Risk and Protective Factors in Substance Abuse: Systematic Literature Review
Abstract
Substance abuse among adolescents and young adults is a significant global public health concern with complex consequences. Understanding the interplay between risk and protective factors is vital for developing effective prevention and intervention strategies. This systematic review aims to synthesize knowledge on these factors across diverse cultural contexts. Adhering to PRISMA guidelines, a systematic literature search was performed in four databases: PubMed, Scopus, PsycINFO, and Web of Science. Keywords related to substance abuse, risk and protective factors, and relevant populations were used, focusing on studies published between 2014 and 2023 involving adolescents and young adults with either quantitative or qualitative designs. From an initial pool of 3,152 articles, 36 studies met the inclusion criteria and underwent thematic analysis. The findings reveal significant interacting risk factors: social and environmental risks, including permissive peer influences, high-risk settings, and substance availability; familial risks, such as lack of parental supervision and unstable family dynamics; and psychological risks, such as sensation-seeking, impulsivity, and mental health issues. Moreover, genetic predispositions interact with environmental exposures. Protective factors, such as strong family bonds, positive peer relations, resilience, prosocial behaviours, and community support, mitigate these risks. The review’s findings are aligned with Social Influence, Attachment, and Sensation-Seeking and Impulsivity theories, emphasizing the complex dynamics between risks and protective factors. While protective factors counter risks, the intricate interactions necessitate addressing multiple influences concurrently. The limitations of cross-sectional studies underscore the need for longitudinal research, exploring temporal and causal pathways within diverse populations using robust frameworks.
Keywords
Full Text:
PDFReferences
Afifi, R. A., El Asmar, K., Bteddini, D., Assi, M., Yassin, N., Bitar, S., & Ghandour, L. (2020). Bullying victimization and use of substances in high school: does religiosity moderate the association? Journal of Religion and Health, 59(1), 334–350. https://doi.org/10.1007/s10943-019-00789-8
Amialchuk, A., Ajilore, O., & Egan, K. (2019). The influence of misperceptions about social norms on substance use among school-aged adolescents. Health Economics (United Kingdom), 28(6), 736–747. https://doi.org/10.1002/hec.3878
Bjork, J. M. (2020). The ups and downs of relating nondrug reward activation to substance use risk in adolescents. Current Addiction Reports, 7(3), 421–429. https://doi.org/10.1007/s40429-020-00327-7
Brook, J., Rifenbark, G. G., Boulton, A., Little, T. D., & McDonald, T. P. (2015). Risk and protective factors for drug use among youth living in foster care. Child and Adolescent Social Work Journal, 32(2), 155–165. https://doi.org/10.1007/s10560-014-0345-5
Calling, S., Ohlsson, H., Sundquist, J., Sundquist, K., & Kendler, K. S. (2019). Socioeconomic status and alcohol use disorders across the lifespan: A co-relative control study. PLoS ONE, 14(10), 1–14. https://doi.org/10.1371/journal.pone.0224127
Chebet, J. J., McMahon, S. A., Tarumbiswa, T., Hlalele, H., Maponga, C., Mandara, E., Ernst, K., Alaofe, H., Baernighausen, T., Ehiri, J. E., Geldsetzer, P., & Nichter, M. (2023). Motivations for pre-exposure prophylaxis uptake and decline in an HIV-hyperendemic setting: findings from a qualitative implementation study in Lesotho. AIDS Research and Therapy, 20(1), 1–12. https://doi.org/10.1186/s12981-023-00535-x
Dash, G. F., Gizer, I. R., Martin, N. G., & Slutske, W. S. (2023). Specificity in genetic and environmental risk for prescription opioid misuse and heroin use. Psychological Medicine, 107(2). https://doi.org/10.1017/S003329172300034X
de Almeida Raimundo, M. F. R., Priolli Jora Pegoraro, N., Carneiro Domingos, J. B., Martins de Souza Gonçalves, A., Teixeira Santos, J. A., & Pillon, S. C. (2016). Binge drinking and its consequences for drug users under treatment. Revista Eletrônica de Enfermagem, 18, 1–10. https://search.ebscohost.com/login.aspx?direct=true&AuthType=sso&db=rzh&AN=118269647&site=ehost-live&scope=site&custid=s5848088
Deak, J. D., & Johnson, E. C. (2021). Genetics of substance use disorders: A review. Psychological Medicine, 51(13), 2189–2200. https://doi.org/10.1017/S0033291721000969
Doggett, A., Battista, K., Jiang, Y., de Groh, M., & Leatherdale, S. T. (2022). Patterns of cannabis use among canadian youth over time; examining changes in mode and frequency using latent transition analysis. Substance Use and Misuse, 57(4), 548–559.
