Illicit drug use in one's social network and in one's neighborhood predicts individual heroin and cocaine use.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Schroeder
J R
JR
Clinical Pharmacology and Therapeutics Research Branch, National Institute on Drug Abuse Intramural Research Program, Baltimore, MD 21224, USA.
Latkin
C A
CA
Hoover
D R
DR
Curry
A D
AD
Knowlton
A R
AR
Celentano
D D
DD
D000328:Adult; D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008396:Maryland / Q000453:epidemiology; D012307:Risk Factors; D012931:Social Environment; D012944:Social Support; D014505:Urban Population