Risk Factors for Problem Drug Use: Identifying vulnerable groups

There has been a growing interest in the risk factors associated with the onset of problem drug use-us distinct from the onset of experimental use. This paper reviews research that has focused on these factors. The literature is divided into retrospective studies of problem users and prospective, longitudinal studies of young people. Risk factors include having parents or siblings with problem drug use, family disruption, poor attachment or communication with parents; child abuse, low school grades, truancy, exclusion from school, childhood conduct disorder, crime, mental disorder (in particular depression and suicidal behaviour during adolescence), social deprivation (although evidence is limited) and a young age of drug use onset. These factors arc highly interconnected and best viewed as an interactive 'web of causation'. On the basis of these findings it is possible lo identify high risk or vulnerable groups: the homeless, those 'looked after' by local authorities or in foster care; prostitutes, truants, those excluded from school, young offenders, children from families with substance-abusing parents or siblings and young people with conduct or depressive disorders. Wiile delivering successful preventive interventions to these groups will be a difficult challenge, they should be a focus for future work. A key issue here is the need to embed a drugs input within the work already delivered by the responsible agencies. Future research should concentrate on the prevalence and nature of drug use in these groups, but there is also a need for longitudinal studies that can throw more light on the development of drug careers in the UK.