Social Factors That Influence Teenage Drug Use
A Research Proposal

By:
Kathleen Reynolds

Introduction
The proposed study seeks to examine the social factors that influence teen drug use. Drug use is a problem that affects many adolescents in the United States. The basic questions this study will try to answer are: What explains drug use among teenagers? What drugs are teenagers more likely to use? How are teenagers accessing drugs? And ultimately, what are the social factors that influence teen drug use? This study involves three basic purposes of social research. These are: exploratory, descriptive, and explanatory purposes. The study will explore the body of knowledge that has been produced on the determination of drug use among adolescents. The study will describe the basic characteristics of teen drug users such as the drug of choice, the frequency of use, the sources for the drug, and the financial disposition to acquire the drugs.

The study will also describe some well known factors like peer group, type of parenting style they experience and others. The study will explain three of the social factors that influence teenage drug use. This study is worth considering because many elements in the social environment have a vast influence on individuals of all ages in society. Society has expectations as to how people should act, what people should look like, etc. The social pressures teenagers experience are endless. These social forces can influence individuals positively or negatively. Secondly, teenagers are constantly attempting to prove something to somebody, and typically will do anything to successfully do so. Whether it is to friends, parents, family, and/or teachers, teenagers are going through their experimental years, they test boundaries, and going through puberty. The teen years are and will always be some of the hardest yet memorable times for individuals. However, what adolescents face can ultimately lead them to one of two paths for the rest of their lives.

One path is a robust development of self and the other is a poor image of themselves. Becoming a teenager is hard, yet sets the foundation for an individual’s social life. No matter the upbringing, each teen is able to make decisions for themselves and direct the path they chose to follow. Research will be vital for teaching young adults the reality of social pressures, drugs, and to maintain true to themselves, can make a difference in lives. By performing a study on social factors that influence teen drug use opens a window of possibilities for something that may improve the quality of life, especially for teens. Teenagers are caught up in experiences and emotions. Not only do their bodies put them through a series of changes these are the years that are very influential in the rest f their lives. This study will bring awareness to a problem that has such impact on an individual such as the habitual use of drugs. Social factors that influence teen drug use are certainly not being brought to the attention to enough and/or the correct people to make a difference and ultimately to decrease the rates of teenage drug use as well as social factors. By making this topic more of a priority as well as spreading awareness, will come the hopes of less teens allowing social influences to take control of their lives, and ultimately, save the lives of many. By spreading the knowledge of the topic may make a difference for many.

There are ways in which society can spread the awareness about the social factors that influence teen drug use. An effective way to spread concerns is through the National Institute on Drug abuse which is located in Bethesda, Maryland. This institution focuses on science to control alcohol abuse and addiction, NIDA does so by two strategies: by a strong support of disciplining broadly, and secondly, reassuring the help and rehabilitation of clients through treatments as well as programs. The research through this proposal can certainly benefit many agencies; by focusing on the three reasons previously stated, society, pressures and futures, research allows in depth and to the point reasoning with facts and analysis, facing the teenager’s problems, and finding solutions for how social factors influence teen drug use. By reaching out to agencies about this topic would help tremendously in spreading awareness and knowledge about this topic and ultimately help and save the lives of many. There are some elements or concepts of this study that need to be clarifies or defined.

The term social forces are defined as social events or circumstances that produce a reaction of individuals or groups of individuals. Some examples forces could include are, religious norms, economic changes, family dynamics, political decisions, and others. By definition, teenagers are both males and females ranging in ages from thirteen to nineteen years of age. The term drug use can be defined as the consumption of legal and illegal drugs or prescription medication. Family background is the systematic narrative and research of past events relating to a specific family, or specific families. Peer group is defined as a group of people, usually of similar age, background, and social status, with whom a person associates and who are likely to influence the person’s beliefs and behavior. Delinquency is failure to do what law or duty requires. Together, these components seek to find out the influence on teenage drug use.

Two theories that can be used to analyze the relationship between social factors and teenage drug use include differential association theory as well as labeling theory. Sutherland’s differential association theory states that people are exposed to structural conditions that account for deviance which explains why behavior is learned through interaction with others through communication including, verbal, nonverbal, direct, and indirect. This theory also believes that behavior occurs within an individual’s primary groups which consist of family, friends, and peers. This theory digs to the root in reasoning the behaviors of teenagers; the expectations among society allow social forces to influence individuals, as well as the pressures teenagers encounter in their everyday lives. This is very relevant in the study of social factors that influence teen drug use because as human beings learn from experience every day.

Labeling theory states that people become deviant when considerable members of society label them as deviant and the individual believes those labels as a personal identity. This notion explains that deviance is created by social groups such as: place, time, generation, religion, race, ethnicity, socioeconomic status, etc. Society’s reaction determines what behaviors are considered criminal and which are not. This theory argues that once young people have been labeled as a criminal, they are more likely to offend due to the individual accepting the role, and become more likely to associate themselves with others who have also been labeled. Labeling theory assumes that youths from poor families are more likely to be labeled as deviant which explains why there are more lower-class offenders.

The differential association theory seems to work best for this study because so much of what we learn as adolescents is through social experiences. The specific direction of motives and drives is learned through attitudes towards favorable and unfavorable social factors. Family, and peer relationships are important for teenage drug use because both are primary groups where attitudes and behaviors are specifically learned. It is in these intimate relationships that people are taught, through imitation and reinforcement, attitudes that are favorable or unfavorable to drug use.