https://doi.org/10.1080/10826084.2021.2019785
Doggett, A., Qian, W., Godin, K., De Groh, M., & Leatherdale, S. T. (2019). Examining the association between exposure to various screen time sedentary behaviours and cannabis use among youth in the COMPASS study. SSM - Population Health, 9, 100487. https://doi.org/10.1016/j.ssmph.2019.100487
Forsyth, C. J., Chen, J., Deshotels, T. H., & Biggar, R. W. (2022). A comparison of the drug use and protective factors of rural and urban students. Journal of Crime and Criminal Behavior, 2(2), 67–85. https://doi.org/10.47509/jccb.2022.v02i02.01
Fuentes, M. C., Garcia, O. F., & Garcia, F. (2020). Protective and risk factors for adolescent substance use in Spain: Self-esteem and other indicators of personal well-being and ill-being. Sustainability (Switzerland), 12(15). https://doi.org/10.3390/su12155962
Galvan, A. (2010). Adolescent development of the reward system. Frontiers in Human Neuroscience, 4(February), 1–9. https://doi.org/10.3389/neuro.09.006.2010
George C Patton, Susan M Sawyer, John S Santelli, David A Ross, Rima Afifi, N. B. A. (2016). Our future: a Lancet commission on adolescent health and wellbeing. Lancet, 387(10036), 2423–2478. https://doi.org/10.1016/S0140-6736(16)00579-1
Gmel, G., Akre, C., Astudillo, M., Bähler, C., Baggio, S., Bertholet, N., Clair, C., Cornuz, J., Daeppen, J.-B., Deline, S., Dermota, P., Dey, M., Dupuis, M., Estévez, N., Foster, S., Ga, J., & Wang, J. (2015). The Swiss cohort study on substance use risk factors – findings of two waves. Journal of Addiction Research and Practice, 61(4). https://doi.org/10.1024/0939-5911.a000380
Goliath, V., & Pretorius, B. (2016). Peer risk and protective factors in adolescence: Implications for drug use prevention. Social Work (South Africa), 52(1), 113–129. https://doi.org/10.15270/52-1-482
Gray, K. M., & Squeglia, L. M. (2018). Research Review: What have we learned about adolescent substance use? Journal of Child Psychology and Psychiatry and Allied Disciplines, 59(6), 618–627. https://doi.org/10.1111/jcpp.12783
Guerrero, L. R., Dudovitz, R., Chung, P. J., Dosanjh, K. K., & Wong, M. D. (2016). Grit: a potential protective factor against substance use and other risk behaviors among Latino adolescents. Academic Pediatrics, 16(3), 275–281. https://doi.org/10.1016/j.acap.2015.12.016
Guttmannova, K., Fleming, C. B., Rhew, I. C., Alisa Abdallah, D., Patrick, M. E., Duckworth, J. C., & Lee, C. M. (2021). Dual trajectories of cannabis and alcohol use among young adults in a state with legal nonmedical cannabis. Alcoholism: Clinical and Experimental Research, 45(7), 1458–1467. https://doi.org/10.1111/acer.14629
Hawes, S. W., Trucco, E. M., Duperrouzel, J. C., Coxe, S., & Gonzalez, R. (2019). Developmental pathways of adolescent cannabis use: risk factors, outcomes and sex-specific differences. Subst Use Misuse, 54(2), 271–281. https://doi.org/10.1053/j.gastro.2019.03.013.Mechanical
Huang, C. K., Wu, S., Marsiglia, F. F., & Campos, A. P. (2023). Association between community attachment and prescription drug misuse among American Indian adolescents in Arizona. Societies, 13(79), 1–10. https://doi.org/10.3390/soc13040079
Iranpour, A., Jamshidi, E., Nakhaee, N., Haghdoost, A. A., Shojaeizadeh, D., Eftekhar-Ardabili, M., & Eftekhar-Ardabili Mph, H. (2016). Development and psychometric properties of risk and protective factors of substance use scale in Iran: an application of Social Development Model. Addiction & Health, 7(3–4), 117–129. http://www.ncbi.nlm.nih.gov/pubmed/26885348%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC4741232
Khalid, S., & Kausar, R. (2016). Protective factors, drug use and depression in young drug users. Journal of Behavioural Sciences, 26(2), 116–134.
