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Risk and protective factors of drug abuse among adolescents: a systematic review

Azmawati mohammed nawi.

1 Department of Community Health, Universiti Kebangsaan Malaysia, Cheras, 56000 Kuala Lumpur, Malaysia

Rozmi Ismail

2 Centre for Research in Psychology and Human Well-Being (PSiTra), Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, 43600 Bangi, Selangor Malaysia

Fauziah Ibrahim

Mohd rohaizat hassan, mohd rizal abdul manaf.

3 Clinical Psychology and Behavioural Health Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

Norhayati Ibrahim

Nurul shafini shafurdin, associated data.

All data generated or analysed during this study are included in this published article.

Drug abuse is detrimental, and excessive drug usage is a worldwide problem. Drug usage typically begins during adolescence. Factors for drug abuse include a variety of protective and risk factors. Hence, this systematic review aimed to determine the risk and protective factors of drug abuse among adolescents worldwide.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was adopted for the review which utilized three main journal databases, namely PubMed, EBSCOhost, and Web of Science. Tobacco addiction and alcohol abuse were excluded in this review. Retrieved citations were screened, and the data were extracted based on strict inclusion and exclusion criteria. Inclusion criteria include the article being full text, published from the year 2016 until 2020 and provided via open access resource or subscribed to by the institution. Quality assessment was done using Mixed Methods Appraisal Tools (MMAT) version 2018 to assess the methodological quality of the included studies. Given the heterogeneity of the included studies, a descriptive synthesis of the included studies was undertaken.

Out of 425 articles identified, 22 quantitative articles and one qualitative article were included in the final review. Both the risk and protective factors obtained were categorized into three main domains: individual, family, and community factors. The individual risk factors identified were traits of high impulsivity; rebelliousness; emotional regulation impairment, low religious, pain catastrophic, homework completeness, total screen time and alexithymia; the experience of maltreatment or a negative upbringing; having psychiatric disorders such as conduct problems and major depressive disorder; previous e-cigarette exposure; behavioral addiction; low-perceived risk; high-perceived drug accessibility; and high-attitude to use synthetic drugs. The familial risk factors were prenatal maternal smoking; poor maternal psychological control; low parental education; negligence; poor supervision; uncontrolled pocket money; and the presence of substance-using family members. One community risk factor reported was having peers who abuse drugs. The protective factors determined were individual traits of optimism; a high level of mindfulness; having social phobia; having strong beliefs against substance abuse; the desire to maintain one’s health; high paternal awareness of drug abuse; school connectedness; structured activity and having strong religious beliefs.

The outcomes of this review suggest a complex interaction between a multitude of factors influencing adolescent drug abuse. Therefore, successful adolescent drug abuse prevention programs will require extensive work at all levels of domains.

Introduction

Drug abuse is a global problem; 5.6% of the global population aged 15–64 years used drugs at least once during 2016 [ 1 ]. The usage of drugs among younger people has been shown to be higher than that among older people for most drugs. Drug abuse is also on the rise in many ASEAN (Association of Southeast Asian Nations) countries, especially among young males between 15 and 30 years of age. The increased burden due to drug abuse among adolescents and young adults was shown by the Global Burden of Disease (GBD) study in 2013 [ 2 ]. About 14% of the total health burden in young men is caused by alcohol and drug abuse. Younger people are also more likely to die from substance use disorders [ 3 ], and cannabis is the drug of choice among such users [ 4 ].

Adolescents are the group of people most prone to addiction [ 5 ]. The critical age of initiation of drug use begins during the adolescent period, and the maximum usage of drugs occurs among young people aged 18–25 years old [ 1 ]. During this period, adolescents have a strong inclination toward experimentation, curiosity, susceptibility to peer pressure, rebellion against authority, and poor self-worth, which makes such individuals vulnerable to drug abuse [ 2 ]. During adolescence, the basic development process generally involves changing relations between the individual and the multiple levels of the context within which the young person is accustomed. Variation in the substance and timing of these relations promotes diversity in adolescence and represents sources of risk or protective factors across this life period [ 6 ]. All these factors are crucial to helping young people develop their full potential and attain the best health in the transition to adulthood. Abusing drugs impairs the successful transition to adulthood by impairing the development of critical thinking and the learning of crucial cognitive skills [ 7 ]. Adolescents who abuse drugs are also reported to have higher rates of physical and mental illness and reduced overall health and well-being [ 8 ].

The absence of protective factors and the presence of risk factors predispose adolescents to drug abuse. Some of the risk factors are the presence of early mental and behavioral health problems, peer pressure, poorly equipped schools, poverty, poor parental supervision and relationships, a poor family structure, a lack of opportunities, isolation, gender, and accessibility to drugs [ 9 ]. The protective factors include high self-esteem, religiosity, grit, peer factors, self-control, parental monitoring, academic competence, anti-drug use policies, and strong neighborhood attachment [ 10 – 15 ].

The majority of previous systematic reviews done worldwide on drug usage focused on the mental, psychological, or social consequences of substance abuse [ 16 – 18 ], while some focused only on risk and protective factors for the non-medical use of prescription drugs among youths [ 19 ]. A few studies focused only on the risk factors of single drug usage among adolescents [ 20 ]. Therefore, the development of the current systematic review is based on the main research question: What is the current risk and protective factors among adolescent on the involvement with drug abuse? To the best of our knowledge, there is limited evidence from systematic reviews that explores the risk and protective factors among the adolescent population involved in drug abuse. Especially among developing countries, such as those in South East Asia, such research on the risk and protective factors for drug abuse is scarce. Furthermore, this review will shed light on the recent trends of risk and protective factors and provide insight into the main focus factors for prevention and control activities program. Additionally, this review will provide information on how these risk and protective factors change throughout various developmental stages. Therefore, the objective of this systematic review was to determine the risk and protective factors of drug abuse among adolescents worldwide. This paper thus fills in the gaps of previous studies and adds to the existing body of knowledge. In addition, this review may benefit certain parties in developing countries like Malaysia, where the national response to drugs is developing in terms of harm reduction, prison sentences, drug treatments, law enforcement responses, and civil society participation.

