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Gender differences in prevalence of drug use among high risk adolescents in Israel
Addictive Behaviors 31 (2006) 355 – 358
Short communication
Gender differences in prevalence of drug use among high risk adolescents in Israel Richard Isralowitza,T, Richard Rawsonb a
Dept. of Social Work, Regional Alcohol and Drug Abuse Resources Center, Ben Gurion University, Beer Sheva 84105, Israel b Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
Abstract Background: The use of tobacco, alcohol and illicit drugs is considered to be primarily a male problem. Many studies of drug use in the general population have reinforced this assumption. Other recent findings, however, call the extent of gender differences into question. Methods: Self report data were collected from 911 high risk adolescents who ranged from 12 to 18 years. Results: Last 30 day use was used to compare the youth. Significant findings show girls use cigarettes more than boys; boys use all types of alcohol more than girls; and, boys use marijuana and hashish more than girls. No differences were reported in terms of the patterns of ecstasy, inhalants, prescription drugs, LSD, amphetamines, cocaine, crack cocaine, opium and heroin. Boys more than girls were inclined to binge drink. Boys and girls reported similar patterns of being in a car with a driver who had been drinking and driving a car after drinking. Boys more than girls take loans in order to obtain drugs; girls more than boys were able to acquire drugs without having to use their own money; and boys more than girls gambled to acquire drugs. Discussion: With the exception of cigarettes, boys use drugs and engage in problem behavior more than girls. Underage drinking and driving is a serious behavior problem reported by male and female youth. This factor and binge drinking should be targeted as priority prevention issues. Gender differences in prevalence of drug use among high risk adolescents should be monitored to verify what may be a growing problem among female adolescents in the country and elsewhere (Litt, I., (2003). Drugs and adolescent girls. (editorial). Journal of Adolescent Health, 32, 1-2). D 2005 Elsevier Ltd. All rights reserved. Keywords: Drug use; Gender; Adolescents; Israel
T Corresponding author. Tel.: +11 972 8 6562308; fax: +11 972 8 6562246. E-mail address: [email protected] (R. Isralowitz). 0306-4603/$ - see front matter D 2005 Elsevier Ltd. All rights reserved. doi:10.1016/j.addbeh.2005.05.010
356
R. Isralowitz, R. Rawson / Addictive Behaviors 31 (2006) 355–358
The use of tobacco, alcohol and illicit drugs is considered to be primarily a male problem (Springer, Sambrano, Sale, & Kasim, 2002; Thom, 2003). Many studies of drug use in the general population have reinforced this assumption. Among European Union Member States, for example, males outnumber females who have tried drugs in all countries and all age groups (EMCDDA—European Monitoring Centre for Drugs and Drug Addiction, 2002). In the United States, males are more likely to use, abuse and be dependent on alcohol or illicit drugs than females (Office of Applied Studies, 2004). Among school age youth, rates of tobacco, alcohol and marijuana have declined over the last 25 years but gender differences for these drugs have remained largely unchanged (Wallace et al., 2003). Other recent findings, however, call the extent of gender differences into question. In a national survey, the same percentage (9%) of females and males aged 12 to 17 were dependent on or abusing alcohol or an illicit drug (Office of Applied Studies, 2004). Girls and boys in the 12th grade were found to have roughly the same rates of cigarette smoking (Johnston, O’Malley, Bachman, & Schulenberg, 2004). Among high risk youth, arrestees and detainees, girls were significantly more likely to report dependence. Nearly 16% of girls compared with 11% of boys were classified as polydrug users (Kim & Fendrich, 2002). And, in Britain, 44% of girls age 14–15 had at least one drink per week compared to 42% of boys (JTO—Join Together Online, 2004). A similar pattern was reported for binge drinking with 29% of girls age 15–16 engaged in this behavior compared to 26% of boys (BBC News—Global Internet News, 2004). In Israel, little is known about adolescent gender differences and drug use. It appears, however, that Israeli youth are approaching the prevalence and behavior patterns of European adolescents (Barnea, Rahav, & Teichman, 1992). This present study examines the patterns of alcohol and illicit drug use among high risk male and female adolescents in Israel. Since prevalence defines a pattern of behavior during a particular time period, other drug use related problem behaviors are reported.