According to Sutherland’s theory, learning takes place according to the frequency, duration, intensity, and priority of social interactions. Adolescents are likely to acquire attitudes in favor of drug use if they often associate themselves with others who use drugs as well as attain the same attitude for drug use. Teenagers are more likely to listen to and give priority to people who they admire and look up to. Although peer interactions have extremely strong influences on an individual since they are often frequent, intense, and given high priority by youths, families also are likely to be important influences on the learning of drug use attitudes and behavior.

Symbolic interaction paradigm is a theory that human interaction and communication is facilitated by words, gestures, and other symbols that have acquired conventionalized meanings. Like the differential association theory, the symbolic interaction paradigm is how humans act toward people and things based upon behavior learned in their life experiences. Each individual has a different way of handling things in different situations. That is why social factors that influence teenagers to use drugs are so different from one to the other. There are many key factors that contribute to someone believing or acting the way they do. As adolescents become adults, they have by now developed a core set of beliefs that have been shaped by their life experiences. One can only speculate as to what social factors influence teenagers to experiment in drug use. While the symbolic interaction paradigm may seem to lack well developed concepts, logical models, or theoretical accuracy, it makes up for this by studying social interaction of actual people in the social world.

The factors that influence teenagers to abuse drugs are often measured in terms of physical, psychological, behavioral, and societal influences; however, it is impossible to separate them completely. Physical influences, such as society’s pressures to look a certain way can have a great influence on teenagers experimenting with drugs. For example, teenagers may abuse cocaine for the fact that cocaine suppresses an individual’s appetite and eats away at muscle and eventually will eat away at fat. Teenage years can put much stress on an individual, especially psychologically. Adolescents are constantly under pressure from society, school, and intimate groups. Teenagers feel as if they constantly have to prove something to someone, and that can weigh a person down psychologically which can easily influence them to experiment in drugs, simply to keep their minds off of the stressors in their daily lives. Behavioral influences can be determined by the individual’s actions in which they are perusing. Teenagers tend to fall into the ‘wrong crowds’ for reasons such as: to fit in and to rebel; for the actions of individuals expresses who they are, or who they are attempting to become.

Societal influences may go along with each of the previous influences for society has its own judgments and expectations for each individual and/or group of individuals. Adolescences have different levels of resiliency or hardiness and different personality attributes, so different teens respond differently with social factors that influence drug use. Each individual will have to be closely examined which is tough because not all the subjects are in similar life situations as the rest. Also, when asked about drug use, teenagers will give socially acceptable answers rather than being completely forthright. Due to the fear of getting caught and in trouble, adolescence’s have a tough time being honest when asked about drug use which only makes it difficult for teaching health care providers how to better assess teen drug use. It is also believed the behavior of the teens in the study is consistent with that of most of their peers. While anonymous surveys can increase reports of socially unacceptable behavior, those same reports may be inaccurate because when taking the surveys, adolescence’s do not have to be held responsible for their answers and may not have any motivation to tell the truth. Review of the Literature

Saint-Jean, Gilbert, Carlos A. Martinez and Lee A. Crandall. 2008. “Psychosocial mediators of the impact of acculturation on adolescent substance abuse.” Journal of Immigrant and Minority Health 10(2):187-195. This study is based on the following goals: first to connect and assess differences in substance abuse frequency and socio-psychological factors between Florida youth who are cultured and non-cultured; secondly, to compare the relationship between Florida adolescents’ language spoken at home as an alternative of acculturation and drug use. The main methodology used in this study consisted of quantitative survey the Florida Youth Substance Abuse Survey (FYSAS) was used in a two-stage cluster design. 580 schools were randomly selected in the first stage, and a class within each school was selected in the second stage.

The sample is of approximately 60, 345 students from grades 6-12, ages 10-18. The survey questionnaire included 9 socio-demographic categories which resulted in more than half being between the ages 12-14 years old, 42% 15-17 years old, and only 6% being 18 years old. 60% of participants were Caucasian, 15% African American, 15% Hispanics, with 47% males and 53% females. 60% of participants were living in a two-parent household, and 72% living in urban conditions. Measures used to collect data to compare the 32 R/P factors of dependent and independent variables were based off of T-tests that were used to compare the effects of outcome variables constructed into 6 logistic models evaluating the independent effect of the R/P variables connection with the dependant and the independent variables including communities becoming aware of ethnic groups’ acculturation into the US society and the higher risk of drug use. Dependent, independent, and demographic variables along with only one of the four R/P fields were also models within the six logistic models.

Psychosocial R/P factors tested were those of a community, family, school, and individual/peer. Lastly, the information from the R/P factors were entered in one large model all that were associated with Florida ethnic youth and drug use. Within the past 30 days, 17% of the participants reported using at least one illegal drug. Almost every age is lower for the participants who do not speak English at home in comparison to those to do speak English at home. Participants who speak English at home were 22% less likely to use drugs in a time span of the past 3 months. The main analytical tool of this study consisted of covariates and logistic models. The results support the hypotheses in that acculturation is in fact a big influence on adolescent substance use as well as family predictors are the strongest factors among substance use. As research shows, adolescents who speak English at home are more likely to be engaged within families who show proof in delinquent behavior, to link with peers who deviate, and live in high risk for drug use within communities. Family domain showed the most influence between language used within the home and illegal substance use. English speaking homes resulted in 20% higher than homes that speak another language.

