Does Your Peer Group’s Substance Use Shape Your Own Risk of Addiction?
- Mahendra Singh Uikey
- Dec 1
- 5 min read
When families worry about addiction, the questions usually sound very personal:
“When did you start drinking?”
“Do you use anything else?”
“Does it run in our family?”
These are important questions, but a large global study on substance use disorders reminds us of something we often overlook: the world you grow up in – your friends, your generation, your social norms – quietly shapes your risk too.
In this article, we look at findings from Degenhardt and colleagues using the WHO World Mental Health Surveys, exploring how both personal habits and “generation-level” patterns of alcohol and drug use influence who starts using drugs, who develops a drug use disorder, and who eventually recovers. This is relevant for anyone concerned about addiction, from young people and parents to clinicians and policymakers.
What Did This Global Study on Substance Use Look At?
The researchers analysed interviews from more than 90,000 adults across 25 countries, including high-, middle- and low‑income settings. Participants were asked about:
Any lifetime use of illicit drugs or non-medical use of prescription medicines.
Age at first drug use.
Whether they had ever met the criteria for drug abuse or drug dependence (DSM‑IV).
They then tracked three key transitions related to addiction:
From never using drugs → to first trying drugs.
From trying drugs → to developing a drug use disorder.
From having a drug use disorder → to remission (at least 12 months without symptoms).
Importantly, they also grouped people into birth cohorts – those born in similar years – and estimated how common alcohol and drug use was in each cohort. This allowed them to capture the broader “culture of substance use” for each generation.
How Common Are Drug Use and Drug Use Disorders?
Across all 25 countries, about one in four people had tried an illicit drug or misused a prescription at least once in their lives. Among those who had ever used:
Around 9% developed drug abuse.
About 5% developed drug dependence.
Many people progressed from first drug use to problems relatively quickly. More than half of those who developed drug abuse did so within three years of starting, while dependence tended to appear around five years after initiation.
For those who did recover, remission from drug use disorders often took several years. This reinforces that substance use disorders are frequently long-term conditions, not just short-lived phases.
Why Polydrug Use Is a Red Flag?
One of the most important findings for clinicians and families is the impact of using more than one drug. People who used two or more substances (for example, cannabis plus stimulants, or illicit drugs plus non-medical prescription use) had:
Around five times higher odds of developing drug abuse.
Around six times higher odds of developing drug dependence.
Polydrug use was also linked to a lower chance of remission from abuse, suggesting that each extra substance adds to the burden and may make recovery more difficult.
For anyone working in addiction treatment or early intervention, this underlines the need to:
Routinely screen for all substances, not just the “main” drug.
Treat polydrug use as a clear marker of higher risk.
The “Cohort Effect”: How Your Generation Influences Addiction Risk
The study’s most striking concept is the “cohort effect”. This looks at how much alcohol and drug use is happening in a person’s generation and asks: Does that background level of use change individual risk, even when personal behaviour is considered?
The answer was yes:
For every 10% increase in alcohol use within a birth cohort, the odds that an individual from that cohort would start using drugs increased by about 28%.
For every 10% increase in drug use within the cohort, the risk of initiating drug use increased by about 12%.
In simple language: if alcohol and drug use are very common in your age group, it becomes easier to start using and harder to stay completely substance‑free, even if you begin cautiously.
For teenagers and young adults, this means that risk is shaped not only by their own choices, but also by what feels “normal” in their school, college or workplace. For parents, it is a reminder to pay attention not only to the child in front of them, but also to the wider peer environment.
Recovery From Drug Use Disorders: A Long but Possible Journey
The study also looked at transitions from drug abuse and dependence into remission. Many people did eventually recover, but:
Time to remission was often measured in years.
Having multiple substances in the picture again reduced the odds of remission from abuse.
For addiction treatment planning, this supports:
Setting realistic expectations that recovery is often a long-term process.
Providing sustained follow-up and aftercare, especially for those with polydrug use.
For families, it can be helpful to understand that “relapses” or slow progress do not equal failure. They often reflect the chronic nature of substance use disorders.
Why These Findings Matter for Addiction Prevention and Public Health
Beyond individual stories, this research has clear implications for prevention and policy:
Generations with higher alcohol use tend to see more people starting drug use.
Cohorts with more drug use see higher risks of initiation and more people transitioning into drug use disorders.
Polydrug use is a strong marker of both higher risk and more difficult recovery.
Effective strategies, therefore, need to:
Address alcohol and drug norms together, rather than treating them in separate silos.
Work not only at the individual level (counselling, treatment) but also at the population level – through pricing, availability, advertising rules and evidence-based school and college programmes.
Focus early on groups where multiple substances are becoming “normal”, offering support before a full-blown disorder develops.
Practical Takeaways for Clinicians, Parents and Young People
Some practical, human-level messages from this research include:
Clinicians should routinely ask about all substances and about peer norms, not just about one drug or “occasional” use.
Parents can focus on open, non‑judgmental conversations about alcohol and drug use, rather than one-time warnings or only looking for extreme signs.
Young people benefit from understanding that progression from “just trying” to “having a problem” can be surprisingly fast, especially in high-use environments.
Community-based programmes that change the overall culture of drinking and drug use can protect many individuals at once, making healthy choices easier and risky choices less attractive.
Substance Use as a Shared, Generational Responsibility
The World Mental Health Surveys remind us that substance use is not only about “good” or “bad” choices by one person. It is also about the air we all breathe: laws, prices, media messages, peer norms and the quiet assumptions about what is “normal” in each generation.
Seeing addiction as both an individual struggle and a generational pattern reduces blame and increases shared responsibility. Individuals still make choices, but societies create the conditions around those choices. Suppose future cohorts can grow up with healthier norms around alcohol and drugs. In that case, fewer people will be pulled into harmful patterns – and those who do develop substance use disorders may find it easier to seek help and recover.
For a simple, reader-friendly overview of what Substance Use Disorders are, their symptoms, causes, and treatment options, you can explore our dedicated page here: https://www.psyconnect.in/substanceusedisorders
This article was drafted with the assistance of an AI writing tool and reviewed and edited by Dr. Mahendra Singh to ensure clinical accuracy and relevance.
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