What are risk factors and protective factors?

Research over the past two decades has tried to determine how drug abuse begins and how it progresses. Many factors can add to a person’s risk for drug abuse. Risk factors can increase a person’s chances for drug abuse, while protective factors can reduce the risk. Please note, however, that most individuals at risk for drug abuse do not start using drugs or become addicted. Also, a risk factor for one person may not be for another.

Risk and protective factors can affect children at different stages of their lives. At each stage, risks occur that can be changed through prevention intervention. Early childhood risks, such as aggressive behavior, can be changed or prevented with family, school, and community interventions that focus on helping children develop appropriate, positive behaviors. If not addressed, negative behaviors can lead to more risks, such as academic failure and social difficulties, which put children at further risk for later drug abuse.

Research-based prevention programs focus on intervening early in a child’s development to strengthen protective factors before problem behaviors develop.

The table below describes how risk and protective factors affect people in five domains, or settings, where interventions can take place.

Risk factors can influence drug abuse in several ways. The more risks a child is exposed to, the more likely the child will abuse drugs. Some risk factors may be more powerful than others at certain stages in development, such as peer pressure during the teenage years; just as some protective factors, such as a strong parent-child bond, can have a greater impact on reducing risks during the early years. An important goal of prevention is to change the balance between risk and protective factors so that protective factors outweigh risk factors.

What are the early signs of risk that may predict later drug abuse?

Some signs of risk can be seen as early as infancy or early childhood, such as aggressive behavior, lack of self-control, or difficult temperament. As the child gets older, interactions with family, at school, and within the community can affect that child’s risk for later drug abuse.

Children’s earliest interactions occur in the family; sometimes family situations heighten a child’s risk for later drug abuse, for example, when there is:

• a lack of attachment and nurturing by parents or caregivers;
  
• ineffective parenting; and
  
• a caregiver who abuses drugs.
  

But families can provide protection from later drug abuse when there is:

• a strong bond between children and parents;
  
• parental involvement in the child’s life; and
  
• clear limits and consistent enforcement of discipline.
  

Interactions outside the family can involve risks for both children and adolescents, such as:

• poor classroom behavior or social skills;
  
• academic failure; and
  
• association with drug-abusing peers.
  
  

Association with drug-abusing peers is often the most immediate risk for exposing adolescents to drug abuse and delinquent behavior.

Other factors—such as drug availability, trafficking patterns, and beliefs that drug abuse is generally tolerated—are risks that can influence young people to start abusing drugs.

What are the highest risk periods for drug abuse among youth?

Research has shown that the key risk periods for drug abuse are during major transitions in children’s lives. The first big transition for children is when they leave the security of the family and enter school. Later, when they advance from elementary school to middle school, they often experience new academic and social situations, such as learning to get along with a wider group of peers. It is at this stage—early adolescence—that children are likely to encounter drugs for the first time.

When they enter high school, adolescents face additional social, emotional, and educational challenges. At the same time, they may be exposed to greater availability of drugs, drug abusers, and social activities involving drugs. These challenges can increase the risk that they will abuse alcohol, tobacco, and other substances.

When young adults leave home for college or work and are on their own for the first time, their risk for drug and alcohol abuse is very high. Consequently, young adult interventions are needed as well.

Because risks appear at every life transition, prevention planners need to choose programs that strengthen protective factors at each stage of development.

When and how does drug abuse start and progress?

Studies such as the National Survey on Drug Use and Health, formally called the National Household Survey on Drug Abuse, reported by the Substance Abuse and Mental Health Services Administration, indicate that some children are already abusing drugs at age 12 or 13, which likely means that some begin even earlier. Early abuse often includes such substances as tobacco, alcohol, inhalants, marijuana, and prescription drugs such as sleeping pills and anti-anxiety medicines. If drug abuse persists into later adolescence, abusers typically become more heavily involved with marijuana and then advance to other drugs, while continuing their abuse of tobacco and alcohol. Studies have also shown that abuse of drugs in late childhood and early adolescence is associated with greater drug involvement. It is important to note that most youth, however, do not progress to abusing other drugs.

Scientists have proposed various explanations of why some individuals become involved with drugs and then escalate to abuse. One explanation points to a biological cause, such as having a family history of drug or alcohol abuse. Another explanation is that abusing drugs can lead to affiliation with drug-abusing peers, which, in turn, exposes the individual to other drugs.

Researchers have found that youth who rapidly increase their substance abuse have high levels of risk factors with low levels of protective factors.³² Gender, race, and geographic location can also play a role in how and when children begin abusing drugs.

Preventive interventions can provide skills and support to high-risk youth to enhance levels of protective factors and prevent escalation to drug abuse.