Psychosocial Factors Associated with Substance Use: A Narrative Review

Abstract

Substance use remains a significant public health concern, contributing to substantial physical, psychological, and social morbidity across the lifespan. Its etiology is multifactorial, resulting from the complex interplay between biological vulnerability and psychological, social, and environmental determinants. Among these, psychosocial factors have an important role in the initiation, continuation, and escalation of substance use, as well as in treatment outcomes and recovery. This narrative review explores the major psychosocial factors associated with substance use among adolescents and adults. Particular attention is given to family dynamics, peer and social influences, socioeconomic conditions, psychological distress, chronic stress, adverse childhood experiences, trauma, mental health disorders, coping mechanisms, and social support. The available literature indicates that exposure to adverse psychosocial environments and difficulties in emotional regulation and coping may increase vulnerability to substance use, whereas supportive family and social relationships, resilience, psychological well-being, and adaptive coping strategies may serve as protective factors. Psychosocial determinants may also influence patterns of substance use and the likelihood of relapse, highlighting the importance of considering these factors throughout prevention and treatment. A comprehensive understanding of the psychosocial context of substance use may facilitate early identification of individuals at increased risk and support the development of more effective, individualized, and integrated prevention and intervention strategies. Further research is needed to clarify the interactions among psychosocial determinants and to strengthen evidence-based approaches to substance use across different stages of life.