In the past decade there has been increased concern with broader environmental influences on health and wellbeing, but relatively little attention has been given to the social determinants of problematic alcohol and other drug use. Attempting to fill this gap, this report by Catherine Spooner and Kate Hetherington contains an extensive review of literature on human development and the social determinants of health and their implications for drug outcomes and for social policy, drug policy, and drug-prevention and drug-treatment interventions.

Spooner and Hetherington describe how alcohol and other drug abuse can develop across the lifespan as a result of environmental conditions, in particular the family and local community. They outline how risk and protective factors in these micro-environments (e.g. socio-economic disadvantage) are affected by macro-environmental factors such as cultural factors (e.g. neoliberalism), family and welfare policies, and urban planning. The authors cite research which indicates that disadvantage and the associated behavioural and health problems are strongly influenced by social policies.

The report concludes with recommendations relating to the need to understand the complexity of drug use; invest in human development; adopt holistic approaches; promote a cultural shift; address inequities in problematic drug use; and monitor problems, policies and programs.

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