Journal of Ethnicity in Substance Abuse, 13:179–184, 2014

Copyright # Taylor & Francis Group, LLC

ISSN: 1533-2640 print=1533-2659 online
DOI: 10.1080/15332640.2013.853016

Ethiopian Origin High-Risk Youth: A

Cross-Cultural Examination of Alcohol Use,
Binge Drinking, and Problem Behavior

RICHARD ISRALOWITZ and ALEXANDER REZNIK

Ben Gurion University, Beer Sheva, Israel

Alcohol use among underage youth has a major impact on public

health, accidents, fatalities, and other problem behaviors. In Israel,
alcohol use, binge drinking, and related problem behaviors are a
growing concern. The purpose of this study was to examine under-
served and underreported Ethiopian origin youth by comparing
their substance use patterns and behavior with other high-risk
youth. Data were collected from a purposive sample of boys of Ethio-
pian, former Soviet Union, and Israeli origin who were receiving
treatment for drug use. Youth were asked to complete a simply
worded self-report questionnaire developed for monitoring sub-
stance use and related problem behaviors. Ethiopian youth reported
higher rates of family unemployment and public welfare depen-
dence, last 30-day consumption of beer and hard liquor, serious
fighting, and achievement decline when in school compared with
the other youths. Findings highlight the need for ethno-cultural
specific prevention and intervention efforts and further research
of this high-risk, underserved group of immigrant origin youth.

KEYWORDS alcohol use, binge drinking, Ethiopian youth, sub-

stance use

BEHAVIOR

Alcohol use among underage youth has a major impact on public health and
costs billions of dollars annually in losses that result from traffic accidents and

The authors thank Moshe Kron (past director) and Katya Levin (current director) of Youth
Magal, Jerusalem, for their cooperation with this research.
Address correspondence to Richard Isralowitz, PhD, Ben Gurion University, Beer Sheva,
Israel 84105. E-mail: Richard@bgu.ac.il.

179
180 R. Isralowitz and A. Reznik

fatalities, violent crime, and other problem behavior (Bonnie & O’Connell,
2004). A major factor attributed to this problem is binge drinking, commonly
defined as 5 or more drinks on the same occasion within about 2 hours
(Centers for Disease Control and Prevention [CDC], 2012). In Europe, last
30-day binge drinking rates for youth range from 37% to 60% (Johns Hopkins
Bloomberg School of Public Health, 2012). In the United States, approxi-
mately 90% of the alcohol consumed by youth is in the result of binge drink-
ing (Office of Juvenile Justice and Delinquency Prevention, 2005), reportedly
as high as 36% for 12th grade male (CDC, 2012; Johnston, O’Malley,
Bachman, & Schulenberg, 2012). In a nationally representative sample of
high-risk youth in alternative schools, last 30-day binge drinking has been
reported to be approximately 50% (Windle, 2003).
In Israel, alcohol use, binge drinking, and related problem behaviors are
a growing concern. Among youth receiving substance abuse treatment, 80%
reported last 30-day alcohol use, 33% reported binge drinking, 10% reported
driving a car after drinking, and 14% reported being in car when the driver
had been drinking (Isralowitz & Reznik, 2006). Of youth receiving probation
services for delinquent activity, 61% reported last 30-day alcohol use, 32%
reported binge drinking, 5% reported driving a car after drinking, and 12%
reported being in a car with a driver who had been drinking (Isralowitz &
Rawson, 2006).
This article focuses on alcohol use, binge drinking, and related problem
behaviors among male Ethiopian school dropouts who were receiving treat-
ment for drug use. They are compared with former Soviet Union and Israeli
origin youth with similar status. Data on other drugs (e.g., tobacco, cannabis,
and non-prescription drug use) have been collected as part of an ongoing
effort to monitor patterns of use among dropouts. However, scant
information has been reported about this group of youth.

School Dropouts in Israel

After several years of declining numbers, in 2009 the Ministry of Education
reported an increase of school dropouts by approximately 40% and that three
quarters of the dropouts came from three population groups: immigrants,
ultra-Orthodox Jews, and Arabs (Kashti, 2010). Current dropout rates range
from 4.1% to 10%, depending on ethnic origin (Israel Central Bureau of
Statistics, 2012).

Ethiopian Youth
The Ethiopian origin community in Israel is comprised of approximately
115,000 people, or about 1.5% of the population (Israel Central Bureau of
Statistics, 2014). Difficulties with language, unemployment, low socioeco-
nomic status, and prejudice have been related to problem behavior, including
 Ethiopian Origin High-Risk Youth 181

school dropout, delinquency, and drug abuse (Buckard, 2001; Ringel, Ronell,
& Getahune, 2005). Studies comparing high-risk youth (e.g., juvenile offen-
ders and those with learning and=or behavior problems) show that those with
parents of immigrant origin have significantly higher levels of drug use and
binge drinking (Isralowitz & Reznik, 2007; Kahan-Strawczynski, Ben Simon,
& Konstantinov, 2013; Shechory & Ben-David, 2010).

