ABSTRACT
This chapter addresses social context and physical environment aspects associated with addictive behavior, with an emphasis on substance use, substance misuse, and substance use disorders, but relevant to various behaviors. The role of family, peers, community, and larger social systems (including culture) are examined within a person-in-environment, ecological framework.
Concepts of social determinants, circularity of influence, social control and social trigger mechanisms, proximal and distal factors, social norms, and stigma also are introduced. The influence of family systems and roles, parental supervision, and family relationships in substance use initiation, persistence, and recovery are explored, along with discussion of how an individual’s substance misuse might affect the family system. The social context and physical environment are placed within the biopsychosocial framework, including the interplay between genetics and environment introduced in a previous chapter.
