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What is the Etiology Model and how does it explain why people get involved in substance use?

The Etiology Model, which is based on the socialization process and the Theory of Planned Behavior, a leading behavioral theory, explains the determinants (causes) of problem behaviors, such as psychoactive substance us. In addition the model provides opportunities for effective intervention. Thus, it can help answer one of the most frequently asked questions in regard to psychoactive substance use: why do people use substances—especially when the consequences of such use can lead to dire outcomes?

The Theory of Planned Behavior states that beliefs and attitudes about a behavior play an important function in the decision or intention to engage in a behavior. But what are the factors that influence that decision-making process?

The Etiology Model helps us understand those factors. The term etiology is the study to determine specific factors that cause or are related to a health or behavioral outcome, and the factors which produce or predispose toward a certain disease or disorder. For a problem behavior such as substance use, there is no one clear factor or set of factors involved; in general, it is an interactive process between an individual and his or her micro- and macro-level environments. The Etiology Model also identifies opportunities to intervene with prevention interventions. Let’s look at the components of the process:


Personal Characteristics. When we are born, we have our own biological and physiological characteristics that make us unique. These shape how we behave and interact with our environments. Positive environments support us in our development; negative environments can interfere with development and make us vulnerable. Prevention interventions support positive development and also intervene effectively to help those at risk

Environmental Influences. We are also born into both micro- and macro-level environments, which can play a role in the initiation and continuation of Psychoactive Substance Use. The micro-level environments are the influencers that are immediate or most proximal to us such as our schools and families. School-based interventions help youth develop important life skills and positive decision-making for their health and well-being. The macro-level environments are the larger neighborhood, community, and society. Again, macro-level prevention programming builds prosocial norms that protect against negative influences on youth such as advertising that promote underage smoking and alcohol use.

The interactions between and across these environments can be positive and result in our development and growth into productive adults, but they can also be negative and result in stresses and possibly our engagement in potentially harmful behaviors or lifestyles. It is important to emphasize that this process takes place across the lifespan as we interact with different micro- and macro-level environments.

Can you think about how these interactions can increase the vulnerability to engage in substance use and other harmful behaviors? What kinds of interventions can make a difference?

We invite you to leave your answers in the comments and get the conversation going!


UNODC, 2013.


Sloboda, Z. (2015). Vulnerability and risks: Implications for understanding etiology and drug use prevention. In Scheier, L. M. (Ed.). Handbook of Adolescent Drug Use Prevention: Research, Intervention Strategies, and Practice. Pp. 85-100. Washington, DC: American Psychological Association.

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