Illicit substance use, gender, and the risk of violent behavior among adolescents.

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.