Dynamics of Social Determinants Dynamics of Social Determinants of Health and Social Mechanisms in Returning to Well-Being of Individuals Undergoing Drug and Substance Abuse Treatment: A Phenomenological Study in the Multicultural Context of the Southern Border
Keywords:
family dynamics paradox, returning to well-being, social determinants of health, southern border provinces, substance abuse treatmentAbstract
This phenomenological research aims to (1) explore experiences related to social determinants of health and life skill limitations influencing substance use trajectories in the Southern Border Provinces, and (2) examine the paradoxical dynamics of family and socio-cultural mechanisms that support the recovery process within a multicultural context. Using purposive sampling, the key informants comprised ten individuals undergoing substance abuse treatment. Data were collected through in-depth interviews, with trustworthiness ensured through member checking. Thematic analysis was employed for data interpretation. The findings reveal three main themes. First, the context of vulnerability and the trajectory into substance use stem from life skill limitations and social structures that facilitate easy access to substances, with peer groups acting as both initiators and providers. Second, the paradoxical dynamics of the family function dualistically, serving both as an initial driving force into substance use and as a crucial turning point that draws users back into treatment during crises. Third, socio-cultural capital within the recovery ecosystem—particularly the integration of religious principles and support from community leaders—facilitates psychological healing and the creation of new social spaces. The study suggests that relapse prevention requires addressing social vulnerabilities alongside building a supportive ecosystem interconnected with socio-cultural capital. These findings provide important guidance for public policy formulation in the southern border region.
References
Allport, G. W. (1985). The historical background of social psychology. In G. Lindzey & E. Aronson (Eds.), Handbook of Social Psychology (3rd ed., Vol. 1). Random House.
Archibald, P., Rhodes, D., & Thorpe, R. J. (2025). Social determinants of substance use in Black adults with criminal justice contact: Do sex, stressors, and sleep matter? International Journal of Environmental Research and Public Health, 22(8), 1176. https://doi.org/10.3390/ijerph22081176
Baron, R. A., Byrne, D., & Suls, J. (1989). Exploring social psychology (3rd ed.). Allyn & Bacon.
Belfiore, C. I., Galofaro, V., Cotroneo, D., Lopis, A., Tringali, I., Denaro, V., & Casu, M. (2024). A multi-level analysis of biological, social, and psychological determinants of substance use disorder and co-occurring mental health outcomes. Psychoactives, 3(2), 194-214. https://doi.org/10.3390/psychoactives3020013
Bell, J. S., Watson, D. P., Griffin, T., Castedo de Martell, S., Kay, E. S., Hawk, M., Ray, B., & Hudson, M. (2025). Workforce outcomes among substance use peer supports: A scoping review of individual and organizational influences. Frontiers in Public Health, 12, 1515264. https://doi.org/10.3389/fpubh.2024.1515264
Bellaert, L., Van Steenberghe, T., De Maeyer, J., Vander Laenen, F., & Vanderplasschen, W. (2022). Turning points toward drug addiction recovery: Contextualizing underlying dynamics of change. Addiction Research & Theory, 30(4), 294-303. https://doi.org/10.1080/16066359.2022.2026934
Bensaid, B., Machouche, S. B. T., & Tekke, M. (2021). An Islamic spiritual alternative to addiction treatment and recovery. Al-Jami'ah: Journal of Islamic Studies, 59(1), 127–162. https://doi.org/10.14421/ajis.2021.591.127-162
Boonlom, W. (2023). The relationship between family attachment and deviant drug-use behavior among youth. Journal of MCU Ubon Review, 8(3), 859–872 https://so06.tci-thaijo.org/index.php/mcjou/article/view/270272
Bowen, E., Irish, A., Wilding, G., LaBarre, C., Capozziello, N., Nochajski, T., Granfield, R., & Kaskutas, L. (2023). Development and psychometric properties of the Multidimensional Inventory of Recovery Capital (MIRC). Drug and Alcohol Dependence, 247, 109875. https://doi.org/10.1016/j.drugalcdep.2023.109875
Bowen, M. (1978). Family therapy in clinical practice. Jason Aronson.
Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
Centers for Disease Control and Prevention. (2024, January 17). Social determinants of health (SDOH) https://www.cdc.gov/about/priorities/why-is-addressing-sdoh-important.html
Charmaz, K. (2014). Constructing grounded theory (2nd ed.). SAGE Publications.
