Direct risks for substance abuse:  Whether one continues to use alcohol, tobacco, or other drugs, and move toward “pathological substance abuse” or not, depends on a number of factors, including: (1) Continued drug availability; (2) Consequences from use (physiological responses and changes, extent of reinforcement and punishment, social impacts); (3) Drug-related expectations (Can I handle drug?  Can I repeat the positive experience?  Are there real risks for me?); and (4) Experience of violence or other trauma, which some studies show as an independent risk factor for moving from experimentation to substance abuse.

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