Decades of research have helped to identify several patterns of risk and protective factors contributing to alcohol and drug use in adolescence and in later life. The presence and impact of these factors and their interactions with one another can vary depending on the population for which prevention interventions are planned. Limiting risk factors while strengthening and increasing the availability of protective resources will help to reduce substance abuse and create healthier individuals and communities. Below are some of the most important risk and protective factors identified in the literature:
Age of onset
Alcohol and drug use tends to begin in mid-to-late adolescence, though it is greater among individuals who experience early puberty (O'Connell et al, 2009). The earlier the age at which someone starts drinking the greater the risk that s/he will develop alcohol-related problems later in life. A delay in drinking until 20- to 21-years-old reduces the risk of developing alcohol-related problems (Chou et al, 1992).
Youth perception that parents approve of their alcohol or drug use
One of the most consistent risk factors for adolescent drinking is perceived parental approval (Donovan, 2004). Reported maternal care perception has been shown to be significantly lower among alcohol and those who use multiple drugs (Gerra et al, 2004).
Peers engaging in problem behavior
Associating with drug- or alcohol-using peers, or being rejected by peers, can create problem behaviors and influence attitudes and norms related to substance use (O'Connell et al, 2009). Exposure to peer problem behavior is correlated with increased alcohol and other substance use in the same month (Dishion et al, 2000). Those who drink in a social setting, or who have peers who do so, are more likely to abuse alcohol later in life (Beck et al, 1996).
Early and persistent problem behaviors, risk-taking, and high sensation-seeking
Early aggressiveness or antisocial behavior persisting into early adolescence predicts later adolescent aggressiveness, drug abuse, and alcohol problems (Hawkins et al, 1995).
Parental monitoring (or perception of monitoring)
Adolescents who report low parental monitoring are significantly more likely to use a variety of substances (Shillington et al, 2005). Positive parental style and close monitoring by parents are proven protective factors for adolescent’s use of alcohol and other drugs (Stewart, 2002).
Parent or older sibling drug use (or perception of use)
Familial alcohol-using behaviors are strong predictors of adolescent alcohol use (Birckmayer et al, 2004). In a 2003 study, alcohol initiation most often occurred during family gatherings. Moreover, a family history of alcoholism was a significant risk factor for the development of adolescent problem drinking (Warner et al, 2003).
Low perception of harm
Low perception of harm towards alcohol and drug use is a risk factor for use (Henry et al, 2005). Individuals with attitudes or values favorable to alcohol or drugs are more likely to initiate substance use (Hawkins et al, 1992).
Strong parent and adolescent relationship and family cohesion
Adolescents who have a close relationship with their parents are less likely to become alcohol involved (Birckmayer et al, 2004).
Youth access and availability
The majority of alcohol consumed by youth is obtained through social sources, such as parents and friends, at underage parties and at home (Birckmayer et al, 2004). Availability of alcohol or illegal drugs leads to increased use (Hawkins et al, 1995).
Poor school achievement and low school bonding
Adolescents who have a low commitment to school or do poorly are more likely to become alcohol involved (Birckmayer et al, 2004).
Beck, K., Treiman, KA. (1996). The relationship of social context of drinking, perceived social norms, and parental influence to various drinking patterns of adolescents. Addictive Behaviors, 21(5), 633-44.
Birckmayer, JD, Holder, HD, Yacoubian, GS, & Friend, KB. (2004). A general causal model to guide alcohol, tobacco, and illicit drug prevention: Assessing the research evidence. Journal of Drug Education, 34(2), 121-153.
Chou, S. P. and R. P. Pickering. (1992). Early onset of drinking as a risk factor for lifetime alcohol-related problems. British Journal of Addiction, 87(8), 1199-1204.
Dishion, T. J. and N. M. Skaggs. (2000). An ecological analysis of monthly 'bursts' in early adolescent substance use. Applied Developmental Science, 4, 89-97.
Donovan, J.E. (2004). Adolescent alcohol initiation: A review of psychosocial risk factors. Journal of Adolescent Health, 35(6), 529.
Gerra, G., L. Angioni, et al. (2004). Substance use among high-school students: Relationships with temperament, personality traits, and parental care perception. Substance Use & Misuse, 39(2), 345-367.
Hawkins, J. D., M. W. Arthur, et al. (1995). Preventing substance abuse From Building a Safer Society: Strategic Approaches to Crime Prevention, Volume 19, P 343-427, 1995, Michael Tonry & David P Farrington, eds. United States.
Hawkins, D. J., Catalano, R. F., & Miller, J. Y. (1992). Risk and protective factors for alcohol and other substance problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112(1), 64–105.
Henry, K. L., M. D. Slater, et al. (2005). Alcohol use in early adolescence: The effect of changes in risk taking, perceived harm and friends' alcohol use. Journal of Studies on Alcohol, 66(2), 275-283.
O'Connell, M. E., Boat, T., & Warner, K. E., Eds. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth and Young Adults, Institute of Medicine. Washington, DC: National Academies Press.
Shillington, A. M., S. Lehman, et al. (2005). Parental monitoring: Can it continue to be protective among high-risk adolescents? Journal of Child & Adolescent Substance Abuse, 15(1), 1-15.
Stewart, C. (2002). Family factors of low-income African-American youth associated with substance use: An exploratory analysis. Journal of Ethnicity in Substance Abuse, 1(1), 97-111.
Warner, L. A. and H. R. White. (2003). Longitudinal effects of age at onset and first drinking situations on problem drinking. Substance Use & Misuse, 38(14), 1983-2016.
Developed under the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for the Application of Prevention Technologies contract. Reference #HHSS277200800004C. For training and/or technical assistance purposes only.