1. Methods Data were collected during a 9 month period in 2003 from a purposive sample of 911 high-risk youth—390 boys and 521 girls, in alternative special education/training programs, street "drop-in" centers, and from low-income neighborhoods in the southern Negev and northern Haifa regions of the county. The sample did not include youth who graduated high school. The age of the youth ranged from 12 to 18 years with a median age of 16 years. Study youth were asked to complete, on a voluntary and anonymous basis, a simply worded questionnaire in Hebrew. A project assistant responsible for distributing the questionnaire was available to help the youth understand the questions if necessary. Information was collected in a confidential manner complying with human subject guidelines. The data collection instrument included questions about background characteristics and alcohol use patterns including binge drinking, driving a car after drinking, and being a passenger in a car when the driver has been using alcohol. Chi square analysis was used to examine the study data.
2. Results Last 30 day use was used to compare the youth. Cigarette use was reported by 77% girls and 69% boys (v 2 = 6.40, p b .05). For all alcohol substances, (i.e., beer, wine and liquor such
R. Isralowitz, R. Rawson / Addictive Behaviors 31 (2006) 355–358
357
as vodka and whiskey) boys were significantly more inclined to drink than girls. Results show the following alcohol use patterns: beer (61% boys, 45% girls; v 2 = 45.88, p b .001) wine (48% boys, 36% girls; v 2 = 16.01, p b .01); and liquor (43% boys, 31% girls; v 2 = 20.92, p b .01). A similar pattern of use was found for marijuana and hashish. For marijuana, 8% boys and 3% girls used the substance (v 2 = 15.43; p b .01); 7% boys and 2% girls used hashish (v 2 = 20.05; p b .01). For all other 30 day substance use, no significant differences were found among boys and girls. Findings show: ecstasy—2%; inhalants—4%; prescription drugs including sedatives— 2%; LSD, amphetamines, cocaine, crack cocaine, opium and heroin—1% or less for each substance. Drug related behavior results show that boys (32%) more than girls (23%) were inclined to binge drink (i.e., five or more drinks per drinking occasion) during the last 30 days (v 2 = 14.92; p b .05). Boys and girls reported similar patterns of being in a car with a driver who had been drinking (12%) and driving a car after drinking (5%).
3. Discussion This study is based on a limited population of youth at one point in time. Results show, with the exception of cigarettes, that boys use drugs and engage in problem behavior more than girls. This may be in part attributed to motivations for drug use. According to the Center for Substance Abuse Prevention (Springer et al., 2002) boys initiate and continue to use drugs to increase social bonding with other drug using males, enhance their sense of self, and for sensation seeking and boredom relief. Their drug use tends to be associated with higher levels of problem behavior. The reasons for drug use among girls are different including those of an emotional nature linked to relationships, stress and depression. Research shows that girls are more inclined to internalize self-destructive behavior such as suicidal ideation and depression, have anxiety about weight and have eating disorders. Also, it has been suggested that the pattern of drug use among girls may be do to their earlier maturation and tendency to associate with older males (Kaminer, 2002). Underage drinking and driving is a serious behavior problem. In 2003, 25% of the drivers in the United States ages 15–20 who died in motor vehicle accidents had been drinking alcohol (U.S. Dept. of Transportation, National Highway Traffic Safety Administration, 2004a). This rate is more than twice that for alcohol-involved drivers 21 and older (Yi, Willaims, & Dufour, 2001). Also, male drivers involved in fatal crashes are almost twice as likely as female drivers to be intoxicated (U.S. Dept. of Transportation, National Highway Traffic Safety Administration, 2004b). The present study findings show that 5% of male and female youth are driving a car and drinking. This factor and binge drinking should be targeted as priority prevention issues. Israel is a society comprised mostly of native born Jewish and Arab people as well as immigrants from the Former Soviet Union. Additional research is needed to determine the impact of social and cultural elements including religiosity as well as school and delinquent status on drug use and problem behavior among male and female adolescents. Gender differences in prevalence of drug use among high risk adolescents should be monitored to verify what may be a growing problem among female adolescents in the country and elsewhere (Litt, 2003).
