The association of self-reported neighborhood disorganization and social capital with adolescent alcohol and drug use, dependence, and access to treatment.

ABSTRACT

AIMS: This research examines adolescent perceptions of neighborhood disorganization and social capital to determine if they are associated with adolescent alcohol or drug (AOD) use, AOD dependence, and access to AOD treatment. DESIGN: This is a secondary analysis of data from the 1999 and 2000 National Survey on Drug Use and Health (NSDUH). The NSDUH is a cross-sectional survey of a random sample of the non-institutionalized United States population and is conducted in respondents' homes. PARTICIPANTS: Youth between the ages of 12 and 17, yielding a sample size of 38,115 respondents. MEASUREMENTS Neighborhood disorganization was self-reported by youth in response to eight items; 10 items measured social capital. AOD use was also self-reported. AOD dependence was assessed by a series of questions regarding symptoms and impairment that is consistent with the criteria specified in the DSM-IV. RESULTS: A little more than half of the youth reported never using alcohol or drugs (54.3%), 41.1% reported lifetime AOD use, and 4.6% were AOD dependent. Two percent reported receiving AOD treatment. Medium and high levels of social capital were negatively associated with AOD use and dependence. Social capital was unrelated to access to AOD treatment. Neighborhood disorganization was positively associated with AOD use, dependence, and access to treatment. CONCLUSIONS: After controlling for individual- and family-level characteristics, neighborhood disorganization and social capital were associated with AOD use and dependence. The findings suggest that subjective measures of social context may be an important component of the complex biopsychosocial model of adolescent AOD addiction and treatment utilization.