Peer/Individual domain followed resulting in 32% of immigrant adolescents became more acculturated with U.S society. Lastly, although the community factor does not show any sort of considerable outcomes, it concludes that students who attain social skills were almost twice as high for adolescents who claimed they have had no drug use within the past 30 days, as compared to adolescents who do not have as strong social skills. The analysis is a practical way to evaluate teenagers and the important findings helping understand influences tool in improving the understanding of influences leading to delinquent behaviors and illicit drug use. Tebes, Jacob K., Richard Feinn, Jeffrey J. Vanderploeg, Matthew J. Chinman, Jane Shepard, Tamika Brabham, Maegan Genovese and Christian Connell. 2007. “Impact of a Positive Youth Development Program in Urban After-School Settings on the Prevention of Adolescent Substance Use.” Journal of Adolescent Health 41(3):239-247.

This study examines techniques used through a program known as, the Positive Youth Development Collaborative (PYDC). This study aims to enhance after-school programs by providing an opportunity to apply PYD techniques such as evidence-based practice. PYD is aimed primarily at minority adolescents from urban areas who are at high risk for drug abuse, focusing much on their behaviors and attitudes. It also seeks to examine if adolescent drug use in urban locations can be prevented by after-school programs.

The main methodology of this study consists of evaluation research using participants divided into control and intervention groups. Participants were adolescents in after-school programs where consent letters were sent home to the parents which was then followed up by a phone call from the parent to make sure the parents understood information and that agreement was acquired from the adolescents. The full sample contains 304 adolescents, 53% male, average age being 14 years old. The racial breakdown of the full sample is: 75.5% African American, 19.7% Hispanic, 3.9% Caucasian, and less than 1% American Indian/Asian. 149 (91%) in the intervention group and 155(88%) in the control group.; in the intervention group, adolescents were required in one of five after-school programs, two middle schools and three high schools.

The comparison group, adolescents were required in four programs, in middle school and high school; both groups were required for an entire school year (September through June). Procedures consisted of sending out a letter of consent to the home of the participants and parents, a phone call to the parents following-up the consent letter and its understandings, once the consent was confirmed by the parent, it then needed to be done by the participant as well. Four steps were required: a pretest interview soon after joining the program, curriculum delivery pretest which took place in October and November; a post test after completing the program which took place in June and July, and lastly, a follow up 1 year after the pretest interview, which took place in October and November. All of which contained a substance use, attitudes and behavior evaluations. Interviews took place in after school in private places, taking about 30-45 minutes, and each adolescent got awarded a gift card to the mall worth $40. Measures of this study incorporated a variety of evaluations done in interview form on the adolescents.

First, demographic was evaluated which consisted of characteristics such as the adolescent’s, age, gender, race/ethnicity, grade level in school, living conditions, the number of times the individual’s family had moved within a time-frame of the past year, and through the Center for Substance Abuse and Prevention, using a assessment of the adolescent’s parent education level. Secondly, 2 types of attitudes on substance use were evaluated, risk of harm and beliefs of drugs, both taken from a student survey from CSAP. The scale for Risk of Harm was made up of a five-item assessment with each of the items determined the risk of harm for each of the following substances: marijuana, alcohol, and tobacco. This was done by a four-point Likert scale ranging responses from “no risk” to “great risk.” Beliefs on drugs was made up of a four-item assessment with each of the items determined using a four-item assessment by also using the Likert scale ranging responses from “not wrong at all” to “very wrong” Lastly, an assessment on substance use categorized into alcohol, tobacco, marijuana, other drugs, and any drug use within the past 30 days.

The main analytical tool of this study consisted of a multi level regression modeling and propensity scores obtained through logistic regression. The study found that once completed the program and up to a year after starting the program, the adolescents provided with PYD intervention were much more likely to attain a negative viewpoint on drugs viewing them as being dangerous and unsafe as well as maintaining much lower use with the substances such as that of, alcohol, tobacco, marijuana, other drug use, and any drug use. The authors of this study conclude that intervention using PYD including evidence-based practices in after-school settings within urban areas was shown to be much more successful in preventing teenage drug use.

Harris, Katherine M., Beth A. Griffin, Daniel F. McCaffrey and Andrew R. Morral. 2008. “Inconsistencies in self-reported drug use by adolescents in substance abuse treatment: Implications for outcome and performance measurements.” Journal of substance abuse treatment 34(3):347-355.

This study seeks to evaluate possible influences on the outcomes and other factors of adolescents’ reporting their recent substance use. These self-reports of substance use are relied upon by the SAMHSA in order to accurately measure the individuals performances in the treatment programs, particularly from admission to the follow up after discharge. This study also examines if the adolescents’ inaccurate reports affects the treatment outcomes as well as the individuals’ success when in the programs. The main methodology of this study consists of a Longitudinal Survey. The sample for this study was extracted from a cohort of 1,463 clients ranging from the ages of 18 and younger, from 10 treatment programs, including a variety of 4 types of treatment, who were chosen by SAMHSA’s Center for Substance Abuse Treatment to partake in an Adolescent Treatment Model (ATM); data was collected between 1998-2001.

Participants were followed for a period of 1 year along with 3 assessments: baseline, 6 month follow-up, and 12 month follow-up, each performed by the Global Appraisal of Individual Needs (GAIN) which is an evaluation of information on 8 domains which include that of: mental health, physical health, background, risk behaviors, substance use, and factors including, legal, employment, and environmental. The data of this study comes from the dependent variable is the outcomes, and the independent variable consisted of the number of inconsistent reported substances. First, each assessment was measured based on the client’s recent use of 12 substances set up into 4 categories, “0-3 months,” “4-12 months,” “1 year or longer,” and “never.” If a response between the 6 and 12 month was inconsistent, it received a value of 1. Using the inconsistent indicators, the authors then would range from “0-12” for how many times the client gave inconsistent responses. Next, this study used this measure to research the number of past inconsistent reports was associated with the client’s baseline characteristics by 4 domains which consisted of: common demographic characteristic, the adolescents’ mental and physical health, involvement in the criminal justice system, and involvement with substance use.

