The Social Determinants of Clustering Effects Between Substance Use, Violence, and Other Risk Behaviors of Israeli Youth: Findings From the WHO-HBSC Survey,

This paper explores the complex behavioral co-morbidity of drugs and risk taking behaviors. Adolescent school children who experiment with binge drinking and drugs are more likely to develop risky life styles that expose them to social settings and types of peers that increase the likelihood of their involvement in violence, risk-taking behaviors and truancy. In fact, the strong association be-tween problem drinking and use of cannabis and the involvement in violence is only partially due to the effects of the substance themselves. A significant percentage of variance is explained by the risky behavioral life style associated with substance use, that puts the teen at risk for violence and truancy. The study made use of data from the Israeli 2014 WHO-HBSC survey conducted on a representative sample of 16,145 school children ages 11−17. Findings show that cannabis users are 6 times more likely to report binge drinking and drunkenness compared to non-users of cannabis. Those who reported binge drinking at least once during the past 30 days are 5 times more likely to be involved in bullying others 3 times or more during the past 2 months or report carrying weapons. Similar Odds Rations were found for indicators of hidden dropout and truancy. The strong association between cannabis and excess alcohol drinking, and the behavioral association between substance use and risk taking behaviors such as violence and truancy are discussed from a perspective of social and cultural contexts of substance use and the life styles associated with youth culture and the unique social settings in which most of these behaviors take place. The co-morbidity between substance use and other risk taking behaviors is therefore an association that needs much more attention − both in research and in the development of policy and more effective intervention strategies and programs.