drank alcohol 3 or more times per week (OR = 9.57; 95% CI: 6.09-15.03) and who used drugs 3 or more times per week (OR = 6.51; 95% CI: 4.59-9.25) were more likely to report gang membership than students who did not report alcohol or drug use. Boys were more likely than girls to report alcohol-related fighting and drug selling. DISCUSSION: Gang members were significantly more likely than non-gang members to have initiated alcohol early, to have reported a high prevalence of alcohol use, to have engaged in alcohol-related physical fighting, peer drinking, drug use, drug selling, peer drug selling, and having seen drug deals in their neighborhood. Schools may serve as a critically important source for intervention and prevention efforts for gang members, especially those in 7th grade, who still attend school. Keywords: alcohol; drugs; drug use; gangs; gang members. Citation: Swahn MH, Bossarte RM, West B, Topalli V. Alcohol and drug use among gang members: experiences of adolescents who attend school. J Sch Health. 2010; 80: 353-360. Received on March 25, 2009 Accepted on November 3, 2009

a

Associate Professor, ([email protected]), Institute of Public Health, Georgia State University, Atlanta, GA 30302-3995. Assistant Professor, (Robert [email protected]), Department of Psychiatry, University of Rochester, 300 Crittenden. c Graduate Research Assistant, ([email protected]), Institute of Public Health, Georgia State University, Atlanta, GA 30302-3995. dAssociate Professor, ([email protected]), Department of Criminal Justice, Georgia State University, Atlanta, GA 30302-3995. b

Address correspondence to: Monica H. Swahn, Associate Professor, ([email protected]), Georgia State University, Atlanta, GA 30302-3995.

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© 2010, American School Health Association • 353

T

here has been a proliferation of gangs across the United States1-3 and problems related to gangs have been noted primarily in large cities4 and in many schools.5,6 However, relatively few studies have been conducted to better understand gang membership and its associated alcohol and drug use patterns and exposures among youth who are still attending school. It is well known that gang membership is strongly linked to frequent and serious delinquent and violent behaviors as well as involvement in illegal drug trade.7-19 Research on drug sales and violence, in particular, has been a central focus of gang research so far.20 Much less attention has been given to the issue of alcohol and drug use within gangs.14,16 Recent epidemiological data on the prevalence and patterns of alcohol and drug use and exposures among gang members who attend school is relatively scarce, but suggest that these are critically important concerns for schools. Findings from the longitudinal Seattle Social Development Project (SSDP) show that participants who were gang members had a much higher prevalence, compared to non-gang members, of binge drinking (43% vs 24%), marijuana use (54% vs 26%), and drug selling (51% vs 9%).13 Moreover, early alcohol use and early marijuana use are both identified risk factors for joining a gang among adolescents.12,13 In addition, research shows that gang members report an increase in frequency of drug use when they join a gang, indicating that a high level of drug use is specifically associated with gang affiliation.10 Although the use of hard drugs such as heroin and cocaine is an important public health problem among youth in the United States, the prevalence of hard drug use among students who attend school remains relatively low.21 In contrast, youth who identify as gang members appear to be at particularly high risk of use and exposure to hard drugs primarily because they are often involved in the illegal drug market through the trade of drugs in communities.8,15,19 In addition to illegal drug use, alcohol is also of concern among gang members. Alcohol remains the most commonly used drug among youth in the United States,21 and many studies have documented the adverse health consequences associated with its early use.22-26 Studies on alcohol use patterns specifically among gang members are scarce.14 However, the prevalence of binge drinking appears to be much higher among gang members than non-gang members13 and it is likely that certain contexts for drinking may be unique to gang members and their specific subculture.14 In particular, alcohol use is common during a range of social situations that gang members report (eg, gang initiation, group parties, funerals, and after physical fighting)14 which is consistent with research on co-offending and group criminality.27 A great deal of what we know about gang members is based on a number of relatively small studies, many of which are conducted in focus group formats, or that 354 •

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are based on informal interviews with convenience samples. Because gang membership is relatively rare within the overall population, studies of representative populations have been scarce, with even less focus given to gang members who are girls14,28,29 or of issues related to gender and gang membership.30 This study examines the associations between gang membership and patterns of alcohol and drug use and related exposures among youth (both boys and girls) who attend school in an urban, disadvantaged community. Findings from this relatively large epidemiological study can guide the development of gender-specific interventions to address heavy alcohol and drug use among students in urban, disadvantaged communities.

METHODS Subjects The ‘‘Youth Violence Survey: Linkages among Different Forms of Violence’’ was administered to all public school students enrolled in grades 7, 9, 11, and 12 in a school district in a high-risk community in the United States in 2004. The details of the study have been described elsewhere.26,31 The school district was identified and selected using community indicators of risk (ie, poverty, unemployment, single parent households, and serious crimes) was racially and ethnically diverse, and located in a city with a population of less than 250,000. This district operated 16 schools (elementary, middle, high schools, alternative schools) which all agreed to participate in the study. Within these 16 schools, all students in grades 7, 9, 11, and 12 were invited to participate. Because of the high dropout rate, students in grades 11 and 12 were grouped to produce a sufficient number of participants in the oldest of the 3 age groups. Data collection occurred in April 2004. Students voluntarily completed the anonymous, self-administered 174-item questionnaire in classrooms during a 40minute class period. Students without parental permission or who did not want to participate in the study were assigned individual deskwork (by the classroom teacher) which they completed at their desks or at an alternate location designated by the school during the survey administration. The questionnaire, an optically scannable booklet in multiple-choice format, was administered by field staff highly experienced in school-based survey data collection. All Englishspeaking students in the targeted grades were invited to participate in the study. However, students who could not complete the questionnaire independently (eg, enrolled in a special education class, required the assistance of a translator, had cognitive disabilities that would prevent adequate understanding and responding to the survey) (n = 151), or who were no longer attending school (eg, had dropped out of school, had been expelled, or were on long-term out-of-school

