Prevalence and Associates of Substance Abuse Among Street Children and Adolescents in Iran

Background: The issue of street children and adolescents represents a significant global challenge, often interconnected with issues such as substance abuse. The present research aims to ascertain the prevalence of substance abuse and its associated determinants within the population of street children and adolescents in Zahedan, Iran. Methods: This cross-sectional study, conducted between December 2021 and May 2022, focused on street children and adolescents. A validated questionnaire was administered through face-to-face interviews to evaluate the prevalence of substance abuse and associated factors within this population. The collected data were analyzed using bivariable and multivariable logistic regression models. Additionally, penalized logistic regression techniques were employed in the statistical analysis. Findings: A cohort of 200 street children, with a mean age of 13.6 years, was examined. The majority of the sample comprised male individuals (n=156, 98.15%). The study revealed that 27% of the participants (95% confidence interval [CI]: 0.21–0.33) reported a history of substance abuse (n=54). Key risk factors identified encompassed increasing age (odds ratio [OR]=1.32, 95% CI: 1.12–1.55), prior detention (OR=5.45, 95% CI: 1.92–15.42), and a family history of substance abuse (OR=7.53, 95% CI: 3.02–18.77), indicating a heightened likelihood of substance abuse with each of these factors. The logistic regression model exhibited satisfactory predictive accuracy (area under the curve [AUC]=0.78, 95% CI: 0.72–0.86). Conclusion: This study identified age, a familial history of substance use, and prior incarceration as significant predictors of substance abuse among street children and adolescents. Consequently, there is a demonstrated need for focused interventions that address familial, social, and psychological determinants to mitigate substance abuse within this at-risk demographic.