illustration of web of people

People with a history of injection drug use were found to have better odds of stopping injection when their social networks included more people who don’t inject, according to new research from Abby Rudolph, associate professor of epidemiology and biostatistics. 

The findings, published in the journal Addiction, are part of ongoing research that Rudolph and colleagues have been conducting to examine the social context of opioid use in rural Eastern Kentucky, a region hit hard by the opioid crisis and Hepatitis C. 

In her work, Rudolph uses social network analyses to understand connections between an individual’s behaviors and the behaviors (both actual and perceived) of their social contacts, ultimately leading to ideas for effective health interventions.

This study uses data from a long-term project called Social Networks among Appalachian People (SNAP), in which hundreds of people have been interviewed about their drug use and the people in their social networks. For people who inject drugs, many contacts in their networks are others who currently or previously injected drugs.

“Injection drug use is a social behavior,” Rudolph says.

 In another study, it was found that those with a network member who stopped injecting were more likely to stop injecting over the following 6-month period. The influence was stronger for certain members of a person’s social circle, particularly family members and those providing social support. That suggested that treatment approaches that consider familialism and social support may be more effective.

 The new study looks at changes in people’s injection status, and the composition of their social networks, over multiple six-month intervals. It finds that for each additional network member who does not inject drugs, there is a higher odds of recent and sustained injection cessation. 

“If the number of people that you know who inject diminishes over time, then you may be more likely to stop injecting as there become fewer people in your network to inject with,” Rudolph says.

Social networks are fluid, and cessation attempts can be as well, so research like this is challenging. The goal is to understand social network effects on drug use patterns and use that knowledge to identify opportunities to minimize risk. Interconnected social networks, with people influencing one another, by nature can have a multiplying effect.

“If someone is able to stop injecting, they could be one of the disruptors in the network,” Rudolph says. “If key members of the network stop injecting, this behavior change could cascade through the network.”