Lastly, studies of associations between inconsistency in “recent substance use report and 5 treatment outcomes each of which was based off of 4 of GAIN’s scales; Substance use was based on a 7-item Substance Frequency Scale by taking the average response within use of the past 90 days. Substance problems were evaluated by a 16-item Substance-Problem Scale (SPS) taking the average symptoms of substance use within the past 30 days. Illegal behavior was collected using a 3-item Illegal Activities Scale (IAS), which collects the average illegal activities within the past 90 days through a range of 0-1. Emotional problems were assessed through a 7-item Emotional Problem Scale (EPS), this scale also ranged from 0-1, evaluating frequency and severity of any psychological sufferings. Time in a controlled environment was assessed using the MAXCE variable which was evaluated based off of any environment they were forced to attend keeping them away from abusing drugs and/or being on the streets, for example, jail treatment centers, etc. within the past 90 days. The study is based on the coefficient of a linear regression model for statistical analysis. The 3 types of analyses are used to explain the inconsistencies when reporting substance use and the influences on the outcomes of each dimension.

This study resulted in approximately 77% of the adolescents reported responses that were inconsistent for 1 of the 12 substances with rates being the lowest for alcohol at 7.45%, marijuana at 5.67%, and heroin at 8.75% with rates being twice as high for other inconsistencies for other substances. African-American’s recorded substances inconsistency reported to less than half in comparison than Caucasians and Hispanics a little less than Whites. Clients who had run away from home and/or were homeless reported higher rates of inconsistency along with clients who had mental illness and clients who first used substances at a age younger than 15 years old. Inaccurate reports show to be much related to the adolescents who have experienced much substance use with little treatment, have high mental stressors, and lack strong living conditions. The study assumes that adolescents who engage themselves in substance use more frequently are more likely to have inaccurate reporting; although due to lack of empirical studies, the authors made it clear that there are many influences as to why inaccurate reports measures up to denial of drug use.

Finally, it was common for clients in the ATM sample to obtain inconsistent reports if recent use of substances. The author’s findings state that inconsistencies in recent reports of substance abuse do not happen randomly among the adolescents or treatment programs; rather, inconsistencies are in relation with factors that influence treatment outcomes, including socio-demographic and social factors. Adolescents who showed a greater number of inaccurate reports also report having more improvement with the outcomes of their treatment. Findings also show that improvement on measures of treatment outcomes share a positive relationship between both inconsistent substance use reports and self-report. This study proved that there needs to be greater awareness on substance use reports with adolescents and that inaccurate report can greatly affect the outcome and performance in treatment. Silver, Marisa M., Golfo Tzilos, and Deborah Yurgelun-Todd, A. 2008. “Relationship between white matter volume and cognitive performance during adolescence: effects of age, sex, and risk for drug use.” The Authors Journal compilation: Society for the Study of Addiction 103(9):1509-1520. This study aims to determine whether or not history of drug abuse in a family has an impact with cognitive development during adolescent years.

This study examines the relationship between cognitive performances in adolescents, both males and females who are then split into two groups based on high-risk (FH+) or low-risk (FH-) as well as the brain volume, specifically cerebral tissue (which consists of Grey matter and White matter, also referred to as GM and WM). The study hypotheses the following: H1: A positive relationship would be observed between WM volume and performance on tasks that measure information processing speed/efficiency, whereas a negative relationship was expected between GM volume and performance on these tasks.

H2: FH status would have a significant influence on these relationships. The research is based on an experimental method examination and permitted by the Institution Review Board of McLean Hospital in Belmont, MA. A written consent was required to be filled out by the adolescents as well as their parent/or guardian before participation of this study. Recruitment for this study was by advertising as well as word of mouth. Volunteers consisted of 33 adolescents, 17 females (53%) and 16 males. Ages ranged from 8-18 years old equaling to grades 3-12. About all of the volunteers were from the middle-upper class status. The racial breakdown of this study amounts to 82% Caucasian, 9% African-American and 3% Hispanic along with Asian. Mothers of the adolescents also were involved, being interviewed about Family History (FH+ – FH-) to Epidemiologic (FHE). If the substance abuse from parents and grandparents was positive, the volunteers were considered F+; this came out to be 41% and 59% of the overall subjects.

The main methodology of this study was clinical experimental research approved by the Institution Review Board of McLean Hospital. A series of tests were performed for cognitive performance, brain volume, and correlation between WM and GM volume vs. cognitive processing speed. First, a clinical psychiatric interview was given to the adolescents using the Kiddle-Schedule for Affective Disorders and Schizophrenia (K-SAD-E) in order to rule out any possibility mental disorders according to the Diagnostic and Statistical Manual version IV (DSM-IV). Once volunteers were cleared from those results; a neuropsychological academic and logical test was given to determine their academic and cognitive functioning by using a “Wide Range Achievement Test (WRAT-R) which consists of tests variations of: math, reading, and spelling, a Stroop color-word interference test, and Wechsler Adult Intelligence Scale (WAIS-R) which consists of digit span and symbol subtests.”

