Alcohol Can Both Support and Undermine Young People's Well-being

The researchers followed a group of young people in Sweden over a seven-year period, examining how their substance use and well-being evolved over time.

The study is based on qualitative interviews with 29 participants, conducted repeatedly between 2017 and 2023. Four participants were followed in particular depth, allowing the researchers to explore the different ways in which alcohol and other substances, such as cannabis, became part of their everyday lives.

“What distinguishes this study from much previous research on young people's substance use is that earlier studies have tended to focus on negative effects while paying less attention to positive ones. Our findings challenge the idea that alcohol is either wholly good or wholly bad,” says Jukka Törrönen, Professor at the Department of Public Health Sciences, Stockholm University.

Positive Experiences Often Come with a Downside

Participants described how alcohol and other substances could temporarily change how they felt about themselves and how they interacted with others.

Alcohol, for example, could make them feel more relaxed, sociable, confident, expressive and flirtatious. For some, drinking also provided a temporary escape from stress and overthinking, creating a sense of freedom.

At the same time, these positive experiences were often intertwined with negative consequences. More extensive substance use could be followed by anxiety, sadness, shame, restlessness and feelings of weakness or imbalance.

One participant described becoming more sociable and self-confident when intoxicated, but also experiencing anxiety, sadness and shame afterwards. Another found that alcohol temporarily helped her escape stress, while longer periods of heavier drinking increased her anxiety and contributed to weight gain.

These experiences led participants to gradually reconsider when, where and how much they drank.

“Our study shows that alcohol use can have both positive and negative effects on young people, and that these effects may influence their substance use over time. Young people gradually learn to weigh the benefits against the drawbacks and to manage these conflicting experiences, which in turn shapes their patterns of use,” says Jukka Törrönen.

The Social Context Matters

The study also highlights that alcohol and drug use does not occur in isolation from the rest of people's lives. Its effects were influenced not only by where and with whom substances were used, but also by participants' relationships, work situations, daily routines, mental health and other life circumstances.

One participant, for example, associated drinking with socialising, new experiences and a sense of freedom. During the COVID-19 pandemic, many of these social contexts disappeared because of restrictions. Drinking became less enjoyable and her desire to drink declined.

For another participant, the pandemic brought a more balanced lifestyle, with reduced work pressure and more time for exercise and leisure activities. During this period, the need to use alcohol or other substances disappeared. When work demands increased again after the pandemic, substance use returned.

“Young people's alcohol consumption is strongly shaped by the nature of their social environments and the wider conditions of their lives. When these conditions change, drinking patterns often change as well,” says Jukka Törrönen.

Moderate Drinking Was Easier to Combine with Well-being

The researchers also observed differences between moderate and heavier drinking.

One participant initially avoided alcohol because she associated intoxication with a loss of control and potentially negative consequences. Later, when she began drinking moderately with friends and family, she found that small amounts of alcohol made her feel happier and more expressive while still allowing her to remain in control.

However, when her drinking later increased and she began drinking to intoxication more often, she experienced unwanted drunkenness and heightened anxiety. These experiences led her to stop binge drinking and return to more moderate drinking habits.

The study also illustrates how alcohol and other substances can become part of people's strategies for coping with challenging life situations.

One participant described using alcohol and cannabis while working in a highly stressful job. He felt that the substances helped him relax and cope with long working days. At the same time, periods of daily cannabis use, combined with workplace problems, poor routines and other difficulties, left him feeling apathetic and “like a zombie”.

These experiences prompted him to reflect on the relationship between his substance use and his broader life situation. He subsequently paid greater attention to his working environment, friendships, routines, diet and mental well-being.

A More Nuanced Understanding Is Needed

The researchers emphasise that their findings should not be interpreted as evidence that alcohol or other drugs are beneficial for young people, nor that their use should be encouraged. Instead, the aim is to better understand why young people use substances and how their patterns of use change over time.

“This study shows that substance use often involves a balance between positive and negative effects. Research that focuses only on one side risks producing an oversimplified picture and overlooking the fact that these effects can be both complex and contradictory,” says Jukka Törrönen.

Participants gradually learned to identify the circumstances associated with positive and negative experiences and adjusted their behaviour accordingly. Some drank less frequently, others stopped binge drinking, while others became more aware of the relationships and life circumstances surrounding their substance use.

The researchers argue that prevention efforts and other interventions need to take this complexity into account. An exclusive focus on negative consequences may fail to explain why alcohol and other substances can be attractive to young people, while an emphasis on positive experiences risks downplaying potential health harms.

According to the researchers, a more comprehensive approach should therefore consider both sides of the issue, as well as the social and broader life circumstances that shape how substance use affects well-being.

Facts

The study, Substance use assemblages as producers of healthy and unhealthy bodies: What do young people do with substances, and what do substances do to them?, was recently published in SSM - Qualitative Research in Health.

In addition to Professor Jukka Törrönen, the study was conducted by Ulrika Winerdal (Department of Public Health Sciences, Stockholm University), Josefin Månsson (Department of Social Work, Stockholm University), Filip Roumeliotis (Department of Criminology, Stockholm University), and Eva Samuelsson (Department of Social Work, Stockholm University).