Short communicationDrug use in the social networks of heroin and cocaine users before and after drug cessation
Introduction
Social network analysis (SNA) is an approach to conceptualizing and measuring the people with whom an individual has social interactions and who may influence an individual's behaviors and attitudes (Latkin et al., 1995). A social network consists of an index individual and the individuals with whom the index is connected by interactions or behaviors of interest (Wasserman and Galaskiewicz, 1994). Social networks have been used to examine drug use (e.g., Latkin et al., 1995, Costenbader et al., 2006, Gyarmathy and Neaigus, 2006). Only recently has SNA begun to be used for theory testing (Baerveldt, 2005, Helleringer and Kohler, 2005). The focus of the present study was to examine one theory on the relationship between cessation of drug use and social network drug use.
Prior research has consistently demonstrated a relationship between an individuals’ substance use and the substance use of their social network members (e.g. Latkin et al., 1995, Latkin et al., 1999, Best et al., 2005, Kandel et al., 1978). There are several competing theories that explain this relationship. One key difference among the theories is directionality, i.e. whether drug-using peers lead to drug use or drug use leads to drug-using peers. Social control (also referred to as social selection) posits that individuals who have poor bonding to conventional society use drugs, and consequently seek out drug-using friends (Hirschi, 1974). The theory further hypothesizes that an individual who has increased their bond to society, often through marriage or a new job, decreases their association with drug-using individuals.
Research that has examined these theories has largely focused on adolescents (Akers et al., 1988). Among adults, drug cessation is a particularly critical area in the study of drug use transitions (Bruneau et al., 2004), in part due to the high mortality and morbidity associated with drug use (Hser et al., 2001). Prior research on social factors and drug cessation has tended to focus on individuals seeking treatment, yet the majority of individuals who use drugs quit without treatment (Granfield and Cloud, 2001). Furthermore, out-of-treatment samples have been found to have higher rates of HIV, risk behaviors, stimulant use, and are also older and more often non-white (Flynn et al., 1993, Watkins et al., 1992). Additionally, time in treatment is associated with improved cognitive and psychological functioning (Bell et al., 1996).
The present study used longitudinal data from a community sample of adults who use drugs to examine whether quitting is associated with a subsequent change in drug use among social network members. Evidence that individuals decrease their connections with drug-using individuals when they quit would suggest that social control processes play a role in adult drug use cessation.
Section snippets
Participants
Data for the present secondary analysis come from interviews conducted at waves 1 and 2 (with an average of 9 months between) of the Self-help in Eliminating Life-threatening Diseases (SHIELD) HIV Prevention Study (Latkin et al., 2003) in Baltimore, MD. Eligibility to the study included having contact with drug users and age 18 or older. While the majority of the sample was found through street-recruitment methods, 35% of the total sample was recruited from the social networks of other
Results
Of the 629 individuals, 121 (19%) reported quitting by time 2. Quitters had a greater reduction in the percent of their network made up of active drug users (24%, from 40% to 16%) than non-quitters (6%, from 44% to 38%), in a two-sample test of proportions (p < 0.001).
Table 1 demonstrates that quitters were not statistically different than those who did not quit in age, having a main partner, attainment of a high school diploma, gender, and network characteristics at baseline. Drug treatment in
Discussion
The results of this study lend support for social control processes in the cessation of drug use among adults. The findings lend partial support to the suggestion by drug treatment programs to avoid contact with active drug users. However, the majority of those who quit continued to report drug users in the social networks, albeit a diminished number. Those who did not quit reported fewer non-drug using network members at follow-up, unlike those who quit. Collectively the models suggest that
Conflict of interest
None.
Acknowledgments
The authors wish to thank Carla Storr, Kipling Bohnert, and the Drug Dependence Epidemiology Trainees for feedback on this manuscript.
Role of funding source: This research was supported by NIDA grants 5T32DA007292 and R01DA13142. NIDA had no additional role in study design, data collection, analysis and interpretation of the data, nor in the preparation and submission of the report, including the decision to submit.
Contributors: Author Amy Buchanan designed the analysis plan for the manuscript,
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2019, MidwiferyCitation Excerpt :SNA offers a method of examining how naturally occurring social groups exert influence of particular behaviors and beliefs on a focal individual (index) as a product of the number and strength of social ties within the network (Latkin et al., 1995). SNA employed in drug use studies have confirmed the way behaviors of a social network are directly associated with the types, combinations, quantities, and frequencies of substance use observed in the index member (Buchanan and Latkin, 2008). Previous research on social networks and drug dependency have additionally discussed the long-term negative impacts on women's physical and psychological health when having close social ties with substance-using individuals such as intimate partners and family members (Dawson et al., 2007).