Secondly, three magnetic meaning imaging tests were then given to alter images consisting of a high-resolution 3D imagery test. These were done on a “1.5 Tesla GE scanner”. Thirdly, using a computerized semi-automated segmentation, a morphometric analysis of images including a computerized section and an anatomical section to test brain tissue, GM/WM intensities, and cerebrospinal fluid, without any prior knowledge of neurocognitive showing, age, or family history, these tissue volumes were the calculated voxel ratios.

The main analytical tool of this study is based on the coefficient of a linear regression model for statistical analysis. Results showed that cognitive performances among younger females took longer to finish the color test as males the same age did; however, improvement among females showed to be more than males. The word testing did not have much difference between females to F+ males, but not F- males. Females and F+ males showed improvement with age. Concluding that there were some differences with the age/gender factor, but differences in age were not significant enough for effect. Regardless of FH status, males were seen to show 10% more totally brain volume than females. Findings also showed that family history did not have much influence on GM or WM brain volumes, or the brain total. FH+ males and females tested different rates and prototypes of development than males and females of FH-, but overall there was no major statistically differences in brain tissue volumes and cognitive performance between the adolescents of FH+ and FH-. Differences in age in neuropsychological functioning may be a risk factor of adolescents of substance abuse who have yet to try substances.

This study also showed the importance of adolescents becoming aware of the risks in substance abuse at an earlier age and by using drugs at a young age increases the risk of cognitive performances along with brain functioning and development. Reginald, Simmons, Ungemack, Jane, Sussman, Jennifer, Anderson, Robyn, Adorno, Sandra, Aguayo, Jose, Black, Khary, Hodge, Steven, Trinady, Rachel. 2008. “Bringing Adolescents into Substance Abuse Treatment Through Community outreach and Engagement: The Hartford Youth Project.” Journal of Psychoactive Drugs 40(1), 41-54. This study aims to reach out to adolescents within the Hartford, CN to prevent substance abuse. The study is based on the following goals: first, before becoming involved with the criminal justice system, reach awareness out to adolescents in the community, Second, “to increase access and engagement in adolescent substance abuse treatment by bringing together a network of stakeholders in adolescent substance abuse treatment including: referral sources, community-based outreach agencies; treatment providers; and an administrative service organization responsible for project coordination and implementation of management information system.”

The main methodology for this study was the HYP model. HYP gathered qualitative data through a number of groups such as: agency stakeholders, sources of referral, treatment providers, community-based outreach agencies, and services for project coordination. Engagement Specialists (ES) were put through extensive training to master advocacy, community knowledge, supervision, and commitment. The Connecticut Department of Children and Families (DCF) executed the Hartford Youth Project (HYP) as a study targeting adolescents in the Hartford, CN community hoping to reduce substance abuse, and to provide a variety of substance abuse treatment services along with services of aftercare for the adolescents. DFC focused on family support programs and therapies. HYP aimed for participants who were members of the Hartford community varying in the ages from 10-17, with the average being 14 years old and at risk for developing or maintaining a substance abuse disorder; 3 out of 4 participants were males.

339 adolescents completed a baseline test with 209 moving forward receiving the recommended treatment. 190 (91%) of the adolescents were then referred to a clinical treatment program by the HYP. 117 (62%) of the participants were Hispanic, with 73% of them living in a home of a single parent, 63 (63%) were African-American, 60% living in a home of a single parent, and 10 (5) were from another racial group. 36% of participants reported having a substance abuse problem prior to admission, marijuana being the main substance used. 95% Blacks and 86% of Hispanics had a history of involvement in the juvenile justice program.

After the ES received the referrals, they contacted the adolescent along with their guardians, informing them on the services HYP provide as well as receiving approval for the study which is based on regressions for statistical analysis. Global Assessment for Individualized Needs (GAIN-Q) assessments were given within the first contact to the participant to “evaluate possible substance use, health including physical and mental, potential criminal activities, and risk behaviors.” Global Assessment of Individual Needs Interview (GAIN-I) was then used as a baseline test which gave information for treatments and project evaluations. After the recommendations for treatment, service planning meetings were then performed with the participant and guardian to build goals and guidelines for the treatment. Three, six, and twelve month, 3 day post-tests were performed.

The main analytical tool of this study consisted of covariates and the HYP model. Findings of this study are important given the differences in providers and staff, the focus on mainly Latino and African American residents in the Hartford community; along with family-focused treatment’s dedication to the adolescents and their caregivers. Although the HYP project started with 360 referrals and decreased to 190 participants, approximately 48% completion rate for HYP as compared to prior outpatient treatments which had a 30% completion rate. The HYP model showed that a family-focused treatment was shown to be the most effective for adolescents pertaining to families of color dealing with substance abuse.

The authors also concluded that success with the HYP approach was crucially based upon not only the adolescent’s involvement with the program, but also the parents. In order for the E.S staff to be prepared for their work, the staff was mandated for intense training in subjects such as substance abuse, evaluations, treatment models, motivational interviewing, and ties within the community stakeholders. This analysis of distinct mutually exclusive subgroups of adolescents and the examination of promotive factors, although HYP did not have a significant more success rate compared to the rest of the U.S’s treatment programs, the family-focus and motivational treatments makes this study unique and valuable for prevention planning among adolescents and substance use.

Proposed Methodology
For the proposed study, the methodology that would work best is quantitative. By using a quantitative methodology, one would be able to gain more accurate and concrete information on what social factors that influence teenage drug use. By gathering data through a questionnaire, one will be able to make conclusions as to what the most common social factors that are influences seen from the target population because it can include a large number of participants. Quantitative research will help assess the relative importance of the various factors that explain drug use/abuse through data and numbers in the form of statistics which are then constructed in attempts to explain what is being studied.

