Cannabis Dependence and Peer Selection in Social Networks of Frequent Users
Liebregts, Nienke, Benschop, Annemieke, Van Der Pol, Peggy, Van Laar, Margriet, De Graaf, Ron, Van Den Brink, Wim, Korf, Dirk J., Contemporary Drug Problems
In a Dutch longitudinal study on the dynamics of cannabis dependence, at baseline 600 frequent cannabis users (≥ 3 days cannabis use per week in past 12 months) aged 18-30 years were interviewed. Nearly half of all participants (42%) met DSM-IV criteria for cannabis dependence in the 12 months prior to the interview. Participants were recruited by respondent-driven sampling; referrals were understood as proxy for social networks to explore peer associations and social exclusion. Analyses revealed that networks of frequent cannabis users were mostly heterogeneous. Cannabis dependence did not emerge as a main selector. However, within segments of networks some clustering of cannabis dependence (indicating differential inclusion), sex and ethnicity was found. Methodological questions are discussed regarding the applicability of respondent-driven sampling in noninjecting, nonmarginalized drug users. The study's limitations are noted.
KEY WORDS: Cannabis dependence, respondent-driven sampling, social networks, frequent cannabis use, social exclusion.
Drug use is often a social activity that occurs in an environment with other users (Fountain & Korf, 2007). In his classic study How to become a marihuana user, Becker (1963) argues that continued drug use is typically the result of social learning. In addition, Zinberg (1984) states that the effects of drugs experienced by users are influenced by three intertwined factors (drug, set, and setting), the latter including informal social control. The relevance of this social control lies in minimizing the harm of drug use, thus resulting in controlled intoxicant use. Violating the appropriate informal rules and norms regarding drug use within a group of users leads to social sanctions, and violators might eventually be excluded from the group. Alternatively, rituals and elements of social settings prevent uncontrolled drug use like dependence (Dunlap, Johnson, Sifaweck, & Benoit, 2005; Goode, 1999; Zinberg, 1984) and this explains why many cannabis users carefully choose when, where and with whom to use the drug (Reinarman & Cohen, 2007). Consequently, processes of social inclusion and exclusion may play an important role in drug using careers (cf. Vervaeke, van Deursen, & Korf, 2008).
In a wider context, Glueck & Glueck (1950) argue that, in line with the saying "birds of a feather flock together," once deviant, juveniles are more likely to associate with deviant peers. In his classic theory of differential association, Sutherland (1947) stated that deviant behavior is learned through association and interaction with other delinquents, especially in small, informal peer groups. Akers (1998), who further explored and refined Sutherland's theory, found that the probability of frequent substance use increased when individuals in their social networks were more often exposed to favorable than to unfavorable definitions of use, including cannabis use.
A crucial question in the current study is the extent to which frequent cannabis use and cannabis dependence is an important unifying factor in peer networks. Is cannabis the "feather" that makes users flock together? In line with Zinberg' s theory, it could be argued that cannabis dependence indicates less controlled use, and thus a violation of the social norms of drug use, which then leads to social exclusion from social networks of frequent but not dependent users. The question then is, whether cannabis dependent users become socially isolated (exclusion), or tend to congregate in social networks of dependent users (differential inclusion). Alternatively, it could be argued that frequent cannabis use by itself is already a violation of the social norms of controlled use, and therefore dependence will not lead to social exclusion from frequent but nondependent users. The question then arises of which other factors might bond social networks of frequent cannabis users. The main purpose of the current study is to explore the role of social exclusion and inclusion, by analyzing social networks within the total sample of 600 frequent cannabis users, who were recruited through respondent-driven sampling, by exploring the role of cannabis use - cannabis dependence in particular - and sociodemographic variables in peer associations in high-risk and dependent cannabis users. …