METHOD

Data were collected from 2004 to 2012 from a purposive sample of 57

Ethiopian, 176 former Soviet Union, and 193 Israeli origin males receiving
90-day drug treatment in a residential program. During their intake interview
for treatment, youth were asked to complete a simply worded self-report
questionnaire. Data were collected in a voluntary and anonymous manner
complying with human subject guidelines of the residential treatment facility,
the Ministry of Health and Ben Gurion University.
The Substance Use Survey Instrument (SUSI) was used for data collec-
tion; it consists of 31 questions about background characteristics, substance
use patterns, and related problem behaviors. Prepared in English, the ques-
tionnaire was translated to Hebrew and then back translated. The instrument
has been found to be reliable (Cronbach alpha, 0.93).
Statistical analyses were performed using SPSS version 19 software. Chi
square and one-way analysis of variance analyses were used to determine
alcohol use, binge drinking, and related problem behaviors based on country
of origin.

RESULTS

The age of the youth ranged from 13 to 18 years, with a median age of 17.0
years. Rates of Ethiopian parent unemployment and dependence on public
welfare benefits (39.3% and 60.4%, respectively) were significantly higher
(p < .001 and p < .01, respectively) than those with former Soviet Union
(17.8% and 25.9%) and Israeli origin status (29.4% and 53.1%).
The majority (93.8%) of youth reported lifetime alcohol use. Former
Soviet Union origin youth were significantly more likely to begin drinking
at an earlier age (p < .001). Ethiopian youth reported significantly higher rates
of current, last 30-day beer (85.7%, 69.1%, 67.7%; p < .05) and hard liquor use
(76.8%, 58.6%, 59.6%; p < .05) than FSU and Israeli origin youth. No signifi-
cant difference was reported for last 30-day binge drinking. However,
Ethiopian youth were significantly more likely than FSU and Israeli origin
youth to have been in a serious fight and report a decline in school achieve-
ment before dropping out of school. Table 1 provides results based on
country of origin status.
182 R. Isralowitz and A. Reznik

TABLE 1 Ethiopian, Former Soviet Union, and Israel Origin High-Risk Youth: Alcohol Use,
Binge Drinking, and Problem Behaviors

Origin

Ethiopia FSU Israel v2 or F

Alcohol and Problem Behaviors (n ¼ 57)1 (n ¼ 176)1 (N ¼ 193)1 value

Lifetime any alcohol use, % (n) 96.4 (54) 94.3 (166) 92.5 (173) 1.2
Beer use
Lifetime, % (n) 92.9 (52) 90.3 (159) 88.9 (169) 0.8
Age of start (y), mean (SD) 13.7 (2.5) 12.4 (2.6) 13.3 (1.9) 8.4



Wine use
Lifetime, % (n) 75.4 (43) 76.1 (134) 64.7 (121) 6.4

Age of start (y), mean (SD) 14.0 (2.6) 12.3 (2.6) 13.4 (2.3) 8.5



Hard liquor use
Lifetime, % (n) 89.5 (51) 80.7 (142) 85.3 (162) 2.9
Age of start (y), mean (SD) 14.1 (2.7) 12.8 (2.3) 13.8 (2.0) 7.9



Last 30 days
Any alcohol use, % (n) 89.3 (50) 76.9 (133) 76.9 (143) 4.4
Beer use, % (n) 85.7 (48) 69.1 (121) 67.7 (128) 7.1

Wine use, % (n) 44.6 (25) 36.8 (64) 36.6 (68) 1.3
Hard liquor use, % (n) 76.8 (43) 58.6 (102) 59.6 (107) 7.5

Binge drinking, % (n) 52.6 (30) 45.2 (76) 45.9 (85) 1.0
Driving after drinking, % (n) 13.0 (7) 11.7 (19) 10.3 (19) 0.4
Passenger when the driver had been 24.1 (13) 18.1 (30) 23.9 (44) 2.0
drinking, % (n)
Past 12 months
Decline in school achievement, % (n) 65.9 (27) 56.5 (61) 45.0 (68) 7.0

Decline relations with family 50.0 (26) 68.8 (110) 65.2 (118) 6.1

members, % (n)
Decline relations with friends, % (n) 43.4 (23) 56.4 (88) 47.1 (81) 4.0
Gotten into serious fight, % (n) 61.1 (33) 54.3 (89) 44.3 (81) 6.2



p < .05;


p < .001.
1
Up to 5 participants with missing data on one or more variables.

