Research has revealed that there are many risk factors for developing a substance use disorder, each representing a challenge to the psychological and social development of an individual and each having a different impact depending on the phase of development.
Factors in the family that may be critical in the development of substance use problems include:
Other risk factors relate to children interacting with others outside of the family, specifically at school, with peers, and in the community. Some of these factor are:
Additional factors—such as the availability of substances, trafficking patterns, and beliefs that substance use will be generally tolerated—also influence the number of young people who initiate use.
The National Institute on Drug Abuse reports some of the most salient protective factors, include:
Researchers note “when people feel bonded to society, or to a social unit like the family or school, they want to live according to its standards or norms” (Hawkins et al., 1992). Furthermore, reports show that “strong norms, beliefs, or behavioral standards that oppose the use of alcohol or the use of illegal drugs by adolescents protect against drug use and abuse” (Hawkins, 2002).
An adolescent’s community, including family, teachers, coaches, and churches, has a responsibility to assist the adolescent to make healthy decisions. Research on factors and processes that increase the risk of using drugs or protect against the use of drugs has identified the following primary targets for preventive intervention: family relationships, peer relationships, the school environment, and the community environment. Each of these domains can deter the initiation of drug use through increasing social and self-competency skills, adoption of pro-social attitudes and behaviors, and awareness of the harmful health, social, and psychological consequences of drug abuse. Educating children about the negative effects of drugs, especially the most immediate adverse effects in their lives, is an important element in any prevention program. In addition, helping children become more successful in school helps them form strong social bonds with their peers, the school, and the community.
For most children, research has shown that the vulnerable periods for engaging in at-risk behaviors occur during transitions from one developmental stage to another. For example, when children advance from elementary school to middle school or junior high, they often face social challenges, such as learning to get along with a wider group of peers. Even day-to-day transitions between school and home make adolescents more vulnerable to misuse of alcohol and other drugs. There is an increase in substance use when adolescents are not engaged in school or other formal activities like summer and after school. Prevention programs need to provide support at each developmental stage and during transitions between stages.
Screening and Brief Intervention (SBI) is designed specifically for individuals using unhealthy or hazardous levels of alcohol—like binge drinking. Since most adolescents who use do so episodically and in a binge pattern (5 or more drinks per occasion), but are not dependent, SBI can be an effective approach to change behavior.
Research has shown that 6 months after adolescents receive brief interventions in emergency departments they have a 32% reduction in driving under the influence and 50% fewer alcohol-related injuries compared to adolescents who only receive educational materials (Monti et al., 1999).