Compound Risk: An Analysis of Biocultural, Familial, and Structural Risks Among Substance Using Adolescent Girls

Abstract

Adolescent substance abuse represents a complex, difficult challenge in the United States. Substance addiction research requires rich contextualization that takes into account individual, familial, and community experiences. This project focuses on how adolescent girls' substance use interacts with risk and vulnerability. More specifically, how the social and biological body influences substance initiation and how local contexts and constraints effects recovery from addiction. The sample includes adolescent girls who are enrolled in substance abuse treatment programs. The methodological approach encompasses a mixture of quantitative and qualitative, including analysis of a nation-wide dataset, narrative interviews, participant observation, and case following. While the quantitative analysis was with the nation-wide dataset, the qualitative data are derived from a sample of adolescent girls in Tucson, Arizona. Risk is assessed along three axes, biocultural, familial, and structural. Biocultural risk examines the influence that an early pubertal developmental trajectory has on substance initiation. Familial risk analyzes how the culture and habitus of the family affects youth initiation of substance use. Structural risk highlights the continued vulnerability that youth who are raised in the `system' face and specifically their challenges to recovery after substance abuse treatment. Findings from the nation-wide sample include a significant relationship between pubertal timing and age of onset of substance use. In the Tucson sample, familial immersion in substance use was so extensive that girls were not only expected to begin using but also initiation of use became a 'rite of passage' within the family. Finally this research documents the unintended role the child welfare system plays as a structural impediment to girls' recovery from substance abuse.