358
R. Isralowitz, R. Rawson / Addictive Behaviors 31 (2006) 355–358
Acknowledgment This research was supported by a grant (TA-MOU-02-M23-010) from the United States Agency for International Development—Middle East Regional Cooperation Program.
References Barnea, Z., Rahav, G., & Teichman, M. (1992). Alcohol consumption among Israeli youth—1989: Epidemiology and demographics. British Journal of Addiction, 87, 295 – 302. BBC News—Global Internet News. (2004). "Ladette" binge drinkers outnumber males, Dec. 15 (Retrieved January 15, 2005, from). http://www.dehavilland.co.uk European Monitoring Centre for Drugs and Drug Addiction. (2002). 2002 Annual report on the state of the drugs problem in the European Union and Norway (Retrieved January 26, 2005 from). http://ar2002.emcdda.eu.int/en/page23-en.html Johnston, L., O’Malley, P., Bachman, J., & Schulenberg, J. (2004). Monitoring the future: National results on adolescent drug use, overview of key findings 2003, (NIH Publication No. 04-5506). Bethesda, MD7 U.S. Department of Health and Human Services. Join Together Online. (2004). UK girls drink more than boys (Retrieved August 18, 2004 from). www.jointogether.org/sa/news/ summaries/print/0,1856,574166,00.html Kaminer, Y. (2002). Addictive disorders in adolescents. International Addiction, (Retrieved January 15, 2005 from http:// www.uofcpress.com/journals/IA/addictive_frame.html). Kim, J., & Fendrich, M. (2002). Gender differences in juvenile arrestees’ drug use, self-reported dependence, and perceived need for treatment. Psychiatric Service, 5, 70 – 75. Litt, I. (2003). Drugs and adolescent girls. (editorial). Journal of Adolescent Health, 32, 1 – 2. Office of Applied Studies. (2004). Results from the 2003 national survey on drug use and health: National findings, (DHHS Publication No. SMA 04-3964, NSDUH Series H-25). Rockville, MD7 Substance abuse Mental Health Services Administration. Springer, J., Sambrano, S., Sale, E., & Kasim, R. (2002). The national cross-site evaluation of high-risk youth programs: Making prevention effective for adolescent boys and girls. Gender differences in substance use and prevention, (DHHS Publication No. (SMA)00-3375). Rockville, MD7 U.S. Department of Health and Human Services. Thom, B. (2003). Risk-taking behaviour in men: Substance use and gender. London7 Health Development Agency. U.S. Dept. of Transportation, National Highway Traffic Safety Administration. (2004a). Traffic safety facts 2003: Alcohol. Washington, DC7 NHTSA (Retrieved January 28, 2005 from www.nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/TSF2003/ 809761.pdf). U.S. Dept. of Transportation, National Highway Traffic Safety Administration. (2004b). Traffic safety facts 2003: Young drivers. Washington, DC7 NHTSA (Retrieved January 28, 2005 from www.nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/TSF2003/ 809761.pdf). Wallace, J., Bachman, J., O’Malley, P., Schulenberg, J., Cooper, S., & Johnston, L. (2003). Gender and ethnic differences in smoking, drinking and illicit drug use among American 8th, 10th and 12th grade students, 1976–2000. Addiction, 98(2), 225 – 234. Yi, H., Willaims, G., & Dufour, M. (2001). Trends in alcohol-related fatal crashes, United States, 1979–99. Surveillance Report, vol. 56. Bethesda, MD7 NIAAA.