Kim, B. K. E., Oesterle, S., Catalano, R. F., & Hawkins, J. D. (2015). Change in protective factors across adolescent development. J Appl Dev Psychol, 40, 26–37. https://doi.org/doi:10.1016/j.appdev.2015.04.006
Kim, S. Y., & Cho, S. il. (2022). Developmental trajectories of tobacco use and risk factors from adolescence to emerging young adulthood: a population-based panel study. BMC Public Health, 22(1), 1–10. https://doi.org/10.1186/s12889-022-14070-3
Kovács, K. (2018). A comparison of factors influencing health risk behaviour of college students in the countries of the carpathian basin **. European Journal of Mental Health, 13(2), 184–210. https://doi.org/10.5708/EJMH.13.2018.2.5
Maldonado, R., Calvé, P., García-Blanco, A., Domingo-Rodriguez, L., Senabre, E., & Martín-García, E. (2021). Vulnerability to addiction. Neuropharmacology, 186(December 2020). https://doi.org/10.1016/j.neuropharm.2021.108466
Marin, S., Heshmatian, E., Nadrian, H., Fakhari, A., & Mohammadpoorasl, A. (2019). Associations between optimism, tobacco smoking and substance abuse among Iranian high school students. Health Promotion Perspectives, 9(4), 279–284. https://doi.org/10.15171/hpp.2019.38
Nasir, S., Rosenthal, D., & Moore, T. (2014). “It’s not easy but it’s still possible to be an abstainer here”: Non-drug use among young men in a slum area in Makassar , Indonesia. International Journal of Criminology and Sociology, 3, 336–347.
Nichols, L. M., Pedroza, J. A., Fleming, C. M., O’Brien, K. M., & Tanner-Smith, E. E. (2021). Social-ecological predictors of opioid use among adolescents with histories of substance use disorders. Frontiers in Psychology, 12(July), 1–13. https://doi.org/10.3389/fpsyg.2021.686414
Öngel Atar, A., Yalçin, Ö., Uygun, E., Çıftçı Demırcı, A., & Erdoğan, A. (2016). The assessment of family functions, dyadic adjustment, and parental attitude in adolescents with substance use disorder. Noropsikiyatri Arsivi, 53(1), 35–41. https://doi.org/10.5152/npa.2015.8750
Opara, I., Rodas, E. I. R., Garcia-Reid, P., & Reid, R. J. (2022). Ethnic identity, empowerment, social support and sexual risk behaviors among black adolescent girls: examining drug use as a mediator. Child Adolesc Social Work J, 39(1), 71–86. https://doi.org/10.1007/s10560-020-00706-z
Piquero, A. R. (2021). The life-course of a Life-Course Criminologist: The David P. Farrington lecture for the division on developmental and life-course criminology lifetime achievement award address 2020. Journal of Developmental and Life-Course Criminology, 7, 297–307. https://doi.org/10.1007/s40865-021-00173-9
Pusat Penilitian Data dan Informasi Badan Narkotika Nasional. (2023). Laporan Hasil Pengukuran Prevalensi Penyalahgunaan Narkoba tahun 2023. Pusat Penelitian Data, dan Informasi Badan Narkotika Nasional (PUSLITDATIN BNN). www.bnn.go.id
Qeadan, F., Ross, S., Barbeau, W. A., Madden, E. F., Venner, K. L., & English, K. (2023). Psychostimulant misuse among American Indian, Alaskan native, or native Hawaiian college students in the U.S. from 2015 to 2019. Substance Abuse: Research and Treatment, 17, 1–14. https://doi.org/10.1177/11782218231209667
Rehm, J., & Shield, K. D. (2019). Global burden of disease and the impact of mental and addictive disorders. Current Psychiatry Reports, 21(2), 1–7. https://doi.org/10.1007/s11920-019-0997-0
Rodríguez-Ruiz, J., Zych, I., Llorent, V. J., & Marín-López, I. (2021). A longitudinal study of preadolescent and adolescent substance use: Within-individual patterns and protective factors. International Journal of Clinical and Health Psychology, 21(3). https://doi.org/10.1016/j.ijchp.2021.100251
