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Carolyn Piver Dukarm, MD; Robert S. Byrd, MD, MPH; Peggy Auinger, MS; Michael Weitzman, MD

Arch Pediatr Adolesc Med. 1996;150(8):797-801.

Abstract
Objectives
To analyze data from a nationally representative sample of high school students to investigate the relationship between substance use and violent behavior among adolescents and to examine this relationship in both male and female adolescents.

Design
Cross-sectional analyses of the 1991 Centers for Disease Control and Prevention's Youth Risk Behavior Survey.

Setting
Public and private schools in the 50 states. Participants: The participants were 12 272 high school students.

Main Outcome Measure
To determine the prevalence of weapon carrying and physical fighting among male and female adolescents.

Results
A significant increase in the number of male and female adolescents carrying weapons and physically fighting was associated with all forms of substance use. Reports of carrying a weapon increased with recent alcohol consumption (34% vs 17%, P<.001) and use of marijuana (48% vs 22%, P<.001), cocaine (71% vs 25%, P<.001), and anabolic steroids (62% vs 25%, P<.001). The prevalence of physical fighting was also significantly higher among adolescents who used illicit substances than among adolescents who denied drug use. The risk of violent behavior increased significantly, and was of equal magnitude, for adolescent females and males who were illicit substance users.

Conclusions
Alcohol and illicit substance use are highly associated with an increased risk of violent behavior. These data also demonstrate that the risk of violence by adolescent females who are substance users is substantial.

Arch Pediatr Adolesc Med. 1996;150:797-801

Author Affiliations
From the Divisions of Adolescent Medicine (Dr Dukarm) and General Pediatrics (Drs Dukarm, Byrd, and Weitzman and Ms Auinger), Department of Pediatrics, the University of Rochester (NY) School of Medicine and Dentistry.

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