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Friends and Family: Positive relationships can offset poor ones for youths at risk.

As any substance-abuse counselor can attest, William Wordsworth’s wistful observation that the “child is the father of the man” has a dark side.

The seeds of adult dissoluteness and dysfunction are often sown in youth, a time when pubescent anxiety mixes with bravado and incautiousness to make poor choices seem reasonable. Broken homes, peer pressure and academic failure create an allure around the use of illicit drugs and alcohol. Eventually the young user begets the adult abuser, a blighted birthright frequently repeated from generation to generation.

This pattern is unique to no single ethnic group, but young people in American Indian communities seem particularly vulnerable, says MU public health researcher ManSoo Yu in a paper published in the July issue of the journal Addictive Behaviors.

Yu, an assistant professor of social work and public health, and co-author, Arlene Stiffman of Washington University in St. Louis, cite statistics from the U.S. Department of Health and Human Services pegging the rate of past-month illicit drug use among 12- to 17-year-old American Indian adolescents at close to 19 percent, nearly twice that of whites, blacks or Hispanics.

Additional data, this time from a 2003 report compiled for the U.S. Senate, showed that the drug-related death rates for American Indians and Alaska Natives—now 65 percent higher than the general population—more than doubled from 1981 to 1996.

The effects of these dismal statistics on Native American communities are well documented. But what is to be done?

Focus on life at home, Yu says. In the study, Yu and Stiffman examined how the “mediating roles” of positive environments; e.g., healthy, non-abusive families and constructive religious affiliations, stacked up against negative environments such as addicted family members, deviant peers and negative school environment as a predictors of illicit drug use. Public health researchers say identifying these “mediators” can clarify the roles various risk and protective factors play in enabling or forestalling addictive behaviors.

Identifying ‘mediators’ can clarify the roles various risk and protective factors play in enabling or forestalling addictive behaviors.

Perhaps not surprisingly, Yu and Stiffman found that positive family relationships mediated the otherwise powerful effects of addicted family members, violence, victimization and negative school environments.

“We found that addicted family members and deviant peers directly and positively predicted illicit drug symptoms, while positive family relationships... directly and indirectly mediated their impact on illicit drug symptoms,” they wrote.

The finding expands prior research indicating that healthy family environments give adolescents a leg up in avoiding delinquent behaviors, including drug problems.

The study also examined whether religious affiliation might have a mediating effect.

It did, chiefly through the ability of religious groups to limit the exposure of at-risk youth to “negative peer influence.”

In short, Yu says, the study affirms what many researchers had suspected all along: that, on the one hand, youths living among addicted family members and deviant peers are at greater risk for illicit drug use and, on the other, that positive family relationships and religious affiliation mediate the impact of these risk factors.

“Establishing effective treatment and prevention plans requires a greater understanding of the complex associations between negative and positive variables in predicting substance use disorders,” Yu says. “It is clear that strategies to help youths with drug problems can be more effective by addressing family, school and peer contexts.”

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