Drug-using Peers Research Articles

Role of social context in addiction etiology and recovery

While social context has long been considered central to substance use disorder prevention and treatment and many drug-taking events occur in social settings, experimental research on social context has historically been limited. Recent years have seen an emergence of concerted preclinical and human laboratory research documenting the direct impact of social context on substance use, delineating behavioral and neurobiological mechanisms underlying social influence's role. We review this emerging preclinical and human laboratory literature from a theoretical lens that considers distinct stages of the addiction process including drug initiation/acquisition, escalation, and recovery. A key conclusion of existing research is that the impact of the social environment is critically moderated by the drug-taking behavior and drug use history of a social peer. Specifically, while drug-free social contexts can reduce the likelihood of drug use initiation and act as a competitive non-drug alternative preventing escalation, drug-using peers can equally facilitate initiation and escalation through peer modeling as a contingent reward of use. Likewise, social context may facilitate recovery or serve as a barrier that increases the chances of a return to regular use. We conclude by discussing evidence-based treatments and recovery support services that explicitly target social mechanisms or that have identified social context as a mechanism of change within treatment. Ultimately, new areas for research including the expansion of drug classes studied and novel human laboratory designs are needed to further translate emerging findings into clinical practice.

Do Control, Peers, and Permissive Attitudes to Drugs Influence Drug Use Frequency in a Gendered Way?

The dominant role of heroin in Chinese drug scenes has been gradually replaced by synthetic drugs since 2014. The gendered patterns of drug use have also changed with the transformation in drug consumption. Drawing upon survey data from 716 drug users detained in compulsory detoxification institutions, this study shows that permissive attitudes to drug use are a significant correlate of drug use frequency, and the correlation is much stronger among males than females. Neither self-control nor family attachment is significantly associated with drug use frequency. Drug-using peers are a constantly powerful correlate for drug use frequency among both males and females. Policy implications for improving treatment programs for detained drug users in compulsory detoxification institutions are discussed from a gender-specific perspective.

Pathways linking ethnic discrimination and drug-using peer affiliation to underage drinking status among Mexican-origin adolescents.

Using a three-wave longitudinal data set of Mexican-origin adolescents (N = 602, Mage = 12.92, SD = 0.91 at Wave 1), this study examines parallel pathways from early exposure to ethnic discrimination and drug-using peers, separately, to underage drinking status by late adolescence. Negative affect was expected to mediate the link from ethnic discrimination to underage drinking status (the stress-induced pathway), whereas social alcohol expectancy was expected to mediate the link from drug-using peers to underage drinking status (the socialization pathway). Our findings lend support to the stress-induced pathway while controlling for the socialization pathway. For the stress-induced pathway, we found that early ethnic discrimination experiences were related to higher likelihood of having engaged in underage drinking by late adolescence through elevated negative affect sustained across adolescence. For the socialization pathway, we found no association between affiliation with drug-using peers in early adolescence and underage drinking status, either directly or indirectly. Present findings highlight the unique role of early ethnic discrimination experiences in underage drinking among Mexican-origin adolescents, over and above the effect of drug-using peers. Alcohol use interventions targeting ethnic minority adolescents should account for adolescents' ethnic discrimination experiences by helping adolescents develop adaptive coping strategies to handle negative affect induced by discrimination (e.g., reappraisal) rather than using alcohol to self-medicate. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Social Contact Reinforces Cocaine Self-Administration in Young Adult Male Rats: The Role of Social Reinforcement in Vulnerability to Drug Use.

Drug-using peers are recognized as a leading factor influencing drug use among adolescents and young adults. One mechanism by which peers influence drug use is by providing social reinforcement for using drugs. Social reinforcement may be provided in multiple ways, including by making social contact contingent on drug use (i.e., an individual must use drugs to gain/maintain access to a peer). The purpose of this study was to develop a preclinical model in which intravenous cocaine self-administration was positively reinforced by access to a social partner. Young adult male rats were trained to self-administer cocaine in operant conditioning chambers with a guillotine door that could be opened to an adjacent compartment housing either a social partner or a non-social stimulus. Once cocaine self-administration was established, the guillotine door was activated, and cocaine intake was reinforced by brief access to either a social (age- and sex-matched peer) or non-social (black-and-white athletic sock) stimulus. Contingent access to a social partner rapidly increased cocaine self-administration. Total cocaine intake was 2- to 3-fold greater in rats assigned to the social versus non-social condition across a 100-fold dose range. Cocaine intake rapidly increased when rats in the original non-social group were later provided with social partners, whereas cocaine intake resisted change and remained elevated when rats in the original social group had their partners removed. These data indicate that contingent access to a social partner increases drug intake and suggest that social reinforcement may represent a vulnerability factor that is particularly resistant to psychosocial interventions.