This systematic review was conducted using three databases, PubMed, EBSCOhost, and Web of Science, considering the easy access and wide coverage of reliable journals, focusing on the risk and protective factors of drug abuse among adolescents from 2016 until December 2020. The search was limited to the last 5 years to focus only on the most recent findings related to risk and protective factors. The search strategy employed was performed in accordance with the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) checklist.

A preliminary search was conducted to identify appropriate keywords and determine whether this review was feasible. Subsequently, the related keywords were searched using online thesauruses, online dictionaries, and online encyclopedias. These keywords were verified and validated by an academic professor at the National University of Malaysia. The keywords used as shown in Table  1 .

The search strings

Selection criteria

The systematic review process for searching the articles was carried out via the steps shown in Fig.  1 . Firstly, screening was done to remove duplicate articles from the selected search engines. A total of 240 articles were removed in this stage. Titles and abstracts were screened based on the relevancy of the titles to the inclusion and exclusion criteria and the objectives. The inclusion criteria were full text original articles, open access articles or articles subscribed to by the institution, observation and intervention study design and English language articles. The exclusion criteria in this search were (a) case study articles, (b) systematic and narrative review paper articles, (c) non-adolescent-based analyses, (d) non-English articles, and (e) articles focusing on smoking (nicotine) and alcohol-related issues only. A total of 130 articles were excluded after title and abstract screening, leaving 55 articles to be assessed for eligibility. The full text of each article was obtained, and each full article was checked thoroughly to determine if it would fulfil the inclusion criteria and objectives of this study. Each of the authors compared their list of potentially relevant articles and discussed their selections until a final agreement was obtained. A total of 22 articles were accepted to be included in this review. Most of the excluded articles were excluded because the population was not of the target age range—i.e., featuring subjects with an age > 18 years, a cohort born in 1965–1975, or undergraduate college students; the subject matter was not related to the study objective—i.e., assessing the effects on premature mortality, violent behavior, psychiatric illness, individual traits, and personality; type of article such as narrative review and neuropsychiatry review; and because of our inability to obtain the full article—e.g., forthcoming work in 2021. One qualitative article was added to explain the domain related to risk and the protective factors among the adolescents.

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PRISMA flow diagram showing the selection of studies on risk and protective factors for drug abuse among adolescents.2.2. Operational Definition

Drug-related substances in this context refer to narcotics, opioids, psychoactive substances, amphetamines, cannabis, ecstasy, heroin, cocaine, hallucinogens, depressants, and stimulants. Drugs of abuse can be either off-label drugs or drugs that are medically prescribed. The two most commonly abused substances not included in this review are nicotine (tobacco) and alcohol. Accordingly, e-cigarettes and nicotine vape were also not included. Further, “adolescence” in this study refers to members of the population aged between 10 to 18 years [ 21 ].

Data extraction tool

All researchers independently extracted information for each article into an Excel spreadsheet. The data were then customized based on their (a) number; (b) year; (c) author and country; (d) titles; (e) study design; (f) type of substance abuse; (g) results—risks and protective factors; and (h) conclusions. A second reviewer crossed-checked the articles assigned to them and provided comments in the table.

Quality assessment tool

By using the Mixed Method Assessment Tool (MMAT version 2018), all articles were critically appraised for their quality by two independent reviewers. This tool has been shown to be useful in systematic reviews encompassing different study designs [ 22 ]. Articles were only selected if both reviewers agreed upon the articles’ quality. Any disagreement between the assigned reviewers was managed by employing a third independent reviewer. All included studies received a rating of “yes” for the questions in the respective domains of the MMAT checklists. Therefore, none of the articles were removed from this review due to poor quality. The Cohen’s kappa (agreement) between the two reviewers was 0.77, indicating moderate agreement [ 23 ].

The initial search found 425 studies for review, but after removing duplicates and applying the criteria listed above, we narrowed the pool to 22 articles, all of which are quantitative in their study design. The studies include three prospective cohort studies [ 24 – 26 ], one community trial [ 27 ], one case-control study [ 28 ], and nine cross-sectional studies [ 29 – 45 ]. After careful discussion, all reviewer panels agreed to add one qualitative study [ 46 ] to help provide reasoning for the quantitative results. The selected qualitative paper was chosen because it discussed almost all domains on the risk and protective factors found in this review.

A summary of all 23 articles is listed in Table  2 . A majority of the studies (13 articles) were from the United States of America (USA) [ 25 – 27 , 29 – 31 , 34 , 36 – 45 ], three studies were from the Asia region [ 32 , 33 , 38 ], four studies were from Europe [ 24 , 28 , 40 , 44 ], and one study was from Latin America [ 35 ], Africa [ 43 ] and Mediterranean [ 45 ]. The number of sample participants varied widely between the studies, ranging from 70 samples (minimum) to 700,178 samples (maximum), while the qualitative paper utilized a total of 100 interviewees. There were a wide range of drugs assessed in the quantitative articles, with marijuana being mentioned in 11 studies, cannabis in five studies, and opioid (six studies). There was also large heterogeneity in terms of the study design, type of drug abused, measurements of outcomes, and analysis techniques used. Therefore, the data were presented descriptively.

Study characteristic and main findings

After thorough discussion and evaluation, all the findings (both risk and protective factors) from the review were categorized into three main domains: individual factors, family factors, and community factors. The conceptual framework is summarized in Fig.  2 .