Not only will quantitative methodology help gather larger amounts of data, it will also offer more than just statistical numbers; with the hopes that the findings will allow researchers to become more aware of the social factors that influence our youth to become engaged in drug use and how substances are being accessed. Using statistical analysis is very useful in this research because it involves the study of data and analyzing it to help resolve the social factors that influence teenage drug use. By targeting specific individuals who have experienced drug use, one can get a firsthand account of the differences between each individual who has used drugs due to social factors influencing them. The study is based on the following hypothesis:

H1: Peer group relationships will be positively associated with drug use.
H2: Teenagers growing up in intact families will be less likely to use illegal drugs than teenagers who grow up in single parent homes.
H3: Teenagers who use illegal drugs are likely to have parents who are low income.
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The population for this study consists of students in Mankato, MN from the range of middle schools which consist of: Dakota Meadows Middle School and Mankato East Jr. High. High schools which consist of: Mankato West High School and Mankato East High School; also including, Loyola Catholic School, Riverbend Academy Charter School, and Central Freedom School. Lastly, colleges which consist of: Minnesota State University, Mankato, Bethany Lutheran College, Rasmussen College, and SCTC. The target population for this study is individuals, males and females, who are in the age range of 14-19 varying from eighth graders to sophomores in college.

The sampling frame for this study will be a list of the adolescents who have had some sort of access with a substance abuse treatment facility in MN, particularly, Hazelden addiction treatment facility. Individuals who are between the ages of 14-19 years old is an ideal age to study because the subjects are in the early stages of adulthood and are constantly facing influences both negative and positive in their everyday lives. This target population will also be most beneficial for this study primarily because these are the years when individuals face the most in adolescents. This study will only seek to attract youth from Mankato because according to Drug Abuse Statistics in Minnesota, “With over 115,000 state inhabitants under the influence of drugs. It is even more startling to find that over 26,000 of these addicts are between 12 and 17 years; and 43,000 between 18 and 25 years.” (Drug Abuse Statistics in Minnesota, 2009). The participants in this study will be selected from among 10,492 individuals; the reasoning for this number is that it is the average number of adolescents ranging from the ages of 14-24. Snowball sampling would work best for a study such as this because by it starts with a few participants and helps lead researchers to new cases. By placing the sample group in the Mankato population into percent and age, for instance, 5.26% of the population ranges from the ages of 10-14, 2.63% male, and 2.67% female. 14.26% of the population ranged from ages 15-19, 9.13% male and 7.13% female. 21.66% of the population ranged from the ages of 20-24, 9.99% male and 11.67% female.

Also included in this research is by placing the Mankato population by race/ethnicity, for instance: 85.3% of 10-14 white, 5.2% of 10-14 African American, 4.7% of 10-14 Hispanic, 4.0% of 10-14 Asian. All who have which had some sort of affiliation with treatment centers in MN, primarily, Hazelden addiction treatment facility, through this sampling frame, one will be able to make claims about how these factors play a role in the influences seen in the study population. With organizations such as Hazelden whose main objective is to help adolescents, adults, families, and communities who have been impacted by alcohol and other drug use, improve to a better life.

The study population will be individuals who have dealt with substance use rather than a population where victims of substance use are not always apparent. The questionnaire will be mailed to 400 individuals who have been in contact with the substance abuse organization Hazelden. Hazelden deals with patients and families of drug abuse and helps them in many different ways with their use, addiction, and recovery. Once the questionnaire is returned, the data will be collected and placed into two different subgroups which are population of Mankato into percent and age, as well as by placing the Mankato population by race/ethnicity.

By splitting the Mankato population by age and race/ethnicity, and obtaining a listing of the population within this age range that have had an association with Hazelden Addiction Treatment Center, the differences between groups will be more relevant and submit data that is much easier to analyze and make accurate conclusions. Over 80% of drug and alcohol patients continue to be sober or drastically decrease their use within 1 year after their treatment and 98% of patients say they would recommend this treatment facility to others who are battling addiction. Instead the data will be collected from a mail medium questionnaire that will seek to gather information about the adolescent’s social factors such as their demographic backgrounds, peer groups, their families’ income, and parents’ marital status. Variables will include those of: gender which will take on two values, male or female, their parents’ marital status which consists of, married, separated, divorces, re-married, or other; socioeconomic background which consists of, upper class, middle class, working poor, or other. daily stressors, how they cope with their stressors, which substances they prefer, how they get the substances, who they get the substances from, how often they use, how many times they have used within the past three months, why they use, and what social factors they believe to influence teenagers to use drugs. In order to achieve a high response rate, I will send the questionnaire to the target population who had had access with treatment facilities, particularly Hazelden Treatment Facility.

By the questionnaires, word of mouth by the participants to others, and receiving listings from Hazelden and other treatment facilities, until we receive accurate responses from the questionnaires. From the returned questionnaires, we will be able to determine the variables of the individuals and relate them to the social factors such as the adolescents’ peer groups, socioeconomic status, family background, and other factors such as stress which leads to drug use, and coping with stress. Once the data is collected, the rest of the population will be compared to the sample population which will hopefully show a difference in the social factors, such as peer groups, socioeconomic status, and family background that influence teenage drug use.