Short communication
Gender differences in prevalence of drug use among high risk adolescents in Israel Richard Isralowitza,T, Richard Rawsonb a
Dept. of Social Work, Regional Alcohol and Drug Abuse Resources Center, Ben Gurion University, Beer Sheva 84105, Israel b Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, California
Abstract Background: The use of tobacco, alcohol and illicit drugs is considered to be primarily a male problem. Many studies of drug use in the general population have reinforced this assumption. Other recent findings, however, call the extent of gender differences into question. Methods: Self report data were collected from 911 high risk adolescents who ranged from 12 to 18 years. Results: Last 30 day use was used to compare the youth. Significant findings show girls use cigarettes more than boys; boys use all types of alcohol more than girls; and, boys use marijuana and hashish more than girls. No differences were reported in terms of the patterns of ecstasy, inhalants, prescription drugs, LSD, amphetamines, cocaine, crack cocaine, opium and heroin. Boys more than girls were inclined to binge drink. Boys and girls reported similar patterns of being in a car with a driver who had been drinking and driving a car after drinking. Boys more than girls take loans in order to obtain drugs; girls more than boys were able to acquire drugs without having to use their own money; and boys more than girls gambled to acquire drugs. Discussion: With the exception of cigarettes, boys use drugs and engage in problem behavior more than girls. Underage drinking and driving is a serious behavior problem reported by male and female youth. This factor and binge drinking should be targeted as priority prevention issues. Gender differences in prevalence of drug use among high risk adolescents should be monitored to verify what may be a growing problem among female adolescents in the country and elsewhere (Litt, I., (2003). Drugs and adolescent girls. (editorial). Journal of Adolescent Health, 32, 1-2). D 2005 Elsevier Ltd. All rights reserved. Keywords: Drug use; Gender; Adolescents; Israel
T Corresponding author. Tel.: +11 972 8 6562308; fax: +11 972 8 6562246. E-mail address: [email protected] (R. Isralowitz). 0306-4603/$ - see front matter D 2005 Elsevier Ltd. All rights reserved. doi:10.1016/j.addbeh.2005.05.010
356
R. Isralowitz, R. Rawson / Addictive Behaviors 31 (2006) 355–358
The use of tobacco, alcohol and illicit drugs is considered to be primarily a male problem (Springer, Sambrano, Sale, & Kasim, 2002; Thom, 2003). Many studies of drug use in the general population have reinforced this assumption. Among European Union Member States, for example, males outnumber females who have tried drugs in all countries and all age groups (EMCDDA—European Monitoring Centre for Drugs and Drug Addiction, 2002). In the United States, males are more likely to use, abuse and be dependent on alcohol or illicit drugs than females (Office of Applied Studies, 2004). Among school age youth, rates of tobacco, alcohol and marijuana have declined over the last 25 years but gender differences for these drugs have remained largely unchanged (Wallace et al., 2003). Other recent findings, however, call the extent of gender differences into question. In a national survey, the same percentage (9%) of females and males aged 12 to 17 were dependent on or abusing alcohol or an illicit drug (Office of Applied Studies, 2004). Girls and boys in the 12th grade were found to have roughly the same rates of cigarette smoking (Johnston, O’Malley, Bachman, & Schulenberg, 2004). Among high risk youth, arrestees and detainees, girls were significantly more likely to report dependence. Nearly 16% of girls compared with 11% of boys were classified as polydrug users (Kim & Fendrich, 2002). And, in Britain, 44% of girls age 14–15 had at least one drink per week compared to 42% of boys (JTO—Join Together Online, 2004). A similar pattern was reported for binge drinking with 29% of girls age 15–16 engaged in this behavior compared to 26% of boys (BBC News—Global Internet News, 2004). In Israel, little is known about adolescent gender differences and drug use. It appears, however, that Israeli youth are approaching the prevalence and behavior patterns of European adolescents (Barnea, Rahav, & Teichman, 1992). This present study examines the patterns of alcohol and illicit drug use among high risk male and female adolescents in Israel. Since prevalence defines a pattern of behavior during a particular time period, other drug use related problem behaviors are reported.