Reduced Glutamate Turnover in the Putamen Is Linked With Automatic Habits in Human Cocaine Addiction

BackgroundThe balance between goal-directed behavior and habits has been hypothesized to be biased toward the latter in individuals with cocaine use disorder (CUD), suggesting possible neurochemical changes in the putamen, which may contribute to their compulsive behavior. MethodsWe assessed habitual behavior in 48 patients with CUD and 42 healthy control participants using a contingency degradation paradigm and the Creature of Habit Scale. In a subgroup of this sample (CUD: n = 21; control participants: n = 22), we also measured glutamate and glutamine concentrations in the left putamen using ultra-high-field (7T) magnetic resonance spectroscopy. We hypothesized that increased habitual tendencies in patients with CUD would be associated with abnormal glutamatergic metabolites in the putamen. ResultsCompared with their non–drug-using peers, patients with CUD exhibited greater habitual tendencies during contingency degradation, which correlated with increased levels of self-reported daily habits. We further identified a significant reduction in glutamate concentration and glutamate turnover (glutamate-to-glutamine ratio) in the putamen in patients with CUD, which was significantly related to the level of self-reported daily habits. ConclusionsPatients with CUD exhibit enhanced habitual behavior, as assessed both by questionnaire and by a laboratory paradigm of contingency degradation. This automatic habitual tendency is related to a reduced glutamate turnover in the putamen, suggesting a dysregulation of habits caused by chronic cocaine use.

Typologies of illicit drug use in mid-adulthood: a quasi-longitudinal latent class analysis in a community-based sample of twins.

To identify drug use typologies based on substances used and persistence of use over two time points, use a genetically informed design to explore twin concordance of and genetic influence on the use typologies and compare patterns of declined/discontinued ("desistant") and persistent drug use on drug use correlates. Latent class analysis was applied to data from a cross-sectional self-report survey on current and past drug use. Use characteristics, use disorder, and psychiatric problems were compared across classes. Computer-assisted telephone interview in respondents' homes. A total of 3785 individual twins and siblings (1365 men, 2420 women; Mage =32) from the Australian Twin Registry Cohort III. A comprehensive interview assessed prior to past year and past year use of cannabis, stimulants, cocaine/crack, hallucinogens, opioids, sedatives, inhalants, dissociatives, and solvents; age of first use; opportunity to use; peer drug use; attention deficit/hyperactivity, conduct, antisocial personality, depressive, and substance use disorders; and suicidality. A five-class solution emerged: no/low use (50%), desistant cannabis use (23%), desistant party drug use (18%), persistent prescription drug misuse (4%), and persistent polydrug use (5%). Twin concordances were higher among monozygotic (k =0.30-0.35) than dizygotic pairs (same-sex k =0.19-0.20; opposite sex k =0.07), and biometric modeling suggested that the persistent polydrug use class, in particular, was highly heritable (a2 =0.94). Conduct disorder (OR=2.40), antisocial personality disorder (OR=3.27), and suicidal ideation (OR=1.98) increased persistent polydrug use risk; depression (OR=2.38) and lifetime suicide attempt (OR=2.31) increased persistent prescription misuse risk. Relative to persistent prescription drug misuse, persistent polydrug use was associated with higher rates of cannabis and stimulant use disorder (OR=6.14-28.01), younger first substance use (OR=0.82-0.83), more drug use opportunity (OR=10.66-66.06), and more drug-using peers (OR=4.66-9.20). Unique patterns of declined/discontinued ("desistant") and persistent drug use are differentially heritable and differentially associated with risk factors, psychiatric symptoms, and substance use disorder outcomes.

Police Contact, Procedural Injustice, and Drug Use

Drawing on general strain theory, this article explores whether young people’s perceptions of procedural injustice in their interactions with police, as well as their economic dissatisfaction, are associated with drug use. We examine whether levels of police contact increase the likelihood of perceptions of procedural injustice, and if the relationships between procedural injustice and drug use as well as economic dissatisfaction and drug use are influenced by associations with drug-using peers, legal cynicism, and levels of social support. Using a sample of 449 individuals aged 16–30 years in three Canadian cities, the findings suggest that police contact has a direct relationship with drug use, but it also has an indirect relationship mediated by procedural injustice. Further, economic dissatisfaction, homelessness, legal cynicism, and drug-using peers are also associated with greater drug use. The relationships between procedural injustice and drug use and economic dissatisfaction and drug use are stronger at lower levels of social support. Findings are discussed and suggestions for future research are offered.