© 2010, American School Health Association

suspension) (n = 202), were ineligible to participate in the study. Procedure Prior to data collection, active, signed, written parental permission, and student assent were required for all students under 18 years of age to participate in the study. Students who were 18 years of age or older provided written consent prior to participating in the survey. Parental permission forms were provided in English, Spanish, and other major languages as requested by the schools. Students received a $5 gift card for returning the parental permission form regardless of whether the parent approved or denied the student’s participation in the survey. Students who completed the survey received an additional $5 gift card. The parental permission form returned by the invited students was high (14% of students did not return the form), and parent and student refusals were very low (approximately 1% each). Of the 5098 students who met eligibility criteria, 4131 participated, yielding a participation rate of 81%: 1491 in 7th grade (83.0%), 1117 in 9th grade (73.4%), and 1523 in 11th and 12th grades combined (79.0%). Instruments Gang Membership. All participants were asked how they felt about joining a gang. Response options were ‘‘I don’t want to join a gang’’; ‘‘I would like to join a gang’’; ‘‘I am in a gang now’’; ‘‘I am in a gang now, but would like to get out of it’’; ‘‘I was in a gang, but I got out of it.’’ A dichotomous measure was created to indicate current and former gang membership versus no gang membership. Participants were also asked how often they took part in group fighting, how many of their friends have fought as part of a group against another group, and how many times they have witnessed drug deals in their neighborhood. These measures were used to validate gang membership. Alcohol and Drug Use and Exposures. Participants were asked about their age of alcohol initiation (how old they were when they had their first drink of alcohol) and responses were dichotomized to indicate alcohol initiation before or at age 13 or later. The frequency of alcohol use was measured by a single question asking how many days in the past 12 months they had had at least 1 drink of alcohol, and heavy episodic drinking was measured by a question asking how many days they drank 5 or more drinks in a row during that same time period. They were also asked how many times they got into a physical fight because they had been drinking. Due to the low prevalence and the skewed nature of the data, responses were dichotomized to indicate any alcohol-related physical fighting versus none. Participants were also asked how many of their close friends drank alcohol in Journal of School Health •

the past 12 months. Response options were grouped to indicate most or all of the friends versus some or none. Participants were asked how many days in the past 12 months they used drugs, inhalants (glue or solvents) or illegal drugs such as marijuana, cocaine, or heroin, and how often they sold marijuana or other drugs, which were all coded as dichotomous variables to indicate any versus none for each of those experiences. They were also asked how many of their close friends sold marijuana or other drugs. Response options were grouped to indicate most or all of their friends sold drugs versus some or none of their friends. They were also asked how many times they had witnessed drug deals in their neighborhood and the responses were coded to indicate any versus none. Data Analysis Students who reported that they were present or former gang members were compared with students who reported no gang membership on demographic characteristics (ie, gender, race/ethnicity, and grade), fighting as part of a group, peer involvement in group fights, and having seen gangs in the neighborhood. Chi-square tests were used to determine the statistical associations between demographic characteristics and reports of group fighting by self or peers or witnessing gang activity in the neighborhood as well as the alcohol and drug use measures. Chi-square tests were also used to determine any associations between gender and the alcohol and drug use measures. Finally, logistic regression analyses for the entire sample, as well as stratified by gender and adjusted for grade and race/ethnicity, were computed, to determine the associations between the alcohol and drug use variables and gang membership.

RESULTS In this study, 8.8% of students (5.6% of girls and 12.3% of boys) reported present or former gang membership. Gang and nonmembers differed significantly with respect to gender, grade level, race, and ethnicity (Table 1). Gang membership was most common among students in 7th grade and among students who were Hispanic. Gang and nonmembers also differed significantly in terms of frequency of group fighting, the numbers of friends that group fight, and how often they have seen gangs in the neighborhood. Gang members reported significantly higher prevalence for all of these factors. With respect to alcohol and drug use, gang members initiated alcohol earlier than non-gang members and also had higher prevalence of alcohol use, alcoholrelated physical fighting, peer drinking, drug use, drug selling, peer drug selling, and having seen drug deals in

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Table 1. Comparisons of the Characteristics of Gang Members and Non-Gang Members Current or Former Gang Members (n = 359)

Total Sample (N = 4131)

Gender Boys Girls Missing Race/ethnicity Hispanic Non-Hispanic African American Non-Hispanic White Non-Hispanic Other Missing Grade 7th 9th 11/12th Missing Group fighting Never 1-2 times 3 or more times Number of friends that group fight None Few Most or all Seen gangs in neighborhood Never Few times Many times

Not Gang Members (n = 3725)

N

%

N

%

N

%

1982 2127 0022

48.2 51.8

240 117 067

67.2 32.8

1991 1716

46.3 53.7

1809 1119

44.9 27.8

169 122

48.0 34.7

1616 0987

40.5 24.8

0907 0193 0103

22.5 04.8

044 017 144

12.5 04.8

858 174

21.5 04.4

1484 1114 1515 0018

36.1 27.1 36.8

155 113 090 064

43.3 31.6 25.1

1299 0993 1417

35.0 26.8 38.2

2907 0684 0403

72.8 17.1 10.1

080 094 171

23.2 27.3 49.6

2809 587 224

77.6 16.2 06.2

2792 0802 0358

70.6 20.3 09.1

093 110 139

27.2 32.2 40.6

2685 0681 0215

75.0 19.0 06.0

1969 1094 0924

49.4 27.4 23.2

054 091 202

15.6 26.2 58.2

1902 0993 0714

52.7 27.5 19.8

p-Value∗