This chapter draws together research findings on co-use of multiple drugs and co-occurring mental health problems from the Youth Pathways Project. One hundred and fifty street youth in Toronto (2005-2006) were interviewed for this study and were split evenly by gender. Current use of alcohol and cannabis was greater among male than female street-involved youth (about 80% and 60% respectively); rates for other drugs (hallucinogens, amphetamines, cocaine, crack and heroin), while much lower and involving no more than one third of the sample, were about the same for males and females. The different factors associated with multiple drug use for the young men and women, however, suggested the need for gender-specific approaches to addiction service delivery. In addition, one quarter of those interviewed were found to have concurrent or simultaneous mental health and substance use problems. These more vulnerable street youth were also more transient, and more likely to have a history of abuse and arrest, than those without concurrent problems. In particular, these youth were nearly four times more likely to have been victimized in the past 12 months than street involved youth without these problems. While street youth in general have a need for harm reduction services, those with poorer health and who experience co-occurring mental health and addiction problems deserve particular attention and need access to treatment that addresses multiple conditions. Policies that worsen these conditions, particularly the lack of appropriate and secure housing, must be examined and improved to prevent the path into adult homelessness, addiction and poor social functioning.
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