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National Survey on Drug Use and Health Substance Use and Need for Treatment among Youths Who Have Been in Foster Care
February 18, 2005

Substance Use and Need for Treatment among Youths Who Have Been in Foster Care

In Brief

  • Approximately 680,000 youths (2.7 percent) aged 12 to 17 have ever been in foster care

  • Youths who have ever been in foster care had higher rates of any illicit drug use than youths who have never been in foster care (33.6 vs. 21.7 percent)

  • Youths aged 12 to 17 who were in need of substance abuse treatment in the past year were more likely to have received treatment if they have ever been in foster care
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Youths from substance-abusing families frequently have serious emotional and behavioral problems, including a tendency to choose risky behavior, such as alcohol or other drug use. Substance abuse is a factor in at least three quarters of all foster care placements, and recent studies indicate high rates of lifetime substance use and substance use disorders for youths in the foster care system.1,2 The National Survey on Drug Use and Health (NSDUH) asks youths aged 12 to 17 if they ever stayed in foster care.3 This report looks at the need for and receipt of substance abuse treatment among youths who have been in foster care. All estimates are annual averages based on combined 2002 and 2003 NSDUH data.

An individual is defined as needing treatment if he or she meets Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)4 criteria for dependence on or abuse of alcohol or an illicit drug, or received treatment for a substance abuse problem at a "specialty" substance abuse facility during the past 12 months. Specialty substance abuse facilities include drug and alcohol rehabilitation facilities (inpatient or outpatient), hospitals (inpatient only), and mental health centers.
Proportions of Youths Ever in Foster Care

According to NSDUH data, approximately 680,000 youths (2.7 percent) aged 12 to 17 have ever been in foster care. Among youths, American Indian/Alaska Natives and blacks (6.6 and 4.9 percent, respectively) had higher rates of having been in foster care than whites and Hispanics (2.4 and 2.5 percent, respectively) or Asians (0.7 percent). There was little difference in lifetime foster care status by age or gender (Table 1).

Table 1. Estimated Numbers, Percentages, and Standard Errors for Youths Aged 12 to 17 Ever in Foster Care, by Demographic Characteristics: 2002 and 2003 Figure 1. Percentages of Past Year Alcohol and Illicit Drug* Use among Youths Aged 12 to 17, by Foster Care Status: 2002 and 2003
Table 1. Estimated Numbers, Percentages, and Standard Errors for Youths Aged 12 to 17 Ever in Foster Care, by Demographic Characteristics: 2002 and 2003 Figure 1. Percentages of Past Year Alcohol and Illicit Drug* Use among Youths Aged 12 to 17, by Foster Care Status: 2002 and 2003
Substance Use among Youths Ever in Foster Care

Youths who have ever been in foster care had higher rates of past year use of any illicit drug than youths who have never been in foster care (33.6 vs. 21.7 percent) (Figure 1). The rate of past year alcohol use was similar for these two groups.

Among youths who have ever been in foster care, older youths were more likely than younger youths to use alcohol or any illicit drug in the past year. White youths who have been in foster care were more likely than their black counterparts to have used alcohol (41.4 vs. 29.8 percent) or any illicit drug (36.2 vs. 26.7 percent) in the past year. There was little difference in past year alcohol or any illicit drug use by gender (Table 2).

Needing and Receiving Treatment for a Substance Abuse Problem

Youths who have ever been in foster care had higher rates of need for substance abuse treatment than youths who have never been in foster care. More youths who have ever been in foster care were in need of treatment for alcohol or illicit drug use in the past year (17.4 percent) compared with youths who have never been in foster care (8.8 percent) (Figure 2).

Youths aged 12 to 17 who were in need of substance abuse treatment in the past year were more likely to have received treatment if they have ever been in foster care. Among youths who have ever been in foster care and were in need of substance abuse treatment for an alcohol or illicit drug problem in the past year, 19.1 percent received treatment in the past year. Among youths who have never been in foster care, 7.2 percent who needed treatment for an alcohol or illicit drug problem received treatment in the past year.

Table 2. Percentages of Past Year Alcohol and Any Illicit Drug* Use among Youths Aged 12 to 17 Ever in Foster Care, by Demographic Characteristics: 2002 and 2003 Figure 2. Percentages of Youths Aged 12 to 17 in Need of Substance Abuse Treatment, by Foster Care Status: 2002 and 2003
Table 2. Percentages of Past Year Alcohol and Any Illicit Drug* Use among Youths Aged 12 to 17 Ever in Foster Care, by Demographic Characteristics: 2002 and 2003 Figure 2. Percentages of Youths Aged 12 to 17 in Need of Substance Abuse Treatment, by Foster Care Status: 2002 and 2003

End Notes
  1. Connect for Kids. (1999). The impact of substance abuse on foster care. Accessed January 5, 2005, at www.connectforkids.org/resources3139/resources_show.htm?doc_id=8160.

  2. Ollie, M. T., Vaughn, M. G., McMillen, J. C., Scott, L. A., & Munson, M. (in press). Patterns of substance use among older youth in foster care. Drug and Alcohol Dependence.

  3. NSDUH asks persons aged 12 to 17 to respond yes, no, or don't know to the following two questions regarding foster care: a) During the past 12 months, did you stay overnight or longer in foster care or in a therapeutic foster care home because you had emotional or behavioral problems that were not caused by alcohol or drugs?; b) Have you ever been in foster care? Youths were defined as ever having been in foster care if they answered yes to either question.

  4. American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Figure and Table Notes

* Any Illicit drug includes marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, or any prescription-type drug used nonmedically.

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002 and 2003.
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). Prior to 2002, this survey was called the National Household Survey on Drug Abuse (NHSDA). The 2002 and 2003 data are based on information obtained from 46,310 youths aged 12 to 17, including 1,326 youths who had ever been in foster care and 297 youths who had been in foster care or a therapeutic foster care home during the past year for an emotional or behavioral problem not caused by alcohol or illicit drugs. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.

The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)

Information and data for this issue are based on the following publications:

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, MD: Substance Abuse and Mental Health Services Administration.

Office of Applied Studies. (2003). Results from the 2002 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 03–3836, NSDUH Series H–22). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Also available online: http://www.oas.samhsa.gov.

Because of improvements and modifications to the 2002 NSDUH, estimates from the 2002 and 2003 surveys should not be compared with estimates from the 2001 or earlier versions of the survey to examine changes over time.

The NSDUH Report (formerly The NHSDA Report) is published periodically by the Office of Applied Studies, Substance Abuse & Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available on-line: http://www.oas.samhsa.gov. Citation of the source is appreciated. For questions about this report please e-mail: shortreports@samhsa.hhs.gov.

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