Kadushin C, Reber E, Saxe L, Livert D
City University of New York, New York 10036, USA.
Subst Use Misuse. 1998 Jun;33(8):1681-710. doi: 10.3109/10826089809058950.
Substance use theory and practice have traditionally focused on individuals who misuse substances or who are at risk for substance misuse, but this emphasis is shifting. The present study views both substance use and misuse systematically, assessing the relationships between the physical and social environments and substance use and misuse in dynamic interplay. This substance use system was examined through a survey of approximately 10,000 persons, aged 22-44, from primarily inner-city neighborhoods in the United States. Individual indicators such as race, sex, age, socioeconomic status, education, and religious service attendance relate to both the physical and interpersonal environments, even when each is controlled for the others. Qualities of both environments are strongly associated with substance dependency, even after individual indicators are controlled. These findings suggest the difficulty of bringing about change in drug and alcohol use without fundamental change in the environments where use takes place.
传统上，物质使用理论与实践主要关注那些滥用物质或有物质滥用风险的个体，但这种侧重点正在发生转变。本研究系统地审视了物质使用与滥用情况，评估了物理环境和社会环境与物质使用及滥用之间在动态互动中的关系。通过对约10000名年龄在22至44岁之间、主要来自美国市中心城区社区的人员进行调查，对这个物质使用系统进行了研究。诸如种族、性别、年龄、社会经济地位、教育程度和宗教活动参与情况等个体指标，即便在对彼此进行控制之后，仍与物理环境和人际环境相关。即使在对个体指标进行控制之后，两种环境的特质仍与物质依赖密切相关。这些研究结果表明，若不从物质使用发生的环境进行根本性改变，就难以实现药物和酒精使用方面的改变。
