Illicit Drug Use in One's Social Network and in One's Neighborhood Predicts Individual Heroin and Cocaine Use

ArticleinAnnals of Epidemiology 11(6):389-94 · September 2001with23 Reads
DOI: 10.1016/S1047-2797(01)00225-3 · Source: PubMed
Abstract
The nature of competing social environmental factors' influence on substance abuse is unclear. A longitudinal study was undertaken to determine the relative power of social network and neighborhood characteristics to predict continuing illicit drug use. Three hundred forty-two inner-city adults with a history of injection drug use were followed for 1 year; their heroin and cocaine use were assessed semiannually. Multiple logistic regression models were fit to determine the degree to which social network and neighborhood characteristics, assessed at baseline, predicted continuing heroin and/or cocaine use throughout the study period. Two hundred thirty-six (69%) participants reported continuing heroin and/or cocaine use. Drug use by members of the social network was a stronger predictor of participants' continuing drug use (OR = 4.31, 95% CI 2.51 to 7.40) than was a high level of drug-related arrests in the participant's neighborhood (OR = 2.41, 95% CI 1.24 to 4.71), after adjusting for drug treatment and demographic variables. Both seemed to have independent effects on study participants' drug use. These findings reiterate the importance of breaking ties with drug-using associates, even for those who reside in high-risk environments. Further work is needed to develop interventions that increase drug users' success in altering social network composition or also treat drug-using network members.
    • "" Although direct empirical evidence on situation selection in adolescent students is lacking, it has recently been established that in adulthood, adults who are more self-controlled report intentionally avoiding situations replete with temptation (Ent, Baumeister, & Tice, 2015; Imhoff, Schmidt, & Gerstenberg, 2014). Relatedly, for drug addicts, encounters with trigger cues are perhaps the strongest predictor of recidivism, and treatment programs invariably advise deliberately avoiding people, places, and objects that induce craving (Bonson et al., 2002; Doyle, Friedmann, & Zywiak, 2013; Goldstein, 1994; Kelley, 2004; O'Brien, 1976; Osgood, Wilson, O'Malley, Bachman, & Johnston, 1996; Schroeder et al., 2001; Weiss, 2005). As a practical matter, unfortunately, students cannot always transport themselves to different locations, nor can they easilyFigure 1. "
    [Show abstract] [Hide abstract] ABSTRACT: A growing body of research indicates that self-control is critical to academic success. Surprisingly little is known, however, about the diverse strategies students use to implement self-control or how well these strategies work. To address these issues, we conducted a naturalistic investigation of self-control strategies (Study 1) and two field experiments (Studies 2 and 3). In Study 1, high school students described the strategies they use to manage interpersonal conflicts, get academic work done, eat healthfully, and manage other everyday self-control challenges. The majority of strategies in these self-nominated incidents as well as in three hypothetical academic scenarios (e.g., studying instead of texting friends) were reliably classified using the process model of self-control. As predicted by the process model, students rated strategies deployed early in the impulse-generation process (situation selection, situation modification) as being dramatically more effective than strategies deployed later (attentional deployment, cognitive change, response modulation). In Study 2, high school students randomly assigned to implement situation modification were more likely to meet their academic goals during the following week than students assigned either to implement response modulation or no strategy at all. In Study 3, college students randomly assigned to implement situation modification were also more successful in meeting their academic goals, and this effect was partially mediated by decreased feelings of temptation throughout the week. Collectively, these findings suggest that students might benefit from learning to initiate self-control when their impulses are still nascent.
    Full-text · Article · Apr 2016
    • "The interaction of the social environment with the development of a SUD and treatment trajectory have been of interest since the 1980's, and the nuances of social factors progressively explored. For example, the detrimental effects of a substance-using network on abstinence appear to outweigh both the quantitative and qualitative support received in that network [26, 27]. Furthermore, the composure and impact of social networks appears to differ between genders; substance use among partners and family members has stronger negative effects on women's treatment outcomes than on men's282930. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Quality of life (QoL) is an important measure and outcome within chronic disease management and treatment, including substance use disorders (SUD). The aim of this paper was to investigate correlates of poorer QoL of individuals entering SUD treatment in Norway, in order to identify subgroups that may most benefit from different interventions. Methods: Twenty-one treatment facilities invited all incoming patients to participate. Five hundred forty-nine patients who enrolled between December 2012 and April 2015 are analyzed. QoL, substance use, mental and physical comorbidities, and exercise behaviors were measured. Multinomial regression analysis was used to determine variables significantly associated with poorer QoL. Results: The majority of both genders (75 %) reported “poor” or “very poor” QoL at intake. Depression showed a strong association with poor QoL (relative risk ratio [RRR] 3.3, 95 % confidence interval [CI] 1.0–10.3) and very poor QoL (RRR 3.8, 1.2–11.8) among women. Physical inactivity among men was associated with very poor QoL (RRR 2.0, 1.1–3.7), as was reporting eating most meals alone (RRR 2.6, 1.4–4.8). Evaluating one’s weight as too low was also associated with poor QoL (RRR 2.0, 1.0-3.9) and very poor QoL (RRR 2.0, 1.1–3.7) among men. Consuming methadone/buprenorphine was a protective factor for men reporting poor QoL (RRR 0.5, 0.3–0.9) and very poor QoL (RRR 0.4, 0.2–0.9), as well as for women reporting very poor QoL (RRR 0.2, 0.0–0.6). Conclusions: Factors associated with poorer QoL among other healthy and clinical populations, such as impaired social and physical well-being and psychological distress, were also seen associated in this sample. Treatment should be targeted towards patients with these particular vulnerabilities in addition to focusing on substance-related factors, and interventions proven to improve the QoL of other populations with these vulnerabilities should be explored in a SUD context.
    Full-text · Article · Mar 2016
    • "It is well established that among drug addicts trying to quit, abstaining is much more likely among those who experience a significant change of setting (Goldstein, 1994; O'Brien, 1976). Indeed, encounters with trigger cues (i.e., physical or social cues that have through past experience become strongly associated with taking drugs) may be the single most potent impediment to abstinence (Bonson et al., 2002; Kelley, 2004; Weiss, 2005 ), and addicts who break ties with drug-using associates are four times more likely to remain abstinent than those who do not (Schroeder et al., 2001). In fact, it may be that encounters with trigger cues are more important than physiological withdrawal processes in the precipitation of drug craving (Goldstein, 1994). "
    [Show abstract] [Hide abstract] ABSTRACT: Exercising self-control is often difficult, whether declining a drink in order to drive home safely, passing on the chocolate cake to stay on a diet, or ignoring text messages to finish reading an important paper. But enacting self-control is not always difficult, particularly when it takes the form of proactively choosing or changing situations in ways that weaken undesirable impulses or potentiate desirable ones. Examples of situational self-control include the partygoer who chooses a seat far from where drinks are being poured, the dieter who asks the waiter not to bring around the dessert cart, and the student who goes to the library without a cell phone. Using the process model of self-control, we argue that the full range of self-control strategies can be organized by considering the timeline of the developing tempting impulse. Because impulses tend to grow stronger over time, situational self-control strategies—which can nip a tempting impulse in the bud—may be especially effective in preventing undesirable action. Ironically, we may underappreciate situational self-control for the same reason it is so effective—namely, that by manipulating our circumstances to advantage, we are often able to minimize the in-the-moment experience of intrapsychic struggle typically associated with exercising self-control.
    Full-text · Article · Jan 2016
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