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NEUROSCIENCE OF PSYCHOACTIVE SUBSTANCE USE AND DEPENDENCE

make-up does not necessarily mean that a person will develop dependence,
but it may provide useful information for treatment and prevention
approaches.
In summary, the improved understanding of genetic influences on
substance dependence promises to increase our understanding of
dependence-producing processes, and should provide novel prevention and
treatment approaches.

Social and cultural aspects

It should be emphasized that complex genetic risk factors and protective
factors for dependence operate within a biological, social and cultural milieu,
which affects the outcome for each individual person. The following section
briefly highlights some of the relevant social and cultural factors.

Risk factors and protective factors for dependence: an overview
Research on risk factors for dependence involves comparisons of people with
and without dependence, and longitudinal studies with subjects who become
dependent or avoid dependence. There are both environmental risk factors
(e.g. social class, mobility, social change, peer culture, educational style and
occupational risk groups) and individual risk factors (e.g. genetic disposition,
child abuse, personality disorders) (Uchtenhagen, 2000a,b). Cultural norms,
attitudes and views about substance use (e.g. social acceptability, tolerance,
stigma) and local, national or regional policies on illicit drugs, tobacco and
alcohol may also be considered as environmental risk factors.
Risk factors for problem drug use include family disruption and
dependence problems in the family, poor performance at school, social
deprivation, young age of onset of substance use, and depression and suicidal
behaviour during adolescence (Lloyd, 1998).
While risk factors emphasize negative influences and the importance of
prevention, protective factors stress positive alternatives and the necessity
of health promotion. Protective factors can have an independent main effect
or act as intervening variables between risk factors and behavioural outcome.
Individuals draw upon environmental or personal resources that may
enable them to cope better with stress and health-related challenges
(Antonovsky, 1987). This concept in social psychology is mirrored in sociology
in the theory of social capital. Social capital is the sum of the resources that
an individual or a group has access to through social, family or institutional
relationships (Klingemann et al., 2001).
Environmental resources include economic situation, social support,
social integration, learning models and temporal factors (Schmid, 2000). With
respect to temporal factors, age at onset of substance use is important as
well as events in life that can be characterized by a higher vulnerability to
substance use, such as experimenting with drugs when entering adolescence,

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