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Conceptual framework of risk and protective factors related to adolescent drug abuse

DOMAIN: individual factor

Risk factors.

Almost all the articles highlighted significant findings of individual risk factors for adolescent drug abuse. Therefore, our findings for this domain were further broken down into five more sub-domains consisting of personal/individual traits, significant negative growth exposure, personal psychiatric diagnosis, previous substance history, comorbidity and an individual’s attitude and perception.

Personal/individual traits

Chuang et al. [ 29 ] found that adolescents with high impulsivity traits had a significant positive association with drug addiction. This study also showed that the impulsivity trait alone was an independent risk factor that increased the odds between two to four times for using any drug compared to the non-impulsive group. Another longitudinal study by Guttmannova et al. showed that rebellious traits are positively associated with marijuana drug abuse [ 27 ]. The authors argued that measures of rebelliousness are a good proxy for a youth’s propensity to engage in risky behavior. Nevertheless, Wilson et al. [ 37 ], in a study involving 112 youths undergoing detoxification treatment for opioid abuse, found that a majority of the affected respondents had difficulty in regulating their emotions. The authors found that those with emotional regulation impairment traits became opioid dependent at an earlier age. Apart from that, a case-control study among outpatient youths found that adolescents involved in cannabis abuse had significant alexithymia traits compared to the control population [ 28 ]. Those adolescents scored high in the dimension of Difficulty in Identifying Emotion (DIF), which is one of the key definitions of diagnosing alexithymia. Overall, the adjusted Odds Ratio for DIF in cannabis abuse was 1.11 (95% CI, 1.03–1.20).

Significant negative growth exposure

A history of maltreatment in the past was also shown to have a positive association with adolescent drug abuse. A study found that a history of physical abuse in the past is associated with adolescent drug abuse through a Path Analysis, despite evidence being limited to the female gender [ 25 ]. However, evidence from another study focusing at foster care concluded that any type of maltreatment might result in a prevalence as high as 85.7% for the lifetime use of cannabis and as high as 31.7% for the prevalence of cannabis use within the last 3-months [ 30 ]. The study also found significant latent variables that accounted for drug abuse outcomes, which were chronic physical maltreatment (factor loading of 0.858) and chronic psychological maltreatment (factor loading of 0.825), with an r 2 of 73.6 and 68.1%, respectively. Another study shed light on those living in child welfare service (CWS) [ 35 ]. It was observed through longitudinal measurements that proportions of marijuana usage increased from 9 to 18% after 36 months in CWS. Hence, there is evidence of the possibility of a negative upbringing at such shelters.

Personal psychiatric diagnosis

The robust studies conducted in the USA have deduced that adolescents diagnosed with a conduct problem (CP) have a positive association with marijuana abuse (OR = 1.75 [1.56, 1.96], p  < 0.0001). Furthermore, those with a diagnosis of Major Depressive Disorder (MDD) showed a significant positive association with marijuana abuse.

Previous substance and addiction history

Another study found that exposure to e-cigarettes within the past 30 days is related to an increase in the prevalence of marijuana use and prescription drug use by at least four times in the 8th and 10th grades and by at least three times in the 12th grade [ 34 ]. An association between other behavioral addictions and the development of drug abuse was also studied [ 29 ]. Using a 12-item index to assess potential addictive behaviors [ 39 ], significant associations between drug abuse and the groups with two behavioral addictions (OR = 3.19, 95% CI 1.25,9.77) and three behavioral addictions (OR = 3.46, 95% CI 1.25,9.58) were reported.

Comorbidity

The paper by Dash et al. (2020) highlight adolescent with a disease who needs routine medical pain treatment have higher risk of opioid misuse [ 38 ]. The adolescents who have disorder symptoms may have a risk for opioid misuse despite for the pain intensity.

Individual’s attitudes and perceptions

In a study conducted in three Latin America countries (Argentina, Chile, and Uruguay), it was shown that adolescents with low or no perceived risk of taking marijuana had a higher risk of abuse (OR = 8.22 times, 95% CI 7.56, 10.30) [ 35 ]. This finding is in line with another study that investigated 2002 adolescents and concluded that perceiving the drug as harmless was an independent risk factor that could prospectively predict future marijuana abuse [ 27 ]. Moreover, some youth interviewed perceived that they gained benefits from substance use [ 38 ]. The focus group discussion summarized that the youth felt positive personal motivation and could escape from a negative state by taking drugs. Apart from that, adolescents who had high-perceived availability of drugs in their neighborhoods were more likely to increase their usage of marijuana over time (OR = 11.00, 95% CI 9.11, 13.27) [ 35 ]. A cheap price of the substance and the availability of drug dealers around schools were factors for youth accessibility [ 38 ]. Perceived drug accessibility has also been linked with the authorities’ enforcement programs. The youth perception of a lax community enforcement of laws regarding drug use at all-time points predicted an increase in marijuana use in the subsequent assessment period [ 27 ]. Besides perception, a study examining the attitudes towards synthetic drugs based on 8076 probabilistic samples of Macau students found that the odds of the lifetime use of marijuana was almost three times higher among those with a strong attitude towards the use of synthetic drugs [ 32 ]. In addition, total screen time among the adolescent increase the likelihood of frequent cannabis use. Those who reported daily cannabis use have a mean of 12.56 h of total screen time, compared to a mean of 6.93 h among those who reported no cannabis use. Adolescent with more time on internet use, messaging, playing video games and watching TV/movies were significantly associated with more frequent cannabis use [ 44 ].

Protective factors

Individual traits.

