Risk Factors Surrounding Children 

One issue that continues to be investigated is what factors are associated with an individual going beyond initial drug use to drug abuse and then what is associated with chronic drug abuse.  Fortunately, the majority of initial drug use does not lead to chronic drug abuse with its profound consequences.  The factors that predispose a person to initial drug use are somewhat distinct from those that predispose an individual to chronic drug abuse.  In general, initial drug use and infrequent drug involvement, which neither escalate nor have major negative consequences, are a function of social and peer factors, while chronic drug abuse appears to be more related to biological and psychological processes.

Although biological and genetic factors play an important role in drug abuse, it is also clear that these factors interact in complicated ways with psychological, social, and environmental factors to ultimately determine avoidance of drug use or drug abuse.  Prevention researchers are attempting to integrate these scientific findings to better understand the processes associated with drug abuse and to develop cost-effective interventions to prevent drug abuse.

Substance abuse has many causes and involves a complex interaction of risk factors.  These risk factors can be categorized in several ways.  One way is to group them in the same five areas that prevention programs target:

Individual and interpersonal risk factors: low self-esteem, genetic susceptibility, sensation seeking, aggressiveness, conduct problems, shyness, rebelliousness, alienation, academic failure, low commitment to school, and so on.

Peer group factors: associating with individuals who use illegal drugs, rejection in elementary grades, friendship with other rejected children, bonding with peers who abuse alcohol and drugs and engage in other delinquent activities; peer pressure to use substances, and association with peers who abuse substances.  Associating with substance-abusing peers is the final determinant of substance abuse among many youth.  Resistance to peer pressure can be increased through involvement in peer resistance training programs.

Family risk factors: alcoholic parents; perceived parent permissiveness toward drug/alcohol use; lack of or inconsistent parental discipline; negative communication patterns; conflict; low bonding; stress and dysfunction caused by death, divorce, incarceration of parents, or low income; lack of extended family or support systems; emotionally  disturbed parents; parenting problems; lack of skills to cope with family problems; parental rejection (for example, the unwanted child); lack of adult supervision; lack of family ritual (such as holiday family gatherings); poor family management and communication; physical and/or sexual abuse; and parental or sibling substance abuse.  Strengthening families can reduce the negative effects of family environmental influences on youth for substance abuse.  Prevention strategies can include conducting parenting programs, providing family support, and providing family skills training.  Family therapy has been found to reduce the effects of substance abuse risk factors including delinquency, misconduct, and depression.

School risk factors: lack of support for positive school values and attitudes; school dysfunction, high rates of substance abuse and pro-substance abuse norms.  Drug-using gang members; low teacher and student morale.  School climate that provides little encouragement and support, student perceptions that teachers do not care about them, lack of appreciation for school and educational process.   Academic failure, lack of involvement in school due to discrimination, lack of opportunities for involvement and reward, perceived unfair rules, and norms that are conductive to substance abuse.  School climate improvement programs, have been effective in reducing the negative effects of adolescent substance abuse.

Community risk factors: high crime rate, high population density, physical deterioration, availability, norms supporting alcohol and other drug abuse, ambivalent or pro-substance abuse community values and attitudes.  Community dysfunction, transient populations, lack of active community institutions, lack of feeling part of the community, being in a community that condones substance abuse.  Disorganized neighborhoods lacking leadership, lack of opportunities for youth involvement in positive activities, high rates of substance abuse, poverty and lack of employment opportunities, easy availability of drugs and alcohol; and lack of economic mobility and social supports.  Increased opportunities for positive community involvement may reduce the effects of the negative environmental influences on youth for substance abuse.

Survey research studies often are used also as the basis for identifying risk factors based on demographic factors.  Demographic risk factors include: gender; ethnicity; age; socioeconomic status; employment; income; education; and location of residency.

The Parent's Role

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Acknowledgement: This page was adapted by Alonso Lopez from the original Drug abuse prevention: What Works. U. S. Department of Health and Human Services.  DHHS