The sample represents the average individual in the American society. From the questionnaire, each individual will have documented variables such as, demographic backgrounds, peer groups, their parents’ marital socioeconomic background, daily stressors, and their current or past substance abuse. Given that the questionnaires were issued only to individuals who had been victims of drug use, we can make accurate conclusions as to what differences there are in terms of the influences and if the variables make a difference. Knowing that not all questionnaires will be returned, I decided to send it out to as many individuals as possible to yield a high return rate. Expected Findings

From the questionnaire we can gain information on a variety of levels. First off, I believe the most important information we can get from the questionnaire is what social factors influence teenagers to abuse drugs. Given that drug use can be caused by many things, individuals exposed to the use of drugs at a young age, are much more likely to use drugs when they grow up. With the findings I hope to be able to show that family and peers are incredibly influential social factors with teenage drug use. A teenager’s relationship with family is very important and has great impact on whether or not the individual will use illegal drugs throughout their lifetime. By gathering data about the teenagers socioeconomic background as well as parent’s marital status, we can make a clear assumption about the individual and if the relationship with their family might have caused them to use drugs more frequently.

This information would be very beneficial to substance treatment and organizations such as Hazelden to help better understand the individual, their background, and ultimately their chances of using drugs so that we do not see the incline in drug use as a result of their family. Girls and boys are genetically different when it comes to emotions and how they handle different situations. By categorizing them into different groups, we can develop a supportive theory that boys and girls are affected in different ways. Peers are another common social factor that can be an influential social factor with teenage drug use.

From the sample I hope to show that there is a correlation between teenage drug use and the subject’s peers. Peers influence on an individual is very common among teenage drug use and one can only image what percentage of drug use is caused by this. By showing this correlation, we can bring awareness to the topic and hopefully diagnose the cause of the social factors that influence teenage drug use.

From the review of the literature and my hypothesis’, I expect to find that the subjects association with their family and peers is crucial in the influence towards drug use, especially at a young age. By identifying family background in middle and high school age adolescents and teenagers, we can make an effort to target substance abuse interventions and treatment education to the group of vulnerable adolescents and teenagers. I believe that both variables will show clear associations to one another. Given that the most important development stage is their adolescent years, drug use can have many effects on the individual’s likely cause and future. This is why it is so important to target the adolescents at a younger age who are showing symptoms of drug use. Adolescents internalize the majority of what they experience in their life, and it is most likely not until they become exposed to substances that they show external behaviors.

Many studies have been done on this subject and I hope to reinforce what I have already learned from other studies. Adolescent growing up in family who has a history of drug use are resulting effects that I believe will show strong association to teenage drug use. Regarding the community and school, I expect that by education programs and reaching awareness out to adolescents in the community, will reduce the overall involvement with the criminal justice system. Given that most of them are uneducated and lack supervision, this would hold true. Lastly, I believe there will be evidence to show that different ethnic and racial backgrounds can be associated with drug use.

References
Drug Rehab Addiction Treatment Alcohol Rehabilitation.Minnesota Illicit Drugs Statistics. (n.d.). Retrieved April 2, 2012, (http://www.usnodrugs.com/statistics.htm?state=Minnesota;cat=illicit)

Harris, Katherine M., Beth A. Griffin, Daniel F. McCaffrey and Andrew R. Morral. 2008. “Inconsistencies in self-reported drug use by adolescents in
substance abuse treatment: Implications for outcome and performance measurements.” Journal of substance abuse treatment 34(3):347-355.

National Institute on Drug Abuse . Home | National Institute on Drug Abuse . (n.d.). Home |
Retrieved April 10, 2012, from http://www.drugabuse.gov/

Reginald, Simmons, Jane Ungemack Jennifer Sussman, Robyn Anderson, Sandra Adorno, Jose Aguayo, Khary Black, Steven Hodge, Rachel Trinady. 2008. “Bringing Adolescents into Substance Abuse Treatment Through Community outreach and Engagement: The Hartford Youth Project.” Journal of Psychoactive Drugs 40(1), 41-54. Saint-Jean, Gilbert, Carlos A. Martinez and Lee A. Crandall. 2008. “Psychosocial mediators of the impact of acculturation on adolescent substance abuse.” Journal of Immigrant and Minority Health 10(2):187-195. Silver, Marisa M., Golfo Tzilos, and Deborah Yurgelun-Todd, A. 2008. “Relationship between white matter volume and cognitive performance during adolescence: effects of age, sex, and risk for drug use.” 103(9):1509-1520.

Tebes, Jacob K., Richard Feinn, Jeffrey J. Vanderploeg, Matthew J. Chinman, Jane Shepard, Tamika Brabham, Maegan Genovese and Christian Connell. 2007. “Impact of a Positive Youth Development Program in Urban After-School Settings on the Prevention of Adolescent Substance Use.” Journal of Adolescent Health 41(3):239-247.

Appendicies
A.- Cover Letter
B.- Letter of Access
C.- Informed Consent
D.- Unstructured Questionnaire

A. Cover Letter

March 20, 2012

Dear Respondent,
I am conducting a study to determine the social factors that influence teenage drug use. With the help of Hazelden Minnesota, you have been selected to fill out a survey on the issue of drug use and the social factors in which influence it. As adolescent substance abuse has been on the rise, with your help, we can help identify the major social factors that are indeed influencing adolescents to abuse drugs and inform the public of these dangers. Please take a minute to fill out the survey regarding this issue. Your identity will remain anonymous and the data gathered from the survey will be very beneficial for our study. The package will include a letter of access to Hazelden asking for their help for this study, an informed consent form which explains the instructions for the questionnaire including a place for the participant to sign and date for consent, also a place for legal guardians to sign and date for any participant who is under the age of 18; lastly, a 13 question questionnaire that will take approximately 5-10 minutes to complete. Once completed, I ask the participant to please return the survey back to the following address:

Kathleen Reynolds
1400 Monks Ave.
Mankato, MN 56001

Sincerely,
Kathleen Reynolds

B. Letter of Access

Hazelden MN
15251 Pleasant Valley Road
Center City, MN 55012-0011

Dear Hazelden Organization,

I am conducting a study regarding social factors that influence teenage drug use. I will be issuing a questionnaire to better understand what the social factors are that influence our youth’s substance use. With this study, I hope to come to better conclusions about this topic that has become an issue with adolescents as well as make it more aware to the public in hopes to decrease the rise of teenage drug use. In order to conclude the social factors that influence teenage drug use, I am making a formal request to gain access to addresses of patients that have been in contact with your organization.