Some individual traits have been determined to protect adolescents from developing drug abuse habits. A study by Marin et al. found that youth with an optimistic trait were less likely to become drug dependent [ 33 ]. In this study involving 1104 Iranian students, it was concluded that a higher optimism score (measured using the Children Attributional Style Questionnaire, CASQ) was a protective factor against illicit drug use (OR = 0.90, 95% CI: 0.85–0.95). Another study found that high levels of mindfulness, measured using the 25-item Child Acceptance and Mindfulness Measure, CAMM, lead to a slower progression toward injectable drug abuse among youth with opioid addiction (1.67 years, p  = .041) [ 37 ]. In addition, the social phobia trait was found to have a negative association with marijuana use (OR = 0.87, 95% CI 0.77–0.97), as suggested [ 31 ].

According to El Kazdouh et al., individuals with a strong belief against substance use and those with a strong desire to maintain their health were more likely to be protected from involvement in drug abuse [ 46 ].

DOMAIN: family factors

The biological factors underlying drug abuse in adolescents have been reported in several studies. Epigenetic studies are considered important, as they can provide a good outline of the potential pre-natal factors that can be targeted at an earlier stage. Expecting mothers who smoke tobacco and alcohol have an indirect link with adolescent substance abuse in later life [ 24 , 39 ]. Moreover, the dynamic relationship between parents and their children may have some profound effects on the child’s growth. Luk et al. examined the mediator effects between parenting style and substance abuse and found the maternal psychological control dimension to be a significant variable [ 26 ]. The mother’s psychological control was two times higher in influencing her children to be involved in substance abuse compared to the other dimension. Conversely, an indirect risk factor towards youth drug abuse was elaborated in a study in which low parental educational level predicted a greater risk of future drug abuse by reducing the youth’s perception of harm [ 27 , 43 ]. Negligence from a parental perspective could also contribute to this problem. According to El Kazdouh et al. [ 46 ], a lack of parental supervision, uncontrolled pocket money spending among children, and the presence of substance-using family members were the most common negligence factors.

While the maternal factors above were shown to be risk factors, the opposite effect was seen when the paternal figure equipped himself with sufficient knowledge. A study found that fathers with good information and awareness were more likely to protect their adolescent children from drug abuse [ 26 ]. El Kazdouh et al. noted that support and advice could be some of the protective factors in this area [ 46 ].

DOMAIN: community factors

Risk factor.

A study in 2017 showed a positive association between adolescent drug abuse and peers who abuse drugs [ 32 , 39 ]. It was estimated that the odds of becoming a lifetime marijuana user was significantly increased by a factor of 2.5 ( p  < 0.001) among peer groups who were taking synthetic drugs. This factor served as peer pressure for youth, who subconsciously had desire to be like the others [ 38 ]. The impact of availability and engagement in structured and unstructured activities also play a role in marijuana use. The findings from Spillane (2000) found that the availability of unstructured activities was associated with increased likelihood of marijuana use [ 42 ].

Protective factor

Strong religious beliefs integrated into society serve as a crucial protective factor that can prevent adolescents from engaging in drug abuse [ 38 , 45 ]. In addition, the school connectedness and adult support also play a major contribution in the drug use [ 40 ].

The goal of this review was to identify and classify the risks and protective factors that lead adolescents to drug abuse across the three important domains of the individual, family, and community. No findings conflicted with each other, as each of them had their own arguments and justifications. The findings from our review showed that individual factors were the most commonly highlighted. These factors include individual traits, significant negative growth exposure, personal psychiatric diagnosis, previous substance and addiction history, and an individual’s attitude and perception as risk factors.

Within the individual factor domain, nine articles were found to contribute to the subdomain of personal/ individual traits [ 27 – 29 , 37 – 40 , 43 , 44 ]. Despite the heterogeneity of the study designs and the substances under investigation, all of the papers found statistically significant results for the possible risk factors of adolescent drug abuse. The traits of high impulsivity, rebelliousness, difficulty in regulating emotions, and alexithymia can be considered negative characteristic traits. These adolescents suffer from the inability to self-regulate their emotions, so they tend to externalize their behaviors as a way to avoid or suppress the negative feelings that they are experiencing [ 41 , 47 , 48 ]. On the other hand, engaging in such behaviors could plausibly provide a greater sense of positive emotions and make them feel good [ 49 ]. Apart from that, evidence from a neurophysiological point of view also suggests that the compulsive drive toward drug use is complemented by deficits in impulse control and decision making (impulsive trait) [ 50 ]. A person’s ability in self-control will seriously impaired with continuous drug use and will lead to the hallmark of addiction [ 51 ].

On the other hand, there are articles that reported some individual traits to be protective for adolescents from engaging in drug abuse. Youth with the optimistic trait, a high level of mindfulness, and social phobia were less likely to become drug dependent [ 31 , 33 , 37 ]. All of these articles used different psychometric instruments to classify each individual trait and were mutually exclusive. Therefore, each trait measured the chance of engaging in drug abuse on its own and did not reflect the chance at the end of the spectrum. These findings show that individual traits can be either protective or risk factors for the drugs used among adolescents. Therefore, any adolescent with negative personality traits should be monitored closely by providing health education, motivation, counselling, and emotional support since it can be concluded that negative personality traits are correlated with high risk behaviours such as drug abuse [ 52 ].

Our study also found that a history of maltreatment has a positive association with adolescent drug abuse. Those adolescents with episodes of maltreatment were considered to have negative growth exposure, as their childhoods were negatively affected by traumatic events. Some significant associations were found between maltreatment and adolescent drug abuse, although the former factor was limited to the female gender [ 25 , 30 , 36 ]. One possible reason for the contrasting results between genders is the different sample populations, which only covered child welfare centers [ 36 ] and foster care [ 30 ]. Regardless of the place, maltreatment can happen anywhere depending on the presence of the perpetrators. To date, evidence that concretely links maltreatment and substance abuse remains limited. However, a plausible explanation for this link could be the indirect effects of posttraumatic stress (i.e., a history of maltreatment) leading to substance use [ 53 , 54 ]. These findings highlight the importance of continuous monitoring and follow-ups with adolescents who have a history of maltreatment and who have ever attended a welfare center.