1. Methods Data were collected during a 9 month period in 2003 from a purposive sample of 911 high-risk youth—390 boys and 521 girls, in alternative special education/training programs, street "drop-in" centers, and from low-income neighborhoods in the southern Negev and northern Haifa regions of the county. The sample did not include youth who graduated high school. The age of the youth ranged from 12 to 18 years with a median age of 16 years. Study youth were asked to complete, on a voluntary and anonymous basis, a simply worded questionnaire in Hebrew. A project assistant responsible for distributing the questionnaire was available to help the youth understand the questions if necessary. Information was collected in a confidential manner complying with human subject guidelines. The data collection instrument included questions about background characteristics and alcohol use patterns including binge drinking, driving a car after drinking, and being a passenger in a car when the driver has been using alcohol. Chi square analysis was used to examine the study data.
2. Results Last 30 day use was used to compare the youth. Cigarette use was reported by 77% girls and 69% boys (v 2 = 6.40, p b .05). For all alcohol substances, (i.e., beer, wine and liquor such
R. Isralowitz, R. Rawson / Addictive Behaviors 31 (2006) 355–358
357
as vodka and whiskey) boys were significantly more inclined to drink than girls. Results show the following alcohol use patterns: beer (61% boys, 45% girls; v 2 = 45.88, p b .001) wine (48% boys, 36% girls; v 2 = 16.01, p b .01); and liquor (43% boys, 31% girls; v 2 = 20.92, p b .01). A similar pattern of use was found for marijuana and hashish. For marijuana, 8% boys and 3% girls used the substance (v 2 = 15.43; p b .01); 7% boys and 2% girls used hashish (v 2 = 20.05; p b .01). For all other 30 day substance use, no significant differences were found among boys and girls. Findings show: ecstasy—2%; inhalants—4%; prescription drugs including sedatives— 2%; LSD, amphetamines, cocaine, crack cocaine, opium and heroin—1% or less for each substance. Drug related behavior results show that boys (32%) more than girls (23%) were inclined to binge drink (i.e., five or more drinks per drinking occasion) during the last 30 days (v 2 = 14.92; p b .05). Boys and girls reported similar patterns of being in a car with a driver who had been drinking (12%) and driving a car after drinking (5%).
3. Discussion This study is based on a limited population of youth at one point in time. Results show, with the exception of cigarettes, that boys use drugs and engage in problem behavior more than girls. This may be in part attributed to motivations for drug use. According to the Center for Substance Abuse Prevention (Springer et al., 2002) boys initiate and continue to use drugs to increase social bonding with other drug using males, enhance their sense of self, and for sensation seeking and boredom relief. Their drug use tends to be associated with higher levels of problem behavior. The reasons for drug use among girls are different including those of an emotional nature linked to relationships, stress and depression. Research shows that girls are more inclined to internalize self-destructive behavior such as suicidal ideation and depression, have anxiety about weight and have eating disorders. Also, it has been suggested that the pattern of drug use among girls may be do to their earlier maturation and tendency to associate with older males (Kaminer, 2002). Underage drinking and driving is a serious behavior problem. In 2003, 25% of the drivers in the United States ages 15–20 who died in motor vehicle accidents had been drinking alcohol (U.S. Dept. of Transportation, National Highway Traffic Safety Administration, 2004a). This rate is more than twice that for alcohol-involved drivers 21 and older (Yi, Willaims, & Dufour, 2001). Also, male drivers involved in fatal crashes are almost twice as likely as female drivers to be intoxicated (U.S. Dept. of Transportation, National Highway Traffic Safety Administration, 2004b). The present study findings show that 5% of male and female youth are driving a car and drinking. This factor and binge drinking should be targeted as priority prevention issues. Israel is a society comprised mostly of native born Jewish and Arab people as well as immigrants from the Former Soviet Union. Additional research is needed to determine the impact of social and cultural elements including religiosity as well as school and delinquent status on drug use and problem behavior among male and female adolescents. Gender differences in prevalence of drug use among high risk adolescents should be monitored to verify what may be a growing problem among female adolescents in the country and elsewhere (Litt, 2003).
