Substance use and functional impairment among adolescents directly exposed to the 2001 World Trade Center attacks

Authors

  • Claude M. Chemtob,

    1. Clinical Professor of Psychiatry and Pediatrics at the Departments of Psychiatry and Pediatrics, Mount Sinai School of Medicine, New York, United States
    Search for more papers by this author
  • Yoko Nomura,

    1. Assistant Professor at the Department of Psychiatry, Mount Sinai School of Medicine, New York, United States
    Search for more papers by this author
  • Louis Josephson,

    1. Executive Director at the Riverbend Community Mental Health Center, Concord, New Hampshire, United States
    Search for more papers by this author
  • Richard E. Adams,

    1. Associate Professor at the Department of Pediatrics, Mount Sinai School of Medicine, New York, United States
    Search for more papers by this author
  • Lloyd Sederer

    1. Executive Deputy Commissioner at the New York City Department of Health and Mental Hygiene, New York, United States and is now Medical Director at the New York State Office of Mental Health.
    Search for more papers by this author

Correspondence
Claude M. Chemtob, The Mount Sinai School of Medicine, 1 Gustave Levy Place, Box 1230, New York City, New York, 10029, United States. Telephone: +1 212 987 0559; fax: +1 212 987 0839; e-mail: claude.chemtob@mssm.edu.

Abstract

The relationship between exposure to the World Trade Center (WTC) attacks, increased substance use, functional impairment and mental health service use, controlling for depression and post-traumatic stress disorder, was assessed through an in-school survey of directly exposed students (N = 1040) attending the five middle and five high schools nearest the WTC. The survey was conducted 18 months after the attacks. Students with one WTC exposure risk factor had a five-fold increase in substance use, while those with three or more exposure risks had a nearly 19-fold increase. Increased substance use was associated with impaired school work, school behaviour and grades. Students reporting increased substance use were nearly twice as likely to want help but were no more likely than asymptomatic students to receive services. Adolescents reporting increased substance use, without co-morbidity, were less likely to receive psychological services than others. Attention to the needs of substance-using adolescents exposed to disaster is needed.

Ancillary