Article review: Substance use is not a choice, but a survival strategy
Abstract
This study examined the use of new psychoactive substances (NPS) in three disadvantaged rural Hungarian communities, where substance use often serves as a means of survival under conditions of extreme poverty and hopelessness. According to the authors, substance use is not merely an individual choice but a response to a complex socio-existential trap. The researchers identified seven ideal-typical user and abstainer profiles based on structural position and psychological characteristics, along with common trajectories of downward mobility and transition. The study emphasizes that effective prevention and harm reduction must address the underlying structural factors.
References
Csák, R., Szécsi, J., Kassai, S., Márványkövi, F., & Rácz, J. (2020). New psychoactive substance use as a survival strategy in rural marginalised communities in Hungary. International Journal of Drug Policy, 85, 102639. https://doi.org/10.1016/j.drugpo.2019.102639
Sik, D., Szécsi, J., Rácz, J., Neogrády-Kiss, M., Demetrovics, Z., Kaló, Z., Kapitány-Föveny, M., & Kovács, A. (2025). Structural deprivation, rural segregation, and substance use—A Hungarian case study. International Journal of Mental Health and Addiction. Advance online publication. https://doi.org/10.1007/s11469-025-01521-2










