Illicit Drug Use in One's Social Network and in One's Neighborhood Predicts Individual Heroin and Cocaine Use
Johns Hopkins University, Baltimore, Maryland, United States Annals of Epidemiology
(Impact Factor: 2).
09/2001; 11(6):389-94. DOI: 10.1016/S1047-2797(01)00225-3
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.
Available from: Paul J Draus
- "Networks are a primary mechanism that links individual behaviors and health outcomes to larger social structures and forces (Berkman, Glass, Brissette, & Seeman, 2000; Pescosolido, 2006). Considerable evidence connects social networks and relationships with the likelihood of initiating and continuing patterns of problem drug use (Schroeder et al., 2001), the likelihood of seeking treatment, and the effectiveness of treatment. Relapse into substance abuse correlates with social factors such as poor housing status, limited social support, and lack of drug treatment (Mayer et al., 1993). "
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ABSTRACT: In this article we consider the process of adjustment from active street sex work to life in structured substance abuse treatment among Detroit-area women who participated in a semicoercive program administered through a drug court. We examine this transition in terms of changes in daily routines and social networks, drawing on extensive qualitative data to illuminate the ways in which women defined their own situations. Using concepts from Bourdieu and Latour as analytical aids, we analyze the role of daily routines, environments, and networks in producing the shifts in identity that those who embraced the goals of recovery demonstrated. We conclude with a discussion of how the restrictive environments and redundant situations experienced by women in treatment could be paradoxically embraced as a means to achieve expanded opportunity and enhanced individual responsibility because women effectively reassembled their social networks and identities to align with the goals of recovery.
- "Opioid-dependent patients receiving methadone often spend much of their time in social environments that support and directly reinforce drug use and behaviors that convey considerable risk of harm to self and others [6-9]. Patients are routinely advised to abandon their drug-using supports without having meaningful alternative social networks in place, and this typically results in the individual remaining entrenched in existing social networks. "
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ABSTRACT: Research indicates that 3% of people receiving opiate substitution treatment (OST) in the UK manage to achieve abstinence from all prescribed and illicit drugs within 3 years of commencing treatment, and there is concern that treatment services have become skilled at engaging people but not at helping them to enter a stage of recovery and drug abstinence. The National Treatment Agency for Substance Misuse recommends the involvement of families and wider social networks in supporting drug users' psychological treatment, and this pilot randomized controlled trial aims to evaluate the impact of a social network-focused intervention for patients receiving OST.Methods and designIn this two-site, early phase, randomized controlled trial, a total of 120 patients receiving OST will be recruited and randomized to receive one of three treatments: 1) Brief Social Behavior and Network Therapy (B-SBNT), 2) Personal Goal Setting (PGS) or 3) treatment as usual. Randomization will take place following baseline assessment. Participants allocated to receive B-SBNT or PGS will continue to receive the same treatment that is routinely provided by drug treatment services, plus four additional sessions of either intervention. Outcomes will be assessed at baseline, 3 and 12 months. The primary outcome will be assessment of illicit heroin use, measured by both urinary analysis and self-report. Secondary outcomes involve assessment of dependence, psychological symptoms, social satisfaction, motivation to change, quality of life and therapeutic engagement. Family members (n = 120) of patients involved in the trial will also be assessed to measure the level of symptoms, coping and the impact of the addiction problem on the family member at baseline, 3 and 12 months.
This study will provide experimental data regarding the feasibility and efficacy of implementing a social network intervention within routine drug treatment services in the UK National Health Service. The study will explore the impact of the intervention on both patients receiving drug treatment and their family members.Trial registrationTrial Registration Number: ISRCTN22608399ISRCTN22608399 registration: 27/04/2012Date of first randomisation: 14/08/2012.
Available from: Sara Goodkind
- "Analyses of administrative data that examined racial differences between older African American and White methadone clients revealed that African American clients were older and less likely to be employed or to be receiving public assistance than White clients (Rosen, 2004). These results, along with research on the reasons African Americans abused drugs (Roberts, 2000; Schroeder et al., 2001), influenced the decision to focus the current study on the lives of older-adult African American methadone maintenance clients. Disparities in access to proper treatment for substance abuse treatment has been related to higher rates of substance-related mortality for older adults in methadone maintenance treatment (Clausen, Waal, Thoresen, & Gossop, 2009). "
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ABSTRACT: This article presents findings from a photovoice project designed to identify service needs of older-adult African American methadone clients, as well as their current barriers to and supports for abstinence. The project involved 10 participants (aged 53 to 63 years old) recruited from a methadone maintenance program in a large Northeastern U.S. city. Thematic analysis techniques were used to analyze participants’ narratives of their pictures. Transportation emerged as a significant challenge to accessing services, and caregiving was a motivation for remaining abstinent. Future research should use similar participatory methods and engage a broader group of aging people struggling with substance abuse.
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