Public discourse on substance use behavior as a driver of public policy: a scoping review of South Korean academic and official literature

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Background Drug policies are shaped by the historical context in which substance use problems are embedded. Nonetheless, the views and published narratives of researchers and policymakers about the factors that drive substance use have not been subjected to formal analysis. By reviewing and characterizing the social–ecological themes represented in academic and policy literature in South Korea, we aim to identify opportunities for policy advancement. Method A scoping review was conducted in January 2024, in which academic literature was supplemented by ‘grey literature’ generated from official government documents. We included papers that discussed drivers of substance use using causal arguments or hypotheses. Two reviewers independently screened all papers for eligibility. After study selection, emerging concepts on substance use narratives were coded based on a social–ecological framework. Results We identified 219 academic documents and 19 from governmental data sources. Analysis of documents revealed a strong focus across both data sources on individual, rather than environmental or societal drivers of substance use behavior. Academic literature highlighted a purported link between medically prescribed opioid use in adolescents and suicidality. Government documents placed a bigger emphasis on social and global factors, such as drug trafficking, as drivers of substance use behavior. Discussions Academic documents were characterized by a lack of research on family, environmental, and societal drivers of substance use, reflecting the limitations of current substance use policies in South Korea. Research that addresses structural determinants of substance use is needed to guide coherent, evidence-based drug policy approaches.