Addiction sometimes leads to another addiction, as described by the findings of several studies [ 29 , 34 ]. An initial study focused on the effects of e-cigarettes in the development of other substance abuse disorders, particularly those related to marijuana, alcohol, and commonly prescribed medications [ 34 ]. The authors found that the use of e-cigarettes can lead to more severe substance addiction [ 55 ], possibly through normalization of the behavior. On the other hand, Chuang et al.’s extensive study in 2017 analyzed the combined effects of either multiple addictions alone or a combination of multiple addictions together with the impulsivity trait [ 29 ]. The outcomes reported were intriguing and provide the opportunity for targeted intervention. The synergistic effects of impulsiveness and three other substance addictions (marijuana, tobacco, and alcohol) substantially increased the likelihood for drug abuse from 3.46 (95%CI 1.25, 9.58) to 10.13 (95% CI 3.95, 25.95). Therefore, proper rehabilitation is an important strategy to ensure that one addiction will not lead to another addiction.

The likelihood for drug abuse increases as the population perceives little or no harmful risks associated with the drugs. On the opposite side of the coin, a greater perceived risk remains a protective factor for marijuana abuse [ 56 ]. However, another study noted that a stronger determinant for adolescent drug abuse was the perceived availability of the drug [ 35 , 57 ]. Looking at the bigger picture, both perceptions corroborate each other and may inform drug use. Another study, on the other hand, reported that there was a decreasing trend of perceived drug risk in conjunction with the increasing usage of drugs [ 58 ]. As more people do drugs, youth may inevitably perceive those drugs as an acceptable norm without any harmful consequences [ 59 ].

In addition, the total spent for screen time also contribute to drug abuse among adolescent [ 43 ]. This scenario has been proven by many researchers on the effect of screen time on the mental health [ 60 ] that leads to the substance use among the adolescent due to the ubiquity of pro-substance use content on the internet. Adolescent with comorbidity who needs medical pain management by opioids also tend to misuse in future. A qualitative exploration on the perspectives among general practitioners concerning the risk of opioid misuse in people with pain, showed pain management by opioids is a default treatment and misuse is not a main problem for the them [ 61 ]. A careful decision on the use of opioids as a pain management should be consider among the adolescents and their understanding is needed.

Within the family factor domain, family structures were found to have both positive and negative associations with drug abuse among adolescents. As described in one study, paternal knowledge was consistently found to be a protective factor against substance abuse [ 26 ]. With sufficient knowledge, the father can serve as the guardian of his family to monitor and protect his children from negative influences [ 62 ]. The work by Luk et al. also reported a positive association of maternal psychological association towards drug abuse (IRR 2.41, p  < 0.05) [ 26 ]. The authors also observed the same effect of paternal psychological control, although it was statistically insignificant. This construct relates to parenting style, and the authors argued that parenting style might have a profound effect on the outcomes under study. While an earlier literature review [ 63 ] also reported such a relationship, a recent study showed a lesser impact [ 64 ] with regards to neglectful parenting styles leading to poorer substance abuse outcomes. Nevertheless, it was highlighted in another study that the adolescents’ perception of a neglectful parenting style increased their odds (OR 2.14, p  = 0.012) of developing alcohol abuse, not the parenting style itself [ 65 ]. Altogether, families play vital roles in adolescents’ risk for engaging in substance abuse [ 66 ]. Therefore, any intervention to impede the initiation of substance use or curb existing substance use among adolescents needs to include parents—especially improving parent–child communication and ensuring that parents monitor their children’s activities.

Finally, the community also contributes to drug abuse among adolescents. As shown by Li et al. [ 32 ] and El Kazdouh et al. [ 46 ], peers exert a certain influence on other teenagers by making them subconsciously want to fit into the group. Peer selection and peer socialization processes might explain why peer pressure serves as a risk factor for drug-abuse among adolescents [ 67 ]. Another study reported that strong religious beliefs integrated into society play a crucial role in preventing adolescents from engaging in drug abuse [ 46 ]. Most religions devalue any actions that can cause harmful health effects, such as substance abuse [ 68 ]. Hence, spiritual beliefs may help protect adolescents. This theme has been well established in many studies [ 60 , 69 – 72 ] and, therefore, could be implemented by religious societies as part of interventions to curb the issue of adolescent drug abuse. The connection with school and structured activity did reduce the risk as a study in USA found exposure to media anti-drug messages had an indirect negative effect on substances abuse through school-related activity and social activity [ 73 ]. The school activity should highlight on the importance of developmental perspective when designing and offering school-based prevention programs [75].

Limitations

We adopted a review approach that synthesized existing evidence on the risk and protective factors of adolescents engaging in drug abuse. Although this systematic review builds on the conclusion of a rigorous review of studies in different settings, there are some potential limitations to this work. We may have missed some other important factors, as we only included English articles, and article extraction was only done from the three search engines mentioned. Nonetheless, this review focused on worldwide drug abuse studies, rather than the broader context of substance abuse including alcohol and cigarettes, thereby making this paper more focused.

Conclusions

This review has addressed some recent knowledge related to the individual, familial, and community risk and preventive factors for adolescent drug use. We suggest that more attention should be given to individual factors since most findings were discussed in relation to such factors. With the increasing trend of drug abuse, it will be critical to focus research specifically on this area. Localized studies, especially those related to demographic factors, may be more effective in generating results that are specific to particular areas and thus may be more useful in generating and assessing local control and prevention efforts. Interventions using different theory-based psychotherapies and a recognition of the unique developmental milestones specific to adolescents are among examples that can be used. Relevant holistic approaches should be strengthened not only by relevant government agencies but also by the private sector and non-governmental organizations by promoting protective factors while reducing risk factors in programs involving adolescents from primary school up to adulthood to prevent and control drug abuse. Finally, legal legislation and enforcement against drug abuse should be engaged with regularly as part of our commitment to combat this public health burden.

