How Society and Culture Influence Substance Use

Culture is not only inherited through traditions, it’s also shaped by the media consumed. Popular television shows have captured the attention of viewers with storylines heavily circling around substance use. These shows often blend the gritty realism of substance abuse with glamorized depictions. As a result, these media portrayals can do more than just entertain, they can also influence our shifting societal norms. Therefore, to understand how society and culture influence substance use, it is essential to delve into what culture is and how it informs our attitudes.

Cultural Norms and Substance Abuse

Culture has been described as “a system of patterns of belief and behavior that shape the worldview of the members of a society” ^[1]. In other words, culture shapes how individuals see the world and what they consider acceptable behavior. Culture plays a major role in how communities approach substance use, from defining what is “normal” to setting unspoken societal rules around substance use and abuse. In order to build effective prevention strategies, it is essential to understand these norms within the context of culture.

In some cultures, for example, alcohol is a part of everyday life. It is shared during meals and social gatherings. In others, strict religious or moral codes ban it entirely. These beliefs do not just guide behavior, they shape expectations around what counts as acceptable use. 

Before colonization, many Native American and Indigenous communities had cultural practices that guided the use of substances, often limiting them to sacred traditional ceremonies. Through cultural suppression and forced assimilation, many of these traditional practices were disrupted. As a result, these communities were disconnected from their cultural practices that once acted as anchors to regulate substance use. Generations later, in the face of systemic inequality and trauma, high-risk drinking has become more prevalent in some of these communities ^[2].

Social Expectations Around Substance Use

Social expectations can play a powerful role in shaping attitudes toward alcohol and drug use. They can normalize behaviors in specific settings, such as drinking at social gatherings or using substances to cope with stress. In some communities or peer groups, substance use may even be seen as a rite of passage or a marker of social belonging. 

These social norms are not static, however. Evolving public health messaging, shifting generational attitudes, and increased awareness of mental health are gradually reshaping perceptions around substance use and its associated risks.

Binge Drinking Culture in UK Universities

In the UK, university culture often turns binge drinking into a social milestone. Students regularly take part in pub crawls, drinking games, and themed nights where excessive alcohol use isn’t just common but actively encouraged. Peers may apply subtle pressure to join in, making it difficult to say no to peers, choose moderation, or maintain sobriety in a crowd that celebrates intoxication. Over time, this culture has normalized heavy drinking as part of the “student experience,” making it even harder to draw the line between fun and potential harm.

Alcohol and Social Expectations in East Asia

In contrast, many East Asian cultures approach alcohol consumption with a different set of social expectations. While drinking is widespread in countries like Japan, South Korea, and China, it tends to follow different societal expectations. There are often unspoken rules which emphasize respect and moderation, and public drunkenness, especially if it leads to embarrassment, is frowned upon. While alcohol is widely available, the strong social focus on self-control and composure helps to maintain group harmony. These unwritten boundaries create a cultural buffer against excess, even when alcohol is easily accessible.

How Cultural Framing Shapes Behavior

What makes this contrast so striking is that both cultures involve alcohol, however, the societal framing shapes the experience in entirely different ways. In the UK university setting, heavy drinking often signals camaraderie and freedom. In East Asian contexts, it’s more about social cohesion and self-control ^[3]. By recognizing these cultural differences, policymakers and those working in preventative care can move beyond one-size-fits-all models.

Media Influence on Substance Use

The links between media, society, and culture are deeply intertwined, coming together to shape the changing perception of substance use. Popular movies, television shows, and songs about drug use play powerful roles in defining the conversations and the topics that are relevant. 

As a result, the media becomes both a reflection of cultural norms and a machine that reinforces them. In a society that constantly engages with digital content, frequent mentions of substance use can blur the line between awareness and endorsement. 

Research shows that adolescents exposed to frequent depictions of drugs and alcohol are more likely to experiment themselves. Further, when media trivializes or romanticizes substance use, it can make these behaviors feel more familiar and socially acceptable ^[4].

Evolving Social Norms

Social norms that make up a culture determine whether substance use is seen as taboo or a normal part of life, and these norms shift over time as generations grow and conversations evolve. What people once viewed as unacceptable may later become destigmatized. 

Substance use offers a clear example of how society and cultural norms shift, along with influencing laws to adapt with those evolving norms.

Changing Attitudes Toward Cannabis in the U.S.

In the United States, the way people talk about and use cannabis has changed rapidly. Support for legalization has also grown across the political spectrum. As of 2024, almost 90% of Americans say they support legal access to cannabis for either medical or recreational use ^[5]. This shift in public opinion has paved the way for new laws in more than 20 states. 

As cannabis becomes more visible and accessible, its use feels more socially accepted and less rebellious. In fact, more people in North America are choosing cannabis products for stress relief, sleep, or social connection. 

When a behavior such as substance use becomes common, it often starts to feel normal as there is less stigma around it.

Cultural Differences in Perception and Access

Understandably, in places where cannabis remains illegal, the social messages around it are different. It’s seen as risky rather than routine, and that view shapes behavior just as strongly as availability. 

When social norms differ this much across cultures, public health responses must adapt to reflect those differences. In the U.S., for example, harm reduction and responsible use campaigns may be more effective than abstinence messages. 

When Social Acceptance Masks Potential Harm

As social norms shift and substance use becomes acceptable, it’s important to recognize the boundary towards misuse. What starts as culturally accepted behavior, like consuming alcohol in college or using cannabis to manage stress, can cross into patterns that are harmful and isolating. This is where culture tends to play a double role. 

In some cases, culture creates safety nets such as moderation norms or collectivist community support. In others, it creates blind spots where misuse goes unnoticed because it looks like what everyone else is doing. When behaviors that carry risk become normalized, early warning signs become difficult to notice.

Stigma and Access to Support 

Individuals may not recognize when substance use becomes dependence, especially in societies where use is prevalent. This challenge is compounded by stigma. 

Even when someone acknowledges the need for help, cultural attitudes can make seeking support more difficult. Cultural beliefs around morality, gender, and reputation often shape whether someone feels safe enough to reach out for professional help. 

Stigma manifests in different ways depending on the cultural context, but often includes:

• Framing substance use as a personal failure rather than a medical issue
• Placing gender-based discrimination on substance abuse, limiting an individual’s ability to seek care without judgment
• Avoiding open conversations to protect family honor or public image
• Associating substance use with danger or weakness, rather than with health and recovery
• Silencing individuals through shame, fear, or exclusion from community spaces 

In collectivist societies, individuals may stay silent to avoid bringing shame to their families or communities. Cultural norms don’t simply influence whether someone is supported, they shape who feels allowed to seek support in the first place. In many societies, people who use substances are viewed as morally weak and even dangerous, rather than as individuals needing support and care ^[6].

Reframing Through a Cultural Lens

Understanding substance use through the lens of society and culture offers a more compassionate picture of why people engage with substances and what kind of support they need. 

With substance use becoming more socially acceptable among young people, for example, more parents are seeking help to prevent teenage substance abuse. When prevention and care strategies acknowledge the connection between cultural context and social norms, they become better equipped to create lasting change.If you or someone you know is struggling with substance use, you are not alone. Support is available, and recovery is possible.