Cloud, W., & Granfield, R. (2008). Conceptualizing recovery capital: Expansion of a theoretical construct. Substance Use & Misuse, 43(12-13), 1971-1986. https://doi.org/10.1080/10826080802289762
Cohen, L. E., & Felson, M. (1979). Social change and crime rate trends: A routine activity approach. American Sociological Review, 44(4), 588-608.
Elder, G. H., Jr. (1998). The life course as developmental theory. Child Development, 69(1), 1–12. https://doi.org/10.1111/j.1467-8624.1998.tb06128.x
Hayeesor, A., & Teungfung, R. (2023). Factors affecting substance abuse risk behaviors of undergraduate students at one of the universities in the three southern border provinces. Journal of Social Development, 25(2), 1–18. https://so04.tci-thaijo.org/index.php/jsd/article/view/261760
Hirschi, T. (1969). Causes of delinquency. University of California Press.
Kanato, M., Sarasiri, R., & Leyatikul, P. (Eds.). (2024). ASEAN drug monitoring report 2023. ASEAN Narcotics Cooperation Center.
Koutra, K., Zamkinos, L., Angelopoulos, V., & Makris, A. (2024). Social capital in the recovery of current and former substance users: A qualitative study in Greece. Journal of Community Medicine & Public Health Care, 11(3), 159. https://doi.org/10.24966/CMPH-1978/1000159
Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: From theory to practice. Social Work in Public Health, 28(3-4), 194–205. https://doi.org/10.1080/19371918.2013.759005
Lin, C., Cousins, S. J., Zhu, Y., Clingan, S. E., & Mooney, L. J. (2024). A scoping review of social determinants of health's impact on substance use disorders over the life course. Journal of Substance Use and Addiction Treatment, 166, 209484. https://doi.org/10.1016/j.josat.2024.209484
Nima, P., Hajimad, L., & Lertariyapongkul, R. (2022). Effect of health empowerment on community participation for youth substance abuse prevention in communities in three southern border provinces. Nursing Research and Innovation Journal, 28(1), 127–142. Retrieved March 15, 2026, from https://he02.tci-thaijo.org/index.php/RNJ/article/view/247024
Office of Disease Prevention and Health Promotion. (n.d.). Social determinants of health. Healthy People 2030. Retrieved March 1, 2026, from https://odphp.health.gov/healthypeople/priority-areas/social-determinants-health
Office of the Narcotics Control Board. (2023). Thailand narcotics control annual report 2023. Ministry of Justice. https://aseannarco.oncb.go.th/uploads/Ebook/pdf/1842215407501439.pdf
Purahong, G. (2018). Factors affecting relapsing drug addicted patients in Pathumthani Province. Journal of Nursing and Education, 32(2), 57–72. https://he01.tci-thaijo.org/index.php/phn/article/view/245417
Puti, S., Phukao, D., Tapinta, D., & Pradubmook-Sherer, P. (2021). Model of the cultural competence and cognitive behavioral therapy for drug addiction rehabilitation in the 3 southern border provinces of Thailand. Kasetsart Journal of Social Sciences, 42(4), 753–760. https://doi.org/10.34044/j.kjss.2021.42.4.07
Putnam, R. D. (2000). Bowling alone: The collapse and revival of American community. Simon & Schuster.
Rhodes, T. (2009). Risk environments and drug harms: A social science for harm reduction approach. International Journal of Drug Policy, 20(3), 193–201. https://doi.org/10.1016/j.drugpo.2008.10.003
Sutherland, E. H., & Cressey, D. R. (1978). Criminology (10th ed.). Lippincott.
Teruya, C., & Hser, Y. I. (2010). Turning points in the life course: Current findings and future directions in drug use research. Current Drug Abuse Reviews, 3(3), 189–195. https://doi.org/10.2174/1874473711003030189
Thomas, G. (2016). How to do your case study (2nd ed.). SAGE Publications.
United Nations Office on Drugs and Crime. (2024). World drug report 2024. United Nations. https://www.unodc.org/unodc/en/data-and-analysis/world-drug-report-2024.html
Velleman, R. D. B., & Templeton, L. J. (2007). Understanding and modifying the impact of parents' substance misuse on children. Advances in Psychiatric Treatment, 13(2), 79–89. https://doi.org/10.1192/apt.bp.106.002386
World Health Organization. (2010). A conceptual framework for action on the social determinants of health. World Health Organization. https://apps.who.int/iris/handle/10665/44489
