Models of intervention and care for psychostimulant users, 2nd edition - monograph series no. 51

Risk, protection, transitions and connectedness

Page last updated: April 2004

Simplistic cause and effect models of problematic substance use have not proved helpful and pathological explanations can confuse efforts to understand and respond to drug use by young people (Moore & Saunders, 1991). It should be clear then that the aetiology of problematic drug use during adolescence is multi-determined and that the individual, the environment and the drugs themselves cannot be considered in isolation (Dielman, Butchart, Shope & Miller, 1990-1991; Moncher, Holden & Schinke, 1991; Spooner, Hall & Lynskey, 2001).

However, most adolescents who engage in substance use do not develop a substance use disorder, such as abuse or dependence. Researchers have identified a number of risk factors which may directly or indirectly make young people more vulnerable to the development of problematic substance use (Gilvarry, 2000; Spooner et al., 2001).

Individual factors such as genetic/biological, temperamental, neurobiological and psychological variables and an earlier age of initiation of substance use may increase the likelihood of problematic substance use (Buckstein et al., 1997; Gilvarry, 2000; Newcomb & Felix-Ortiz, 1992; Spooner et al., 2001).

Community factors including the physical environment in which young persons live and their legal, social and cultural context may also play a role (Buckstein et al., 1997; Gilvarry, 2000; Newcomb & Felix-Ortiz, 1992; Spooner et al., 2001). Family influences are vitally important and young people living in families where there is conflict, dysfunction and parental substance abuse and psychopathology are at increased risk of substance use (Gilvarry, 2000; Newcomb & Felix-Ortiz, 1992; Spooner et al., 2001; World Health Organisation, 2002).

The final group of factors found to influence young people's substance use are school and peer factors. Young people who have positive relationships with teachers and feel 'connected' to and are rewarded for their involvement in their school environment are less likely to have problems with substance misuse (Spooner et al., 2001). Peers are of critical importance, as young people with substance using peers with positive attitudes towards substance use are more likely to initiate and maintain substance use (Buckstein et al., 1997; Gilvarry, 2000).

A number of 'protective factors' which may decrease the vulnerability of a young person by enhancing resiliency and ameliorating the effects of existing risk factors have also been identified (Newcomb & Felix-Ortiz, 1992). These include a positive temperament, intellectual ability, a supportive family environment with clear structure and boundaries, prosocial peers and a strong sense of 'connectedness' with family, school or external support systems (Rutter, 1985; Spooner et al., 2001).

It is important to note that exposure to risk and protective factors varies with the developmental stage, perceived meaning of (attribution) and current life circumstances of young people. Risk and protective factors may have direct, indirect interactional and even reciprocal effects on substance misuse (Farrell, 1993; Rutter, 1985). However, methodological difficulties abound in studies on causation and recent research has stressed that there are multiple pathways to substance misuse.