Cumulative continuity and injection drug use among women: a test of the downward spiral framework

Abstract

Although researchers have examined injection drug use among women, the findings vary and remain inconclusive. We know very little about the career of IV drug-using women-specifically, what processes link injection drug use to events and situations prior to adulthood? Using detailed self-report data, we examine the route into injection drug use and its long-term consequences among a sample of incarcerated women. Comparisons are made between women who have and have not injected drugs within the conceptual framework developed by Rosenbaum (1981). We argue that IV drug using women live in social circumstances typified by a narrowing of life's options that decreases their ability to assume conventional roles. The results of path analyses suggest that women who have injected drugs experienced child maltreatment, were inundated in the drug culture, had fewer options in the conventional world, had expanded options in the nonconventional world, and lived in a chaotic lifestyle. We also found that women who have injected drugs were amenable to substance treatment programming while in prison. Our results are consistent with the hypothesis that injection drug users have accumulated high levels of negative events across their life course that effectively narrows their access to conventional opportunities.