Acknowledgements

The authors acknowledge The Ministry of Higher Education Malaysia and The Universiti Kebangsaan Malaysia, (UKM) for funding this study under the Long-Term Research Grant Scheme-(LGRS/1/2019/UKM-UKM/2/1). We also thank the team for their commitment and tireless efforts in ensuring that manuscript was well executed.

Authors’ contributions

Manuscript concept, and drafting AMN and RI; model development, FI, NI and NA.; Editing manuscript MRH, MRAN, NSS,; Critical revision of manuscript for important intellectual content, all authors. The authors read and approved the final manuscript.

Financial support for this study was obtained from the Ministry of Higher Education, Malaysia through the Long-Term Research Grant Scheme-(LGRS/1/2019/UKM-UKM/2/1). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Data availability and materials

Declarations.

This study was approved by the Ethics Committee of the Secretariat of Research Ethics, Universiti Kebangsaan Malaysia, Faculty of Medicine, Cheras, Kuala Lumpur (Reference no. UKMPPI/111/8/JEP-2020.174(2). Dated 27 Mac 2020.

Not applicable.

The authors AMN, RI, FI, MRM, MRAM, NA, NI NSS declare that they have no conflict of interest relevant to this work.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Essay on Drug/ Substance Abuse

Drug and substance abuse remains one of the most challenging and destructive problems facing societies worldwide. It refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. This essay aims to delve into the complexities of drug and substance abuse, examining its causes, effects, and the crucial steps needed to address this epidemic.

Drug and Substance Abuse

Drug and Substance Abuse involves the recurrent use of drugs or substances leading to significant impairment, including health problems, disability, and failure to meet responsibilities at work, school, or home. This includes the misuse of legal substances like alcohol and prescription medications, as well as illegal substances like heroin, cocaine, and methamphetamines.

Causes of Drug and Substance Abuse

The reasons behind drug and substance abuse are multifaceted and can vary from individual to individual:

  • Genetic Predisposition : Research indicates a genetic component to the susceptibility to substance abuse.
  • Mental Health Disorders : Many individuals with mental health disorders such as depression, anxiety, or PTSD turn to substances as a form of self-medication.
  • Peer Pressure : Particularly among adolescents and young adults, peer pressure can significantly influence substance use.
  • Stressful Life Events : Traumatic experiences, chronic stress, or life-changing events can lead to substance abuse as a coping mechanism.
  • Curiosity and Experimentation : Often, particularly in young individuals, there’s a desire to experiment, which can lead to misuse and addiction.

Effects of Drug and Substance Abuse

Drug and substance abuse, a major public health challenge, affects individuals, families, and communities across the globe. This essay explores the multifaceted effects of drug and substance abuse, including physical health, mental well-being, social relationships, and broader societal impacts.

Physical Health Effects

Immediate physical effects.

  • Altered State of Consciousness : Substances like alcohol, marijuana, and hallucinogens alter perception, mood, and consciousness.
  • Overdose Risk : Excessive consumption of drugs can lead to overdose, potentially resulting in coma or death.
  • Infectious Diseases : Intravenous drug use increases the risk of diseases like HIV and Hepatitis B and C due to needle sharing.

Long-Term Health Effects

  • Organ Damage : Chronic substance abuse can lead to severe damage to vital organs like the liver (cirrhosis), heart, and brain.
  • Neurological Impact : Long-term effects on the brain can include memory loss, cognitive decline, and mental health disorders.
  • Physical Dependency : Prolonged use leads to dependency, where the body requires the substance to function normally.

Mental Health and Psychological Effects

  • Mental Health Disorders : Substance abuse can trigger or exacerbate mental health conditions like depression, anxiety, and psychosis.
  • Behavioral Changes : Changes in behavior, such as increased aggression or impulsivity, are common.
  • Cognitive Impairments : Drugs can impair decision-making abilities, judgment, and other cognitive functions.

Social and Relationship Impacts

  • Family Dynamics : Drug abuse can strain family relationships, leading to conflict, mistrust, and breakdown of family structures.
  • Workplace Issues : It affects job performance, leading to decreased productivity, absenteeism, and higher risk of accidents.
  • Legal Problems : Substance abuse can result in legal issues, including arrests for possession, driving under the influence, or engaging in illegal activities to support the addiction.

Societal and Economic Impacts

  • Healthcare Costs : Treating drug-related health complications burdens healthcare systems.
  • Crime and Safety : There’s a correlation between substance abuse and increased crime rates, impacting community safety.
  • Economic Burden : The economic impact includes loss of productivity, healthcare expenses, and law enforcement costs.

Prevention and Treatment

  • Education and Awareness : Programs aimed at educating individuals about the risks of drug use are crucial.
  • Rehabilitation Programs : Effective treatment programs, including therapy and medication-assisted treatment, help individuals recover.
  • Support Systems : Family, community, and peer support are vital in the recovery process.

Addressing Drug and Substance Abuse

  • Prevention Programs : Education and awareness programs, particularly targeting young people, are crucial in preventing substance abuse.
  • Treatment and Rehabilitation : Access to effective treatment, including counseling, medication, and support groups, is vital for recovery.
  • Policy and Regulation : Government policies to regulate the availability of substances, and laws to address drug trafficking and misuse, play a critical role.
  • Community Support : Community-based efforts, including support from families, schools, and religious organizations, are essential in supporting those affected.