Predictors and Implications of Synthetic Drug Use Among Adolescents in the Gambling Capital of China

Synthetic drug abuse has become an increasingly serious problem among adolescents in Macao, the world’s largest gambling market and the only legal gambling place in China. To counteract this trend, a good understanding of the culturally relevant risk factors for this behavior is required. Based on social learning theory and opportunity perspective of deviance, logistic regression analysis was performed on a probability sample of 8,076 Macao students collected in 2014 to investigate whether delinquent peer association, recreational use of time with friends, attitudes toward drug use, and the availability of synthetic drugs are significant predictors of synthetic drug use among adolescents. The analyses revealed that students who had more drug-using peers, perceived drug use to be less harmful, and had easier access to synthetic drugs were more likely to use drugs. The findings indicate that preventing synthetic drug use among adolescents should target individual risk factors and the availability of drugs.

Are Negative Peer Influences Domain Specific? Examining the Influence of Peers and Parents on Externalizing and Drug Use Behaviors.

Most studies tend to characterize peer influences as either positive or negative. In a sample of 1815 youth from 14 different schools in Caracas, Venezuela, we explored how two types of peer affiliations (i.e., deviant and drug-using peers) differentially mediated the paths from positive parenting to youth's externalizing behavior and licit and illicit drug use. We used Zero Inflated Poisson models to test the probability of use and the extent of use during the past 12months. Results suggested that peer influences are domain specific among Venezuelan youth. That is, deviant peer affiliations mediated the path from positive parenting to youth externalizing behaviors, and peer drug-using affiliations mediated the paths to the drug use outcomes. Mediation effects were partial, suggesting that parenting explained unique variance in the outcomes after accounting for both peer variables, gender, and age. We discuss implications for the development of screening tools and for prevention interventions targeting adolescents from different cultures.

Harm Reduction From Below: On Sharing and Caring in Drug Use.

This article focuses on how recreational drug users in the Netherlands and in online communities navigate the risks and reduce the harms they associate with psychoactive drug use. To do so, we examined the protective practices they invent, use, and share with their immediate peers and with larger drug experimenting communities online. The labor involved in protective practices and that which ultimately informs harm reduction from below follows three interrelated trajectories: (1) the handling and sharing of drugs to facilitate hassle-free drug use, (2) creating pleasant and friendly spaces that we highlight under the practices of drug use attunements, and (3) the seeking and sharing of information in practices to spread the good high. We focus not only on users’ concerns but also on how these concerns shape their approach to drugs, what young people do to navigate uncertainties, and how they reach out to and create different sources of knowledge to minimize adversities and to improve highs. Harm reduction from below, we argue, can best be seen in the practices of sharing around drug use and in the caring for the larger community of drug-using peers.

Death matters: understanding heroin/opiate overdose risk and testing potential to prevent deaths.

To describe work undertaken over a 20-year period, investigating overdose characteristics among survivors, effects of acute heroin administration, clustering of risk of overdose fatality and potential interventions to reduce this fatal outcome. Privileged-access interviewers obtained data from non-treatment as well as treatment samples; experimental study of drop in oxygen saturation following heroin/opiate injection; investigation of clusterings of death following prison release and treatment termination; and study of target populations as intervention work-force, including family as well as peers, and action research built into pilot implementation. Overdose has been experienced by about half of heroin/opiate misusers, with even higher proportions having witnessed an overdose, and with high levels of willingness to intervene. Heroin/opiates are associated with the majority of drug-related deaths, despite relative scarcity of use. Heroin injection causes a rapid drop in oxygen saturation, recovering only slowly over the next half hour. Deaths from drug overdose are greatly more likely on prison release and post-discharge from detoxification and other in-patient or residential settings. High levels of declared willingness to intervene are matched by active interventions. Both drug-using peers and family members show ability to improve knowledge and gain confidence from training. Audit study of take-home schemes finds approximately 10% of dispensed naloxone is used in real-life emergency situations. Overdose is experienced by most users, with heroin/opiates contributing disproportionately to drug overdose deaths. High-risk times (e.g. after prison release) are now clearly identified. Peers and family are a willing potential intervention work-force, but are rarely trained or given pre-supply of naloxone. Large-scale naloxone provision (e.g. national across Scotland and Wales) is now being delivered, while large-scale randomized trials (e.g. N-ALIVE prison-release trial) are finally under way. Better naloxone products and better-organized provision are needed. The area does not need more debate; it now needs proper implementation alongside good scientific study.