With help from your organization, I am targeting the population who has had some sort of access to Hazelden, also meaning these adolescents have had a history with substance use. I have high hopes that Hazelden will become more well-known in the public and ultimately, adolescents who are abusing substances will become more familiar with your organization and reach out for help.

Sincerely,

Kathleen Reynolds
1400 Monks Ave.
Mankato, MN 56001

C. Informed Consent

The present research is directed by Kathleen Reynolds in collaboration with Minnesota State University, Mankato and Hazelden. The study seeks to assess social factors that influence teenage drug use. Its main purpose is to explore what the adolescent’s socioeconomic background is, the status with their parents, who the adolescent’s associate themselves with the most, asking them to define themselves and their friends, along with social factors, such as teenagers’ daily stressors, how they cope with them, which substances they prefer, and how they access these substances, who they use with, how often they use, how often they have used within the past 3 months, why they use, and what social factors they believe influence our youth towards drug use.

With the help of Hazelden Minnesota, you have been invited to participate in the project as an informed community member and/or a representative of Hazelden. We encourage you to be honest when filling out the survey in helps to our study in receiving accurate information and helping others in the future. Procedures: You are free to allow or not allow your teen to participate in this study and complete the survey. If you allow your teen to participate if they want to/are legally of age to participate and want to, will include the following:

You will be asked to complete a questionnaire. The questionnaire consists of 13 questions and will take roughly 5-10 minutes. Questions will include questions about your demographic information, socioeconomic backgrounds, the status of your parents, who you associate themselves with the most, how you define yourself and your friends, your daily stressors, how you cope with them, substance of choice, how do you get the substances, who you use with, how often do you use, how many times within the past 3 months have you used, why you use, and what you believe are the social factors that influence teenage drug use.

However, I understand that my participation is entirely voluntary and that my refusal to participate will not result in penalty of any kind.
I understand that my answers will be kept confidential and that the final report will not include my real name. I have been told that this form will be kept in a separate folder and that only the organizers of the study will have access to it.

Finally, I understand that if I have any questions about subjects’ rights I can contact Kathleen Reynolds, conducted researcher in this study at the following address: 1400 Monks Ave. Mankato, MN 56001. I can also contact this person at (507) 999-9999.

I have read this permission form. All my questions were answered. All parts of the instructions for the questionnaire are clear to me.

Please check one:

______ I give my consent for my teen to be part of the program. I have received a copy of this consent form.

______ I DO NOT give my consent for my teen to be part of the program.

______ I am legally of age to consent. D/O/B_____________

__________________________________
Adolescent/Participant Name – Please Print

__________________________________
Parent/Guardian Name – Please Print

__________________________________ __________________ Adolescent/Participant Signature Date

__________________________________ __________________ Parent/Guardian Signature Date

D. Unstructured Questionnaire

Please take a minute to answer the following questions. Accurate answers are strongly advised in the quest to evaluate our research. Instructions: Please circle each answer that applies to the following 13 questions. If you chose ‘Other,’ please fill in the accurate answer. This questionnaire will take 5-10 minutes of your time. Demographic Information:

Gender:

a. Male
b. Female

Race:

a. White/Caucasian
b. African American
c. Asian
d. Hispanic
e. Other: _________________

Age:

a. 13 and below
b. 14-16
c. 17-19
d. 20-22
e. 22 and above

Factors:
1) What is your socioeconomic background?
a. Upper class
b. Middle class
c. Working poor
d. Other: _________________

2) Are your parents:
a. Married
b. Separated
c. Divorced
d. Re-married
e. Other: _________________

3) Who do you most associate yourself with?
a. Family
b. Peers
c. By yourself
d. Other: _________________

4) How do you define yourself and friends?
a. Athletic students
b. Academic students
c. Partier group
d. Other: _________________

5) What are your most common daily stressors?
a. School
b. Friends
c. Family
d. Other: _________________

6) How do you cope with stress?
a. Exercise
b. Sleep
c. Substance Use
d. Talking about it

7) What is your substance of choice?
a. Alcohol
b. Tobacco
c. Marijuana
d. Other: ___________________

8) How do you receive the substances?
a. Buy it yourself
b. A friend
c. A family member
d. Other: _________________

9) Who do you use with?
a. Yourself
b. Friends
c. Family
d. Other: ____________________

10) How often do you use?
a. Everyday
b. 1-5 times a week
c. 5-10 times a week
d. 10 or more a week

11) How many times have you used within the past 3 months?
a. Everyday
b. 1-10
c. 11-20
d. 21-30
e. 30 or more
f. Never

12) Why do you use?
a. Cope with stress
b. Peer pressure
c. Appearance
d. Other: _________________

13) What do you believe are social factors that influence teenage drug use? a. School
b. Peers
c. Family
d. Media
e. Other: _________________