Sajjadi, H., Ghaedamini Harouni, G., & Sharifian Sani, M. (2015). Personal, familial and environmental determinants of drug abuse: a causal-comparative study. Global Journal of Health Science, 7(4), 367–374. https://doi.org/10.5539/gjhs.v7n4p367
Schinke, S., Schwinn, T., Hopkins, J., Gorroochurn, P., & Wahlstrom, L. (2017). Is the legalization of marijuana associated with its use by adolescents? Substance Use and Misuse, 52(2), 256–258. https://doi.org/10.1080/10826084.2016.1223139
Schleimer, J. P., Rivera-aguirre, A. E., Castillo-carniglia, A., Hannah, S., Rudolph, K. E., Cadenas, N., Brasesco, M. V, Martins, S. S., Condes, L., & Building, E. T. (2020). Investigating how perceived risk and availability of marijuana relate to marijuana use among adolescents in Argentina, Chile, and Uruguay over time. Drug Alcohol Depend., 01(201), 115–126. https://doi.org/10.1016/j.drugalcdep.2019.03.029.Investigating
Sfendla, A., Lemrani, D., Ahlström, B. H., Senhaji, M., & Kerekes, N. (2018). Risk and protective factors for drug dependence in two Moroccan high-risk male populations. PeerJ, 2018(11). https://doi.org/10.7717/peerj.5930
Shafie, A. A. H., Othman, K., Baharudin, D. F., Yasin, N. M., Amat, S., Jaladin, R. A. M., Rahimi, M. K. A., Mokhtar, A. N., Wahab, S., & Anuwar, N. H. K. (2023). An analysis on youth drug abuse: protective and risk factors in high-risk area. Pertanika Journal of Social Sciences and Humanities, 31(2), 585–605. https://doi.org/10.47836/pjssh.31.2.07
Shamseer, L., Moher, D., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Shekelle, P., Stewart, L. A., Altman, D. G., Booth, A., Chan, A. W., Chang, S., Clifford, T., Dickersin, K., Egger, M., Gøtzsche, P. C., Grimshaw, J. M., Groves, T., Helfand, M., … Whitlock, E. (2015). Preferred reporting items for systematic review and meta-analysis protocols (prisma-p) 2015: Elaboration and explanation. BMJ (Online), 349(January), 1–25. https://doi.org/10.1136/bmj.g7647
Silva, M. L. da, Guimarães, C. F., & Salles, D. B. (2014). Risk and protective factors to prevent relapses of psychoactive substances users. Revista Da Rede de Enfermagem Do Nordeste, 15(6), 1007–1015. https://doi.org/10.15253/2175-6783.2014000600014
Sloboda, Z., Glantz, M. D., & Tarter, R. E. (2012). Revisiting the concepts of risk and protective factors for understanding the etiology and development of substance use and substance use disorders: Implications for prevention. Substance Use and Misuse, 47(8–9), 944–962. https://doi.org/10.3109/10826084.2012.663280
Spillane, N. S., Schick, M. R., Nalven, T., Goldstein, S. C., Kirk-Provencher, K. T., Hill, D., & Kahler, C. W. (2021). Testing the competing life reinforcers model for substance use in reserve-dwelling First Nation youth. The American Journal of Orthopsychiatry, 91(4), 477–486. https://doi.org/10.1037/ort0000543
Spoth, R., Redmond, C., Shin, C., Trudeau, L., Greenberg, M. T., Feinberg, M. E., & Welsh, J. (2022). Applying the PROSPER prevention delivery system with middle schools: Emerging adulthood effects on substance misuse and conduct problem behaviors through 14 years past baseline. Child Development, 93(4), 925–940. https://doi.org/10.1111/cdev.13746
Stewart, S. A., Copeland, A. L., & Cherry, K. E. (2023). Risk Factors for Substance Use across the Lifespan. Journal of Genetic Psychology, 184(2), 145–162. https://doi.org/10.1080/00221325.2022.2130025
