Individual and social network correlates of recent treatment for substance use disorders

Abstract

Substance use disorders (SUDs) result in numerous negative outcomes, with only a minority of those with a SUD ever seeking treatment. A more complete understanding is needed of the factors that impact treatment enrollment. The purpose of this analysis was to identify individual and social network correlates of treatment enrollment for substance use disorders among a sample of 330 persons who used drugs and resided in Baltimore, MD between 2014 and 2017. Models were built using multivariable logistic regression and sub-analyses were performed among subsets of individuals based on type of drug use and available treatment options for that type. In the overall sample, the number of network members currently enrolled in drug treatment was positively associated with treatment enrollment, with an increase in odds of treatment enrollment of 122% for each additional network member currently enrolled in treatment (95% CI: 1.48, 3.34). The number of network members who used heroin, cocaine, and/or crack was not associated with treatment enrollment (OR: 1.07, 95% CI: 0.88, 1.37); however, the number of network members who used drugs and provided emotional, financial, instrumental or material support (i.e., network members he/she could talk to, socialize with, who pitched in to help him/her, who were willing to provide financial support, or who he/she stayed with) reduced the odds of treatment enrollment by 38% for each additional person who used drugs in the could support network (95% CI: 0.42, 0.92). It appears to be the nature, rather than the number, of ties with other people who use drugs (PWUD) that impacts an individual’s probability of treatment enrollment. The implication may be that, rather than encouraging PWUD to distance themselves from all PWUD in their network, that they focus on fostering close relationships with sober individuals, and that they attempt to transfer sources of emotional and financial support to people who do not use drugs.