Author: Sol Agüero
Alcohol has consistently remained one of the world’s most widely consumed psychoactive drugs. In the Netherlands, alcohol is used by adults of all ages and also by adolescents under eighteen years of age (Trimbos Institute 2018). Alcohol related harm and alcohol dependence may affect anyone, and the factors that lead to alcohol abuse or dependence can be just as diverse as the individuals who suffer from unhealthy drinking habits. According to the World Health Organization, the harmful use of this substance is largely a product of both societal and individual vulnerability factors (WHO 2018).
Societal Vulnerability Factors
Relevant societal or environmental factors which may affect individuals’ alcohol consumption relate to the acceptability, availability, and affordability of alcohol (Trimbos Institute 2018).
1. Acceptability
Like in most Western European contexts, drinking in the Netherlands is not only socially acceptable but is perceived as a social and leisure activity. Drinking is seen as a way to facilitate social bonding and interaction (Gordon et. al. 2012). Eight in ten Dutch people over the age of eighteen have consumed alcohol more than once in the past year (Trimbos Institute 2018). High levels of social acceptability of alcohol consumption can act as a powerful factor that comes to affect first incidences of alcohol use and drinking behaviour in general (Gordon et. al. 2012).
2. Availability
The availability of alcohol is very much related to and dependent on the cultural norms surrounding drinking. As mentioned, within Dutch culture, drinking can be motivated by various social reasons— this is reflected in the widespread availability of alcohol and the existence of places designed for drinking such as bars.
3. Affordability
Affordability of alcohol is not only a function of the consumer price level of alcoholic drinks (which, in the Netherlands, is at the EU average level as of 2018) (Eurostat 2019), but also, of public policy, as enforcement also adds to the costs associated with consuming alcohol. For example, how stringent a country is with enforcing established legal drinking ages or punishing drunk driving can affect the drinking habits of its population.
Individual Vulnerability Factors
Individual vulnerabilities in relation to alcohol develop from a person’s psychological and biological state.
1. Psychological factors
Everyone responds to psychological stressors in their own unique way; however, it is true that when living in exposure to chronic life stressors like living in poverty, socially marginalized groups, or with low-income employment, a person may be more vulnerable to experiencing alcohol-related harm (Loring 2014). People who experience high stress, anxiety, depression, and other mental health conditions are also more susceptible to developing harmful relationships to alcohol (Boschloo et al. 2013). Drinking can be motivated by the desire to cope with various negative psychological pressures. Although no single vulnerability factor is dominant, the more vulnerabilities a person is exposed to, the more likely they are to develop alcohol-related problems (WHO 2018).
2. Biological factors
A person’s sex and age are biological factors that can affect their vulnerability to alcohol-related harm. Additionally, some individuals may be genetically more at greater risk of harm from alcohol consumption than others. This can be due to their sex or younger age, or it can in part be linked to how their brain responds chemically to the alcohol they consume (Galbicsek 2019). The risk of alcohol abusive behaviour may also increase if an individual has a family relative who suffers from alcohol dependence— this is true in part because of genetics, but just as importantly, exposure to this individual’s drinking habits may also be an environmental factor which influences the individual’s own relationship to the substance (Galbicsek 2019 and Heath et al. 1999).
References:
Boschloo, L., Vogelzangs, N., van Den Brink, W., Smit, J. H., Veltman, D. J., Beekman, A. T. F. & Penninx, B. W. J. H. (2013). “Depressive and anxiety disorders predicting first incidence of alcohol use disorders: Results of the Netherlands Study of Depression and Anxiety (NESDA).” The Journal of Clinical Psychiatry 74(12): 1233–1240.
Eurostat (2019). “How alcohol prices vary across the EU.” Eurostat. At https://ec.europa.eu/eurostat/web/products-eurostat-news/-/DDN-20190906-1.
Galbicsek, C. (2019). “Alcoholism Causes and Risk Factors.” Alcohol Rehab Guide. At https://www.alcoholrehabguide.org/alcohol/causes/.
Gordon, R., Heim, D., & Macaskill, S. (2012). “Rethinking drinking cultures: A review of drinking cultures and a reconstructed dimensional approach.” Public Health 126(1): 3-11.
Loring, B. (2014). Alcohol and inequities: Guidance for addressing inequities in alcohol-related harm. (N. Satterley, Ed.). Copenhagen, Denmark: WHO Regional Office for Europe.
Trimbos Institute (2018). “Cijfers drugs: gebruik en trends.” Trimbos Instituut. At https://www.trimbos.nl/kennis/cijfers/cijfers-drugs.
WHO (2018). “Alcohol.” World Health Organization. At https://www.who.int/news-room/fact-sheets/detail/alcohol.
Heath, A. C., Madden, P. A. F., Bucholz, K. K., Dinwiddie, S. H., Slutske, W. S., Bierut, L. J., … Martin, N. G. (1999). “Genetic differences in alcohol sensitivity and the inheritance of alcoholism risk.”Psychological Medicine 29(5): 1069–1081.
