Answers may include:
a. Quite a body of evidence that drinking or substance using peers influence adolescent use in various ways
b. Stressful life events were related to drinking to cope and directly to adolescent alcohol problems and may interact with a family history of alcoholism (i.e., those youth report higher levels of severe stressors; Charles et al., 2014). Specific stressful events linked to adolescent substance abuse include childhood sexual abuse (James, 2014); exposure to violence in families and communities (Schiff et al., 2014); and racial/ethnic discrimination (Sanders-Phillips et al., 2014) (although a cultural orientation serves as a protective factor, Unger, 2014). Adverse childhood experiences have a cumulative effect, with individuals exposed to multiple adverse events demonstrating higher risks for substance abuse (Mersky, Topitzes, & Reynolds, 2013).
c. Trauma is another important pathway to adolescent problem behavior (Chassin et al., 2013). The dual risks of COA status and sexual abuse in adolescence have been related to higher levels of adolescent problems, including chemical abuse, than that found in adolescents with only one risk factor (Fenton et al., 2013).
d. Employing a national data set, Kilpatrick et al. (2003) found connections between substance abuse and dependence during adolescence and (a) family alcohol problems, (b) having been a witness to violence, and (c) having been a victim of physical assault. Posttraumatic stress disorder (PTSD) occurred when sexual assault was added to the mix.
e. Some scholars have theorized that single-parent family structure creates distress in adolescents that may lead to greater affect and mood alteration through substance use.
f. The effect of divorce on alcohol use disorders was moderated by parental psychopathology; the effect of divorce was significant only in the presence of parental psychopathology (Thompson et al., 2014).
g. Homelessness is another particular risk for adolescent substance abuse (James, 2014), particularly for those with poorer coping skills (Nyamathi et al., 2010), as is living in foster care (Brook, Rifenbark, Boulton, Little, & McDonald, 2014).