Transforming Austin: Augmenting the System of Care for Adolescents in Recovery from Substance Use Disorders

Maintaining sobriety and a positive quality of life is a challenge for adults in recovery from addiction, but it is even more challenging for adolescents. Post-treatment resumption of substance-related problems for adolescents range from 60-90%. Adolescent recovery programs have struggled with the best mix of services to assure recovery stability and to promote healthy functioning and a positive quality of life. Although research is limited, evidence suggests that a continuum of care model that incorporates peer supports such as APGs (APG) to replace alcohol and drug-using peers is critical for successful recovery. If the model includes attendance at a high school designated for students in recovery, positive outcomes may be even greater. This article outlines the existing models of adolescent recovery support and provides a case study of the augmentation and development of services to adolescents and emerging adults who desire recovery in Austin, TX.

Working together: Expanding the availability of naloxone for peer administration to prevent opioid overdose deaths in the Australian Capital Territory and beyond.

Since the mid-1990s, there have been calls to make naloxone, a prescription-only medicine in many countries, available to heroin and other opioid users and their peers and family members to prevent overdose deaths. In Australia there were calls for a trial of peer naloxone in 2000, yet at the end of that year, heroin availability and harm rapidly declined, and a trial did not proceed. In other countries, a number of peer naloxone programs have been successfully implemented. Although a controlled trial had not been conducted, evidence of program implementation demonstrated that trained injecting drug-using peers and others could successfully administer naloxone to reverse heroin overdose, with few, if any, adverse effects. In 2009 Australian drug researchers advocated the broader availability of naloxone for peer administration in cases of opioid overdose. Industrious local advocacy and program development work by a number of stakeholders, notably by the Canberra Alliance for Harm Minimisation and Advocacy, a drug user organisation, contributed to the rollout of Australia's first prescription naloxone program in the Australian Capital Territory (ACT). Over the subsequent 18 months, prescription naloxone programs were commenced in four other Australian states. The development of Australia's first take-home naloxone program in the ACT has been an 'ice-breaker' for development of other Australian programs. Issues to be addressed to facilitate future scale-up of naloxone programs concern scheduling and cost, legal protections for lay administration, prescribing as a barrier to scale-up; intranasal administration, administration by service providers and collaboration between stakeholders.

Religiousness, Social Networks, Moral Schemas, and Marijuana Use: A Dynamic Dual-Process Model of Culture and Behavior

Drawing on insights from a dual-process model of culture, social networks, and behavior, this study develops a model that specifies the associations among religiousness and marijuana use during adolescence and young adulthood. In particular, the model highlights potential reciprocal associations among religiousness, marijuana use, drug-using peer networks, religious peer networks, and moral schemas. Analyses of longitudinal data from the National Survey of Youth and Religion (NSYR; n = 2,276) provide some support for the model. In particular, religious and drug-using peer networks play a key role in understanding how marijuana use and religiousness are mutually related during adolescence and young adulthood.

Social Contacts and Ecstasy Offers: Findings of a Population-Based Study

Ecstasy (MDMA) use is relatively common among young adults in many developed countries. However, little is known about how young non-users are first introduced to Ecstasy, including the relative contribution of peer networks and individual risk factors. We assess the role of social contact with Ecstasy-using peers in regard to young adults’ exposure to offers of Ecstasy, using data from the Natural History Study, a population-based study conducted in Australia. Population screening of young adults (19- to 23-year-olds) identified a sample of young Ecstasy users (N = 315) and a comparison group of Ecstasy-naïve participants (N = 199). Two outcomes are considered: being exposed to any Ecstasy offers and being exposed to > 3 offers. Extensive social contact with Ecstasy users was defined as knowing >10 Ecstasy users. Of the Ecstasy-naïve young adults, >40% had ever received Ecstasy offers. Extensive social contact with Ecstasy users independently predicted exposure to multiple (> 3) Ecstasy offers for Ecstasy-naïve young adults. These findings indicate that Ecstasy offers are widespread among users and non-users of Ecstasy. For non-users, exposure to Ecstasy offers occurs through social contact with drug-using peers independently of individual risk factors. The pervasiveness of Ecstasy offers suggests that universal education concerning Ecstasy use is required.

