The importance of environmental modifiers of the relationship between substance use and harm.

This article discusses the role of the social and physical environment in substance addiction. It is noted that the immediate environment in which substance use occurs has been shown to have a strong relationship with harmful outcomes, such as violence. For instance, the wider socio-cultural context in which alcohol is consumed has been shown to be a critical factor in the strength of the association between alcohol use and violence. Likewise, in the illicit drug use field, strong evidence has emerged concerning the crucial role of socio-environmental determinants for drug-related morbidity and mortality. Thus, its is pointed out that the characteristics of the social and physical environment of the user and the immediate environment in which substance use occurs contribute directly to harmful use patterns as well as modifying the level of harm associated with substance abuse.