SOCIAL, STRUCTURAL, AND ENVIRONMENTAL DETERMINANTS OF CHEMICAL DEPENDENCY AND ITS EPIDEMIOLOGICAL, PSYCHOSOCIAL, AND HEALTH CARE IMPACTS IN THE CONTEXT OF PUBLIC HEALTH
DOI:
https://doi.org/10.56238/arev7n12-168Keywords:
Substance Dependence, Social Determinants of Health, Epidemiological Impacts, Public Health, Substance Use Disorders, Social VulnerabilitiesAbstract
Chemical dependency is a complex phenomenon influenced by social, structural, and environmental determinants that shape vulnerabilities throughout the life cycle. The literature shows that socioeconomic inequalities, racial discrimination, precarious work, socially toxic environments, and limited access to health services influence patterns of use and the worsening of problems associated with the consumption of psychoactive substances. Given the epidemiological and healthcare relevance of this scenario, this study aimed to identify social, structural, and environmental determinants linked to chemical dependency and its impacts on public health. This is a narrative literature review, conducted through searches in the SciELO, PubMed/MEDLINE, LILACS, BVS, and Google Scholar databases, including studies published between 2002 and 2025. The analysis of the seven selected studies showed that social vulnerabilities, psychiatric comorbidities, chronic stressors, and institutional weaknesses combine to intensify the risk of problematic use. Significant epidemiological impacts were also identified, such as increased morbidity and mortality and expanded healthcare demands, in addition to psychosocial repercussions related to mental suffering, stigma, and family breakdowns. It is concluded that substance dependence results from multiple determinants, requiring intersectoral responses, strengthening of Primary Care, integration between the psychosocial network, and harm reduction policies.
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