Social and structural factors associated with substance use within the support network of adults living in precarious housing in a socially marginalized neighborhood of Vancouver, Canada.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Social Marginalization*/psychology ; Social Support*; Substance-Related Disorders/*etiology; Adult ; Alcoholism/epidemiology ; Alcoholism/etiology ; Alcoholism/psychology ; British Columbia/epidemiology ; Cocaine Smoking/epidemiology ; Female ; Housing ; Humans ; Longitudinal Studies ; Male ; Marijuana Abuse/epidemiology ; Marijuana Abuse/etiology ; Marijuana Abuse/psychology ; Residence Characteristics ; Smoking/epidemiology ; Smoking/psychology ; Socioeconomic Factors ; Substance-Related Disorders/epidemiology ; Substance-Related Disorders/psychology

Background: The structure of a social network as well as peer behaviours are thought to affect personal substance use. Where substance use may create health risks, understanding the contribution of social networks to substance use may be valuable for the design and implementation of harm reduction or other interventions. We examined the social support network of people living in precarious housing in a socially marginalized neighborhood of Vancouver, and analysed associations between social network structure, personal substance use, and supporters' substance use.
Methods: An ongoing, longitudinal study recruited 246 participants from four single room occupancy hotels, with 201 providing social network information aligned with a 6-month observation period. Use of tobacco, alcohol, cannabis, cocaine (crack and powder), methamphetamine, and heroin was recorded at monthly visits. Ego- and graph-level measures were calculated; the dispersion and prevalence of substances in the network was described. Logistic mixed effects models were used to estimate the association between ego substance use and peer substance use. Permutation analysis was done to test for randomness of substance use dispersion on the social network.
Results: The network topology corresponded to residence (Hotel) with two clusters differing in demographic characteristics (Cluster 1 -Hotel A: 94% of members, Cluster 2 -Hotel B: 95% of members). Dispersion of substance use across the network demonstrated differences according to network topology and specific substance. Methamphetamine use (overall 12%) was almost entirely limited to Cluster 1, and absent from Cluster 2. Different patterns were observed for other substances. Overall, ego substance use did not differ over the six-month period of observation. Ego heroin, cannabis, or crack cocaine use was associated with alter use of the same substances. Ego methamphetamine, powder cocaine, or alcohol use was not associated with alter use, with the exception for methamphetamine in a densely using part of the network. For alters using multiple substances, cannabis use was associated with lower ego heroin use, and lower ego crack cocaine use. Permutation analysis also provided evidence that dispersion of substance use, and the association between ego and alter use was not random for all substances.
Conclusions: In a socially marginalized neighborhood, social network topology was strongly influenced by residence, and in turn was associated with type(s) of substance use. Associations between personal use and supporter's use of a substance differed across substances. These complex associations may merit consideration in the design of interventions to reduce risk and harms associated with substance use in people living in precarious housing.
Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: AMB has received consulting fees or sat on advisory boards for Bristol- Myers Squibb, Eli Lilly, and Roche. WJP sat on paid advisory boards for Vitality Biopharma, Medipure Pharmaceuticals, and Vinergy Resources; has sat on the board of directors of Abbatis Bioceuticals; and is owner of Translational Life Sciences. WGH received consulting fees or sat on paid advisory boards for: the Canadian Agency for Drugs and Technology in Health, AlphaSights, Guidepoint, In Silico, Translational Life Sciences, Otsuka, Lundbeck, and Newron. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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CBG-101827 Canada CIHR; MOP-137103 Canada CIHR

Date Created: 20190924 Date Completed: 20200310 Latest Revision: 20231014

20231215

PMC6756550

10.1371/journal.pone.0222611

31545818