The Role of Society and Individuals

  • Destigmatization : Removing the stigma around substance abuse and addiction encourages individuals to seek help.
  • Educational Initiatives : Schools and universities should have programs to educate students about the dangers of substance abuse.
  • Role Models : Influential figures and celebrities should promote healthy lifestyles and speak out against substance abuse.
  • Supportive Environment : Creating an environment that fosters open discussion and support for those struggling with substance abuse.

In conclusion, Drug and substance abuse is a complex issue requiring a multifaceted approach. It is not just a personal problem but a societal challenge that calls for comprehensive prevention strategies, effective treatment programs, supportive policies, and community involvement. Understanding and addressing the root causes, along with providing support and care for those affected, is crucial in mitigating the impact of this global issue. For students participating in essay competitions, exploring this topic provides an opportunity to contribute to a critical dialogue, advocating for change and supporting those in need.

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Essay on Drug Abuse for Students and Children | PDF Download

Essay on Drug Abuse

What is Drug Abuse?. Drug Abuse refers to the improper or overuse of drugs or medicine. Usually, all the medicines to cure diseases are containing some of the drugs in them. Even in drugs, there are some useful and helpful drugs to cure diseases. On the other hand, some of the drugs change human health in all ways and affect it in all possible ways. Drug abuse is a dangerous issue for people’s health physically and mentally. As similar to the previous points the below essays on Drug Abuse will provide clear information about it. The below essays on Drug Abuse and its impact on society will explain how it damages society similar to the youth of society. In further below of the article, the quotes on Drug Abuse were listed.

Short Essay on Drug Abuse

Drug abuse is one of the major challenges for the world to keep an end to it. But every year the usage of drug abuse by the people increases year by year. The main encouragement of Drug abuse is the youth of the world. The youth of the world is the high user of Drugs which are over limited than they need. The main usage of drugs is to cure some diseases with the proper amount of medication by prescribing a doctor. The proper amount of drugs in the body makes an individual fit and healthy and recover from the issues. The over usage of the drug causes health issues and mainly damages the mental health of an individual. It starts damaging the body internally after a long period it may cause death because of the over amount of quantity in the body.

Some drugs like Cocaine, MDMA/Ecstasy, GHB, Hallucinogens, Heroin, Inhalants, Ketamine are some of the illegal drugs which are banned internationally. These drugs are harmful to health and make an individual addicted to them which cannot take out in daily life. The listed drugs make the pause for mental thinking, the person will see the illusion world and act without any sense. This is the cause that makes the youth attracted to these drugs. The government of all countries was banned these and their products but it was available illegally for a person at a high cost. Some youth thinks of it as a fashion of taking but at the time they realize they cannot live without drugs. Arrests and jailing are the punishments for the people who make, use, or sell these illegal drugs.

Large Essay on Drug Abuse

Drug Abuse is a worldwide challenge for all countries to keep a checkpoint or end to this issue. Abuse means improper usage of substances or overtaking of substances that cannot handle by the body. Drug abuse will make large changes in the body physically and mentally. The person who intakes the drugs will lose his mind and works out of sense. This Drug abuse also leads to the economic destruction of the person as well his family due to this they start practicing illegal activities for the need of Drugs. Usually, the drugs are divided into two types namely useful drugs and harmful drugs. The useful drugs are useful to cure the diseases of humans on the other hand consumption of harmful drugs will lead to mental and physical problems.

All harmful drugs are banned at the international level due to harm caused to humans by their consumption. Drug abuse is done in various ways due to pressure by society, handling situations, for fun, fashion for the youth. Drugs were consumed to skip the situations and not able to handle them by the people. The people are to take the drugs in the form of doses after a huge number of doses the body will be out of control and finally leads to ruins the whole life.

The main problem to keep a checkpoint for Drug abuse is high consumption by the youth. Youth are the people who consume the drug because of unable to handle the situations. As they know the Drug abuse is an illegal activity but they were forced by the situations to consume them. Overtaking doses of Harmful drugs can make the person mentally unfit and physically weak. The youth were addicted to it and getting affected with economic problems and health issues at younger age itself. Most of the youth in urban areas are spoiling their whole career and life with this illegal activity. Even these drugs are costlier they will never for the cost of taking these once they are addicted.

Many people are involved in drug abuse in the world. Some of the people involve as a mediator and make innocent people involved in addiction to drugs. These mediator makes all these to gain money at a high rate without any effort. In India, a huge number of people are involved in drug making and drug distribution. These issues can be seen majorly in metropolitan cities like Mumbai, Hyderabad, Bangalore, Delhi, etc. Some of the Pubs and party centers maintain these illegal drugs in different types according to the needs of their customers.

The Conclusion of the essay on Drug Abuse is the government of the countries should educate their people about the disadvantage of drug abuse and how it leads to the death of the people. As the youth are involved in drug abuse the parents should engage with the children to know their problems and troubles. These interactions can lead to prohibition towards the negative ideas or ways of the children. The government of the countries should bring the rules against drug abuse and allow it at necessary needs with the suggestion of doctors. Many special teams should be set up to look after the drug issues in society. The laws should contain severe punishments and everyone should be fear to encourage these illegal and negative activities.

  • Drugs are a waste of time. They destroy your memory your self-respect and everything that goes along with your self-esteem.
  • It’s not the drugs that make a drug addict, it’s the need to escape reality.
  • Addiction destroys everything in its path. Getting out of the way is the most loving form of detachment you can practice.
  • Stop taking drugs, live the life gifted to you.
  • That’s all drugs and alcohol do, they cut off your emotions in the end.
  • Drugs take you to hell disguised as heaven.
  • It is hard to understand addiction unless you have experienced it.
  • We realize that drug addiction is a sickness, but it’s also a crime.
  • Drug use prevention is the best treatment and it cost less in lives and dollars
  • Children are often the silent victims of drug abuse.