Tomczyk, S., Isensee, B., & Hanewinkel, R. (2016). Latent classes of polysubstance use among adolescents-a systematic review. Drug and Alcohol Dependence, 160, 12–29. https://doi.org/10.1016/j.drugalcdep.2015.11.035
Trucco, E. M. (2020). A review of psychosocial factors linked to adolescent substance use. Pharmacology Biochemistry and Behavior, 196, 1–35. https://doi.org/10.1016/j.pbb.2020.172969
Tyler, K. A., & Ray, C. M. (2019). Risk and protective factors for substance use among youth experiencing homelessness. Children and Youth Services Review, 107(June), 104548. https://doi.org/10.1016/j.childyouth.2019.104548
Volkow, N. D., & Blanco, C. (2023). Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention. World Psychiatry, 22(2), 203–229. https://doi.org/10.1002/wps.21073
Wei, Y., McGrath, P. J., Hayden, J., & Kutcher, S. (2015). Mental health literacy measures evaluating knowledge, attitudes and help-seeking: A scoping review. BMC Psychiatry, 15(1). https://doi.org/10.1186/s12888-015-0681-9
Wendy S. Slutske, Deutsch, A. R., & Piasecki, T. M. (2016). Neighborhood contextual factors, alcohol use, and alcohol problems in the United States: evidence from a nationally- representative study of young adults. Alcohol Clin Exp Res, 40(5), 139–148. https://doi.org/10.1111/acer.13033.Neighborhood
Windle, M. (2020). Maturing out of alcohol use in young adulthood: latent class growth trajectories and concurrent young adult correlates. Alcohol Clin Exp Res, 44(2), 532–540. https://doi.org/doi:10.1111/acer.14268.
Wongtongkam, N., Ward, P. R., Day, A., & Winefield, A. H. (2014). The influence of protective and risk factors in individual, peer and school domains on Thai adolescents’ alcohol and illicit drug use: A survey. Addictive Behaviors, 39(10), 1447–1451. https://doi.org/10.1016/j.addbeh.2014.05.026
Zanetti, A. C. G. (2022). Factors for planning the care provided to substance users, street people and individuals hospitalized due to psychiatric crises. SMAD, Rev Eletrônica Saúde Mental Álcool Drog, 18(2), 1–4. https://doi.org/10.11606/issn.1806-6976.smad.2022.000218
Zapolski, T. C. B., Garcia, C. A., Jarjoura, G. R., Lau, K. S. L., Aalsma, M. C., & Juv, J. (2016). Examining the influence of ethnic/racial socialization on aggressive behaviors among juvenile offenders. J Juv Justice, 5(1), 65–79.
Zhou, K., Zhu, X., & Chen, B. Bin. (2024). Understanding the link between social relationships and adolescent Internet addiction: Perspectives from two approaches to well-being. Computers in Human Behavior, 151(October 2023), 107995. https://doi.org/10.1016/j.chb.2023.107995
Zuckermann, A. M. E., Gohari, M. R., Romano, I., & Leatherdale, S. T. (2021). Changes in cannabis use modes among Canadian youth across recreational cannabis legalization: Data from the COMPASS prospective cohort study. Addictive Behaviors, 122(June), 107025. https://doi.org/10.1016/j.addbeh.2021.107025
Zuckermann, A. M., Gohari, M. R., De Groh, M., Jiang, Y., & Leatherdale, S. T. (2020). Cannabis cessation among youth: Rates, patterns and academic outcomes in a large prospective cohort of Canadian high school students. Health Promotion and Chronic Disease Prevention in Canada, 40(4), 95–103. https://doi.org/10.24095/hpcdp.40.4.01
DOI: https://doi.org/10.21107/personifikasi.v16i1.28324
Refbacks
- There are currently no refbacks.
Copyright (c) 2025 Nurlaela Widyarini, J. Seno Aditya Utama
This work is licensed under a Creative Commons Attribution 4.0 International License.
Personifikasi by Universitas Trunojoyo Madura is licensed under a Creative Commons Attribution 4.0 International License.