Lesson 4 Summary

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In this final lesson on the multi-factorial etiology of substance use, we considered the risk and protective factors for Canada’s youth: mainstream, non-mainstream, and Aboriginal. Significant risk factors can be interpersonal, such as age, gender, and race; or intrapersonal, such as family, peers, and friends. We lightly touched on the influence of school and community.

Noteworthy is that non-mainstream youth have an elevated risk for substance use disorders and face increased stigma and discrimination compared to mainstream youth. Another significant additional risk factor, particularly for Aboriginal youth is their experiences of childhood trauma, and the legacy of residential school policies.

However, understanding risk factors is not sufficient. Substance use prevention and early intervention programs certainly need to be uniquely designed to the particular needs of the individual. Risk factors need to be mitigated while protective factors are simultaneously developed and strengthened.

Now that we have looked at the evidence associated with the cause (etiology) of substance use, and your own values and beliefs about the etiology, the next two lessons of the course will introduce the principles of evidence-based practice.


Bombay, A., Matheson, K., & Anisman, H. (2011). The impact of stressors on second generation Indian residential school survivors. Transcultural Psychiatry, 48(4), 367–391.

Rawana, J. S., & Ames, M. E. (2012). Protective predictors of alcohol use trajectories among Canadian Aboriginal youth. Journal Youth Adolescence, 41, 229–243.

Stone, A. L., Becker, L. G., Huber, A. M., & Catalano, R. F. (2012). Review of risk and protective factors of substance use and problem use in emerging adulthood. Addictive Behaviors, 37, 747–775.