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Risking risk: the influence of types of capital and social networks on the injection practices of drug users

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  • Lovell, Anne M.

Abstract

Although syringe exchange and other harm reduction interventions have generally been effective in reducing blood-borne pathogen incidence among injection drug users (IDUs), in some cases a minority of IDUs continues to engage in risky injection behavior. Building on emerging perspectives in social epidemiology and research on drug use in anthropology that point to the importance of examining fundamental social causes of risk behavior, or what puts individuals at risk for risk, this study used a multilevel perspective to explore whether forms of capital, social network characteristics, and other contextual factors influence continued risky injection behavior. Quantitative and qualitative data were collected on IDUs in the city of Marseilles, France, where sterile injection equipment has been legal and officially promoted since 1995. In multivariate analysis on data concerning active users, location in the densest part of a large, interconnected network of IDUs greatly increased the likelihood of risky injection practices, while there was a non-significant tendency for low Acquired Cultural and Economic Capital to predict this behavior. Among the strongest individual-level characteristics to predict this outcome were illicit use of prescribed medication, generally high dose buprenorphine, and unprotected sex. Parental abuse of psychoactive drugs during the subject's childhood, on the other hand, greatly decreased the chances of engaging in risky injection behavior. Additionally, qualitative data analysis suggests that risky injection may be linked to lack of resources to procure drugs, and not simply to inadequate sterile injection equipment. Further research, including ecological models, is needed to better understand how fundamental social conditions are related to "risk for risk". However, public health interventions can already address the need for community-level interventions, while rethinking the consequences of inaccessible drugs and unintended "leakage" from the introduction of buprenorphine and other medicalized treatments for opiate dependency.

Suggested Citation

  • Lovell, Anne M., 2002. "Risking risk: the influence of types of capital and social networks on the injection practices of drug users," Social Science & Medicine, Elsevier, vol. 55(5), pages 803-821, September.
  • Handle: RePEc:eee:socmed:v:55:y:2002:i:5:p:803-821
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    Cited by:

    1. Damiano Fiorillo & Nunzia Nappo, 2017. "Formal volunteering and self-perceived health. Causal evidence from the UK-SILC," Review of Social Economy, Taylor & Francis Journals, vol. 75(2), pages 112-138, April.
    2. Richardson, Lindsey & Wood, Evan & Kerr, Thomas, 2013. "The impact of social, structural and physical environmental factors on transitions into employment among people who inject drugs," Social Science & Medicine, Elsevier, vol. 76(C), pages 126-133.
    3. Gloria Hongyee Chan & T. Wing Lo & Gabriel Kwun-Wa Lee & Cherry Hau-Lin Tam, 2020. "Social Capital and Social Networks of Hidden Drug Abuse in Hong Kong," IJERPH, MDPI, vol. 17(17), pages 1-15, August.
    4. Barman-Adhikari, Anamika & Rice, Eric, 2014. "Social networks as the context for understanding employment services utilization among homeless youth," Evaluation and Program Planning, Elsevier, vol. 45(C), pages 90-101.
    5. Shoff, Carla & Yang, Tse-Chuan, 2013. "Understanding maternal smoking during pregnancy: Does residential context matter?," Social Science & Medicine, Elsevier, vol. 78(C), pages 50-60.
    6. Reich, Jennifer A., 2020. "“We are fierce, independent thinkers and intelligent”: Social capital and stigma management among mothers who refuse vaccines," Social Science & Medicine, Elsevier, vol. 257(C).
    7. Khawaja, Marwan & Abdulrahim, Sawsan & Soweid, Rima A.Afifi. & Karam, Dima, 2006. "Distrust, social fragmentation and adolescents' health in the outer city: Beirut and beyond," Social Science & Medicine, Elsevier, vol. 63(5), pages 1304-1315, September.
    8. Gowan, Teresa & Whetstone, Sarah & Andic, Tanja, 2012. "Addiction, agency, and the politics of self-control: Doing harm reduction in a heroin users’ group," Social Science & Medicine, Elsevier, vol. 74(8), pages 1251-1260.

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