Longitudinal Determinants of Substance Use Disorders

Substance use and substance use disorders (SUDs) have been linked with marital discord. Relatively little is known, however, about the antecedents of SUDs, the mediators of these factors over time, or their associations with the spousal/partner relationship among urban adults. A better understanding of the longitudinal pathways to marital conflict and to SUDs should help prevention and intervention programs target their precursors within the developmental period in which they occur. The present study, therefore, examined the longitudinal predictors of an unsupportive spousal/partner relationship and SUDs among a community sample of urban African American and Puerto Rican adults from East Harlem, NY. Participants (N = 816) completed structured questionnaires at five time waves, from adolescence to adulthood (mean ages = 14, 19, 24, 29, and 32years). Structural equation modeling examined the effects of earlier environmental and social stressors and intrapersonal and interpersonal factors on later SUDs in adulthood. There was a good fit of the structural equation model (CFI = 0.91; RMSEA = 0.06; and SRMR = 0.06), which revealed three main pathways from adolescence to the spousal/partner relationship and SUDs in adulthood. One pathway linked a weak parent-adolescent attachment relationship with the participant's psychological symptoms in emerging adulthood (p < 0.01), which in turn were related to affiliation with deviant and drug-using peers, also in emerging adulthood (p < 0.001). Peer deviance and drug use were associated with the participant's substance use in young adulthood (p < 0.001), which predicted both an unsupportive spousal/partner relationship (p < 0.05) and SUDs (p < 0.001) later in adulthood. Other pathways highlighted the continuity of psychological symptoms as related to both substance use in young adulthood (p < 0.001) and an unsupportive spousal/partner relationship in adulthood (p < 0.001). Findings showed that the associations of both distal stressors and the parent-adolescent relationship with more proximal intra- and interpersonal problems predicted unsupportive spousal/partner relationships and SUDs among urban adults. Several aspects of the individual's life, at different developmental stages, provide opportunities for interventions to prevent or reduce unsupportive spousal/partner relationships and SUDs.

Double jeopardy through social marginalization: HIV risk among Tajik male labor migrants in Moscow

BackgroundThis study examines the influence of the double jeopardy of being both a migrant and an injection drug user on the social marginalization of male Tajik labor-migrants working in Moscow and the influence of this dual-marginalization on HIV risk. MethodsThree focus group discussions of 8 participants each were conducted in Moscow with a total of 24 Tajik male migrants who regularly inject drugs (IDUs). ResultsResults suggest that male Tajik IDUs are at double jeopardy for social marginalization from both Russian society and their own Tajik migrant community. In the absence of adequate knowledge about HIV risk through needle-borne infection, such dual social rejection can help to push Tajik migrant IDUs toward forging close social alliances with their drug-using peers based on a sense of community through sharing drugs and injection equipment. Sexual contact with Russian female sex workers, many of whom use drugs, further contributes to HIV vulnerability and forms a potential bridge for the cross-over of the virus between both populations. With little to no access to formal health services, family and friends living in Moscow can form a sole source of social support at a personal level that can over-ride general community censure but which can lessen or disappear as drug dependency increases. ConclusionBoth drug and health services are sorely needed for this highly vulnerable population.

Young Mothers, Delinquent Children

Young motherhood is a risk factor for the child’s delinquency. Few studies, however, have attempted to unpack the mediating factors that underlie this relationship. The current study assessed factors that mediate the association between maternal age at childbirth (MAC) and the child’s delinquency using nationally representative data from the United States. Findings revealed that MAC predicted the child’s delinquency in adolescence. The link between MAC and delinquency was not mediated by parenting factors, neighborhood factors, or the child’s level of self-control. Instead, the MAC effect was completely mediated by the child’s level of exposure to drug-using peers.

Height in adolescence predicts polydrug use in adolescence and young adulthood

Prior research has noted a relationship between an individual's height in adolescence and their personality development later in life. This study examined whether height in adolescence – net of possible confounding variables such as age and biological maturity – predicted polydrug use in adolescence and young adulthood. The results revealed a positive and statistically significant association, wherein taller youths were more likely to report using an array of drugs. Supplemental analyses indicated that the relationship is not specific to males as some theories would suggest. Possible mediating mechanisms such as exposure to drug-using peers, self-control, depression, and self-esteem are considered. Implications of the findings are discussed.

A Test of Moffitt’s Hypotheses of Delinquency Abstention

Criminologists have long noted that a small subset of the population will abstain from delinquent activity, even during adolescence, when such behavior is normative. Moffitt’s developmental taxonomy in particular hypothesizes that abstainers “skip” the maturity gap and are likely social isolates who do not associate with peers. The current study assesses this hypothesis by examining whether the maturity gap and peer associations are associated with abstention from delinquency. Findings are consistent with Moffitt’s hypotheses. Specifically, the maturity gap, the amount of time spent with peers, and the amount of contact with drug-using peers were significant predictors of abstention for males and females.