It is sometimes claimed that a substance use problem ‘could happen to anyone’. There is a view that this is de-stigmatising because it challenges notions and moralising views that problem substance use is a consequence of a personal flaw or weakness or that it is a lifestyle choice or a moral failing, a self-indulgence or a sign of delinquency (see lifestyle choice). In this sense, there may be consensus that this is positive and useful way to view the prevalence of problem substance use across communities. And yet analysis of available data suggests that problem drug use does not happen to just anyone and there are clear predictors of problem substance use.
Problem substance is also linked to trauma and adversity in childhood. People who experience trauma or adverse experiences in childhood are more likely to have a substance use problem in adulthood compared with people who have not experienced childhood trauma (see Adverse Childhood Experiences). And similar evidence links problem substance use to trauma in adulthood and to mental health problems including PTSD. (See trauma; see self-medicating)
It may be better to imagine that a substance use problem could happen to anyone; but it doesn’t. For a large majority of people, it links to living in poverty; having had adverse experiences in childhood; being traumatised and having a mental health problem. In light of this, substance use may be thought of as a means of coping with extreme life experiences even when this coping mechanism itself becomes problematic. (See self-medicating; see Rat Park).