DISCUSSION

This study provides an overview of alcohol use, binge drinking, and related
problem behaviors among Ethiopian school drop outs; however, several
limitations affect the ability to generalize the findings. Data were based
on self-reports of youth at the intake stage for treatment. Adolescents,
especially those referred to a residential treatment facility, can be sus-
picious about information gathering and may provide arbitrary or inconsist-
ent responses (Hawke, Hennen, & Gallione, 2005). Also, the possibility of
underreporting alcohol use exists with self-report. However, the high rates
of alcohol use and related problem behavior among Ethiopian youth point
to the need for greater ethno-cultural specific prevention and intervention
efforts.
 Ethiopian Origin High-Risk Youth 183

CONCLUSION

Given the paucity of literature on alcohol use among school dropouts, parti-
cularly those of Ethiopian origin, this article contributes to the understanding
of a segment of society that is neither well understood nor adequately
addressed in terms of education, employment, and health and social services.
Further research is needed to validate the current study findings so such infor-
mation may be useful for policy and services, as well as for training practi-
tioners who are addressing the needs of youth of Ethiopian origin.

REFERENCES

Bonnie, R. J., & O’Connell, M. E. (Eds.), (2004). Reducing underage drinking: A

collective responsibility. Committee on Developing a Strategy to Reduce and
Prevent Underage Drinking, Board on Children, Youth and Families, National
Research Council, Washington, DC: National Academy of Sciences.
Buckard, C. (2001). Ethiopian Jews in Israel. Tel-Aviv, Israel: Heinrich-Boell
Foundation.
Centers for Disease Control and Prevention. (2012). Morbidity and mortality weekly
report: Youth risk behavior surveillance–United States, 2011. Surveillance
Summaries. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/
ss6104a1.htm
Hawke, J. M., Hennen, J., & Gallione, P. (2005). Correlates of therapeutic
involvement among adolescents in residential drug treatment. The American
Journal of Drug and Alcohol Abuse, 31, 163–177.
Israel Central Bureau of Statistics. (2014). Statistical abstract of Israel 2013. Retrieved
from http://cbs.gov.il/reader/shnatonenew_site.htm
Isralowitz, R., & Rawson, R. (2006). Gender differences in prevalence of drug use
among high risk adolescents in Israel. Addictive Behaviors, 31, 355–358.
Isralowitz, R., & Reznik, A. (2006). Brief report: Binge drinking among high risk male
and female adolescents in Israel. Journal of Adolescence, 29, 845–849.
Isralowitz, R. E., & Reznik, A. (2007). Former Soviet Union immigrant and native-
born adolescents in Israel: Substance use and related problem behavior. Journal
of Ethnicity in Substance Abuse, 6, 131–138.
Johns Hopkins Bloomberg School of Public Health. (2012). Prevalence of underage
drinking. Retrieved from http://www.camy.org/factsheets/sheets/prevalence_
of_underage_drinking.html
Johnston, L., O’Malley, P., Bachman, J., & Schulenberg, J. (2012). Monitoring
the Future: National Results on Adolescent Drug Use, Overview of Key Findings
2011. Retrieved from http://www.monitoringthefuture.org/pubs/monographs/
mtf-overview2011.pdf
Kahan-Strawczynski, P., Ben Simon, B., & Konstantinov, V. (2013). The characteris-
tics and needs of youth in youth rehabilitation service programs (executive
summary). Jerusalem: JDC–Brookdale Institute.
Kashti, O. (2010). Student dropout rate jumps by nearly 40 percent. Haaretz, June 17.
184 R. Isralowitz and A. Reznik

Office of Juvenile Justice and Delinquency Prevention. (2005). Drinking in America:

Myths, realities, and prevention policy. Washington, DC: U.S. Department of
Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency
Prevention, 2005. Retrieved from http://www.udetc.org/documents/Drinking_
in_America.pdf
Ringel, S., Ronell, N., & Getahune, S. (2005). Factors in the integration process of
adolescent immigrants: The case of Ethiopian Jews in Israel. International
Social Work, 48, 63–76. doi: 10.1177=0020872805048709
Shechory, M., & Ben-David, S. (2010). A comparative analysis of delinquency among
youth from the former Soviet Union and from Ethiopia in Israel. Journal of
Ethnicity in Criminal Justice, 8, 290–311. doi: 10.1080=15377938.2010.526871
Windle, M. (2003). Alcohol use among adolescents and young adults. Alcohol
Research & Health. Retrieved from http://www.niaaa.nih.gov/publications/
arh27-1/79-86.htm
Copyright of Journal of Ethnicity in Substance Abuse is the property of Taylor & Francis Ltd
and its content may not be copied or emailed to multiple sites or posted to a listserv without
the copyright holder's express written permission. However, users may print, download, or
email articles for individual use.