Freisthler, B., Wolf, J. P., Wiegmann, W., & Kepple, N. J. (2017). Drug use, the drug environment, and child physical abuse and neglect. Child Maltreatment, 22(3), 245–255.
This study explores the connection between drug use, the characteristics of the drug environment and child maltreatment using multilevel modeling. The underlying conceptual model for the study postulates that there are two related components of the drug environment: drug supply and drug demand. Drug supply operates through social networks and routine activities. Social network drug markets are where drug contacts are generated, and these are spaces that are largely invisible to those outside the drug community. Routine activity drug markets are common spaces in the larger community where drug transactions occur. Neighborhoods that frequently host such transactions are characterized by low-level social control, which refers to the inability of the community to maintain state structures. It is within these spaces that the relationship between a caregiver’s exposure to substances and substance use are examined in relation to child physical abuse, physical neglect and supervisory neglect.
For this study, drug supply was measured at a city level, and drug demand was measured at both the individual and city level. Variables were defined using survey data collected from sampled households in the general population and city-level data from police and hospitals. The authors hypothesized that drug demand (i.e., individual drug use) would be associated with higher physical and supervisory neglect while the larger context of social networks in which drug supply was higher would be associated with higher rates of physical abuse.
The findings indicated that children were at higher risk of maltreatment in areas where there was greater drug use and greater drug availability, but the results pointed to more specific mechanisms for understanding these relationships. City-level rates of drug use and drug dependence were associated with higher rates of physical abuse. In areas where there was greater drug availability, drug-using parents reported higher levels of physical abuse and physical neglect. Higher levels of physical neglect were also associated with parents witnessing drug sales as well as city-level density of drug crime incidents. Importantly, emotional support (i.e., parents reporting that they have someone with whom they can share their private worries and fears) buffered the impact of the drug environment for all three types of maltreatment. The results pointed to potential mechanisms that could reduce child maltreatment, including environmental prevention and neighborhood strengthening approaches.
The study used data from 43 cities across California retrieved in 2009. City selection was randomized. The first city was considered the seed city, and each subsequently selected city had boundaries that were at least one mile and two cities away from the previously selected city. Data were collected through landline telephone surveys where valid police data on narcotics was made available. The total sample included 21,114 households, from which there were 2,597 respondents who completed the full survey and self-identified as a caregiver of a child under the age of twelve. The phone interviews, which were approximately 30 minutes long, used a combination of live interviewer on computer-assisted software for 25 minutes and interactive voice recording technology for 5 minutes. Multilevel linear regression modeling was used to assess the relationships between individual-level data collected through the survey and city-level indicators of drug crime, drug abuse and dependence, and demographic control variables.
There are few limitations highlighted in this study. These include the use of landline telephones to conduct interviews and low response rates, which excluded households that only use cell phones, resulting in low-income households and younger families having less representation in the study. In addition, low response rates may bias the findings. Lastly, the authors acknowledge the study as introductory and suggest that further research should contextualize the use of drugs in order to understand where, how much and with whom caregivers are engaging with these substances.