358
R. Isralowitz, R. Rawson / Addictive Behaviors 31 (2006) 355–358
Acknowledgment This research was supported by a grant (TA-MOU-02-M23-010) from the United States Agency for International Development—Middle East Regional Cooperation Program.
References Barnea, Z., Rahav, G., & Teichman, M. (1992). Alcohol consumption among Israeli youth—1989: Epidemiology and demographics. British Journal of Addiction, 87, 295 – 302. BBC News—Global Internet News. (2004). "Ladette" binge drinkers outnumber males, Dec. 15 (Retrieved January 15, 2005, from). http://www.dehavilland.co.uk European Monitoring Centre for Drugs and Drug Addiction. (2002). 2002 Annual report on the state of the drugs problem in the European Union and Norway (Retrieved January 26, 2005 from). http://ar2002.emcdda.eu.int/en/page23-en.html Johnston, L., O’Malley, P., Bachman, J., & Schulenberg, J. (2004). Monitoring the future: National results on adolescent drug use, overview of key findings 2003, (NIH Publication No. 04-5506). Bethesda, MD7 U.S. Department of Health and Human Services. Join Together Online. (2004). UK girls drink more than boys (Retrieved August 18, 2004 from). www.jointogether.org/sa/news/ summaries/print/0,1856,574166,00.html Kaminer, Y. (2002). Addictive disorders in adolescents. International Addiction, (Retrieved January 15, 2005 from http:// www.uofcpress.com/journals/IA/addictive_frame.html). Kim, J., & Fendrich, M. (2002). Gender differences in juvenile arrestees’ drug use, self-reported dependence, and perceived need for treatment. Psychiatric Service, 5, 70 – 75. Litt, I. (2003). Drugs and adolescent girls. (editorial). Journal of Adolescent Health, 32, 1 – 2. Office of Applied Studies. (2004). Results from the 2003 national survey on drug use and health: National findings, (DHHS Publication No. SMA 04-3964, NSDUH Series H-25). Rockville, MD7 Substance abuse Mental Health Services Administration. Springer, J., Sambrano, S., Sale, E., & Kasim, R. (2002). The national cross-site evaluation of high-risk youth programs: Making prevention effective for adolescent boys and girls. Gender differences in substance use and prevention, (DHHS Publication No. (SMA)00-3375). Rockville, MD7 U.S. Department of Health and Human Services. Thom, B. (2003). Risk-taking behaviour in men: Substance use and gender. London7 Health Development Agency. U.S. Dept. of Transportation, National Highway Traffic Safety Administration. (2004a). Traffic safety facts 2003: Alcohol. Washington, DC7 NHTSA (Retrieved January 28, 2005 from www.nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/TSF2003/ 809761.pdf). U.S. Dept. of Transportation, National Highway Traffic Safety Administration. (2004b). Traffic safety facts 2003: Young drivers. Washington, DC7 NHTSA (Retrieved January 28, 2005 from www.nrd.nhtsa.dot.gov/pdf/nrd-30/NCSA/TSF2003/ 809761.pdf). Wallace, J., Bachman, J., O’Malley, P., Schulenberg, J., Cooper, S., & Johnston, L. (2003). Gender and ethnic differences in smoking, drinking and illicit drug use among American 8th, 10th and 12th grade students, 1976–2000. Addiction, 98(2), 225 – 234. Yi, H., Willaims, G., & Dufour, M. (2001). Trends in alcohol-related fatal crashes, United States, 1979–99. Surveillance Report, vol. 56. Bethesda, MD7 NIAAA.