Determinants of harmful substance use and harmful gambling

Abstract

First paragraph: Our understanding of the nature of harmful substance use and harmful gambling is informed by our position as European societies that place a high value on economic productivity, on success and pleasure, and on perpetuating individual physical health. Framed within this context, harmful substance use and harmful gambling is problematic because by definition it is related to negative physical or mental health outcomes and economic, legal, financial, or social costs for the individual, family and friends, or for wider society. In Chapter 1 we outlined why humans might use psychoactive substances and/or gamble, including short-term health (Corrao et al., 1999) and psychosocial benefits (Peele and Brodsky, 2000). The majority of individuals who drink alcohol, gamble, or consume illegal drugs do not experience harm as a result of their behaviour. However, a significant minority do either encounter harm themselves or inflict harm on others. In this chapter we seek to understand the factors that influence whether or not someone with risky substance use or risky gambling goes on to experience or cause material harms (see Chapter l, Section 1.3.3 for a definition of material harms). We begin by elucidating the range of harms considered in this work (see Fig. 4.1) and the prevalence of such harms across Europe.  Additional co-authors: Robin Room, Laura Schmidt, Dike Van de Mheen, Reinout Wiers, and Phil Withington