What Causes Substance Use Disorders? A Look at Social and Environmental Factors

In previous blogs, we looked at physiological and psychological factors that may contribute to the development of Substance Use Disorders (SUDs).  In this entry, we will focus on some social and environmental factors that may lead to the development of SUDs.

When discussing potential social factors contributing to the occurrence of SUDs, it seems reasonable to begin with the child’s primary social group—their family system, or their primary caretakers.  Obviously, the family’s attitude and behavior toward the use of alcohol and other drugs can have a significant impact on that child’s substance use patterns.  If the parents (or the primary caretakers) often abuse drugs and alcohol around the child, this may lead to the child modeling the behavior and repeating it later.  Sometimes, the modeling is not of the parents, but of other influential family members, such as siblings, uncles, aunts, or grandparents. 

Other family factors that have been found to contribute to the development of SUDs in a young person include poor supervision during the formative years, severe disciplinary practices toward the child, frequent family conflicts making the family system seem unsafe, and even economic deprivation or poverty in the household.  In recent studies attempting to identify factors leading to substance abuse in adolescents, the single most important factor for preventing SUDs was the frequency that children ate meals with their primary caretakers.  There seems to be a strong inverse correlation between eating meals with parents and substance use.  Children who frequently ate meals with parents abused substances less often than those who did not. 

Another important factor in a child’s life that contributes to the onset of SUDs is the school system.  Clearly, children with more conduct problems have a greater likelihood of developing SUDs.  This may not be entirely a social issue, as there is growing evidence that conduct disorders and SUDs may have genetic commonalities running in some families.  We do know that a low commitment to school, school failure, truancy, early dropout, and placement in special education classes are all correlated with an increased likelihood of developing SUDs.

A third system that plays an influential role in the life of an adolescent is the peer system.  It seems reasonable that an association exists between a strong acceptance of heavy drug and alcohol use by one’s peers and the development of heavy use in an adolescent.  Does an adolescent seek out peers with similar attitudes towards drug and alcohol use, or does the peer group influence the child’s attitude toward drugs and alcohol?  It seems to work both ways. 

Lastly, there are other environmental factors that appear to contribute to substance abuse, including poverty, unemployment, and a community or cultural leniency towards heavy drug and alcohol use.  Currently, there is a growing controversy as to the influence of television, movies, and video games that portray frequent use and abuse of substances on teen abuse of substances.  We will see what the growing research determines about these factors. 

In summary, there are many social and environmental factors that may contribute to the heavy use and abuse of drugs and alcohol.  Often, simply changing one’s environment and peer group can have significant, positive effects and reduce the likelihood of developing an SUD.

Nicholas Lessa is the Clinical Director of Chat2Recovery, an online substance abuse treatment program, and Inter-Care, a leading substance abuse treatment program in New York City.  He has been in the field of substance abuse treatment for over 30 years.  He is the lead author of two books, Wiley’s Concise Guide to Mental Health: Substance Use Disorders and Living with Alcoholism and Drug Addiction.

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