Abstract

The role of comorbid psychological disorders in alcohol and other drug disorders is considered in the context of other individual, family, peer and broader environmental risk factors. Although peer and environmental factors play an important role in all drug use, family factors, psychological difficulties and emotional distress play a crucial role in the transition from controlled to excessive drug use. Essentially, dysfunctional parent – child relationships and severe family disruption contribute to emotional distress and to a sense of alienation from conventional sources of reward (family, school, work, and intimate relationships). For people who are distressed or alienated, heavy drug involvement can be a way to manage negative affect, bond with others, and/or experience alternative source of reward. Even people who use drugs to manage negative affect, however, are also likely to use them in some circumstances such as to have fun and be social. Excessive substance use also results in emotional distress, and it can be difficult to distinguish cause and consequence.

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