Despite significant expenditure on drug prevention, problematic drug use has increased and new drug-related problems have emerged. For example, while 3 per cent of people born between 1940 and 1994 had used cannabis by age 21, 59 per cent of people born between 1975 and1979 had done so. Further, in the past decade, the use of ecstasy and related drugs increased from a rare phenomenon to a situation where, in 2001, 20 per cent of 20 24 year olds reported that they had ever used ecstasy.
Research indicates negative trends in other psychosocial problems. For example, suicide rates among 15 24 year olds have increased from 6 per 100,000 in 1921 25 to 16 per 100,000 in 1996 98. This common trend, it is argued, reflects some shared aetiology between drug-use behaviours, and other negative outcomes such as delinquency/crime and mental health problems.
A variety of factors contribute to drug use and other problem outcomes, both individual and environmental. While drug prevention and treatment have traditionally focused on changing individual behaviours, such efforts can have only limited impact when changes are not made to the environment, that is, to the social determinants of drug use. These include the social and cultural environment, the economic environment and the physical environment.
Western society is undergoing rapid change (for example, more parents working, longer working hours, changes to family structure, extension of the period of adolescence) and there are concerns that societal institutions (for example, childcare and education) are not coping sufficiently with this change. This situation may be contributing to the negative trends in drug use and other psychosocial problems.
This report focuses on social determinants of drug use, and structural interventions to address those social determinants. It draws upon recent research on the social epidemiology of health. The report incorporates a developmental perspective, noting that the influence of the environment is important and cumulative across the life course of individuals.
Given the broad scope of this report, the authors adopted a methodological approach of integrating, as much as possible, the findings of existing reviews of the literature in each area addressed. As such, the report cannot examine any issue in great depth. Rather, the aim is to provide the reader with a broad understanding of the complex developmental and social issues associated with the development and exacerbation of drug-use problems.

Citation: Spooner, C. and Hetherington, K. (2005) Social determinants of drug use, Sydney: National Drug and Alcohol Research Centre.