Conclusion: We believe that the above essay on drug abuse will help you to know some unknown points and beautify your essays. The above essay on drug abuse and its impact on society will help the students at the time of exams and competitions, Aspirants of UPSC & SSC.

Dear Students and Children, you can download the Drug Abuse   Essay in the Hand Written Format by Clicking the Below Click Here Link.

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  1. PDF Understanding Drug Abuse and Addiction

    of the drug are required to achieve the same dopamine high—an effect known as tolerance. Long-term abuse causes changes in other brain chemical systems and circuits as well. Glutamate is a neurotransmitter that influences the reward circuit and the ability to learn. When the optimal concentration of glutamate is altered by drug abuse, the

  2. (PDF) Forms of Drug Abuse and Their Effects

    smoking of cigarettes and gradually drowns the person into the trap of drug abuse. Stress, anxiety, peer pressure, poverty are some of the main causes of drug abuse.As is well said -"it is ...

  3. (PDF) Drug Abuse: Factors, Types and Prevention Measures

    factors include a vailability of drugs, poverty, social changes, peer in uences, employment status, type of occupa on. and cultural a tudes. Individual risk factors include: being. a vic m of ...

  4. PDF From the War on Drugs to Harm Reduction: Imagining a Just Overdose

    services, and support for people who use drugs and people with opioid dependence, and (2) rethinking prevention to address the underlying determinants of opioid use and dependence. The recommendations emerge from the point of view that the overdose crisis is rooted in health disparities, racially motivated drug

  5. PDF FINAL FULL THESIS copy

    amplified when drugs are acquired illegally due to the lack of quality control and consumer information regarding the contents and purity of a substance acquired via underground markets (Miron and Zwiebel, 1995). 4. Given the dire state of the opioid crisis, this thesis seeks to provide a timely analysis of the effectiveness of PDMPs. ...

  6. PDF DRUG DEPENDENCE AND ALCOHOL-RELATED PROBLEMS

    Drug and alcohol misuse can also cause problems for society at large. Government funds must be spent on law enforcement and medical care. Widespread drug or alcohol misuse leads to broken homes and the neglect of children, who are thevery foundationsof a country's strength and future. A wide range of psychological and social dysfunctions could be a

  7. PDF THE SOCIAL IMPACT OF DRUG ABUSE

    44. Drugs, delinquency and crime are related in many ways. In some cases, drug abuse may lead to crime; in others, criminal behaviour precedes drug abuse. The broader impact of drug abuse and crime may increase tension and other deviance, placing additional burdens on institutions such as the family.

  8. Risk and protective factors of drug abuse among adolescents: a

    1) No/ Low perceived risk increase the odds of past-month marijuana use by 8.22 times compared to those who perceived moderate/great risk. 2) High perceived availability of drug: consistently associated with higher odds of past-month marijuana use. Protective Factors. 1) Moderate/ High perceived risk of substance use.

  9. (PDF) Substance Abuse: A Literature Review of the Implications and

    Substance or Drug abuse is a serious public health problem affecting usually adolescents and young adults. It affects both males and females and it is. the major source of crimes in youth and ...

  10. Adolescents and substance abuse: the effects of substance abuse on

    Implications and effects on parents and family. Zimic and Jackic (Citation 2012) aver that the impact that substance abuse has on the family and on the individual family members merit attention.Lander et al. (Citation 2013) maintains that family members are affected by the individual's substance abuse; however, each individual is affected differently together with, but not limited to, having ...

  11. PDF Sample Informative Essay

    Opiate Painkiller Epidemic in Healthcare. caused by an excessive over prescription of these medications. According to Dr. Nora Volkow, 2017, p. 2). Volkow indicated "more than 300,000 Americans have died of an opioid overdose". since 2013 (Federal Efforts to Combat the Opioid Crisis, 2017, p.2). According to Perez-Pena.

  12. PDF GLOBAL OVERVIEW: DRUG DEMAND DRUG SUPPLY

    the distinctions between "drug use", "drug misuse" and "drug abuse", the neutral term "drug use" is used in the World Drug Report. The term "misuse" is used only to denote the non-medical use of prescription drugs. All uses of the word "drug" and the term "drug use" in the World Drug Report refer to substances controlled

  13. (PDF) An Overview of Drug Abuse: Causes, Effects, and ...

    b) Effects of Drug Abuse: The signs or harmful effects of drug abuse could be physical, emotional, family d ynamics, school behaviours, a nd social problems. They include cardio vascular. disease ...

  14. Essay on Drug/ Substance Abuse [Edit & Download], Pdf

    Drug and substance abuse remains one of the most challenging and destructive problems facing societies worldwide. It refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. This essay aims to delve into the complexities of drug and substance abuse, examining its causes, effects, and the crucial ...

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    THE CONSE QUEN CES OF DRUG. Legal: V ery clear, explicit laws on drug abuse exist in every nation. Some nations have. very hard laws and sentences. Y ou can spend a l ifetime in jail, or many ...

  16. Essay on Drug Abuse for Students and Children

    Dear Students and Children, you can download the Drug Abuse Essay in the Hand Written Format by Clicking the Below Click Here Link. Drug Abuse Essay- Important Link. To download the Drug Abuse Essay PDF. Click Here. Essay on Drug Abuse Drug Abuse refers to the improper or overuse of drugs or medicine. Usually, all the medicines to cure diseases ...

  17. (Pdf) the Problem of Drug Abuse Among Nigerian Youths: a Historical

    In a historical assessment of the evolution of drug abuse among Nigerian youths, Unya & Onya (2022) identified peer group, family, emotional stress, frustration, search for a dreadful identity ...

  18. (PDF) Drug Abuse Among Nigerian Youth and Its Consequences

    The objective of this review is to highlight the dangers and consequences of drug abuse particularly among the Nigerian youths. The review, which consists of literature search of journals and ...