Individual and Network Correlates of Antisocial Personality Disorder Among Rural Nonmedical Prescription Opioid Users

Sociometric network analysis in illicit drugs research: A scoping review

BACKGROUND

Sociometric or whole network analysis, a method used to analyze relational patterns among social actors, emphasizes the role of social structure in shaping behaviour. Such method has been applied to many aspects of illicit drug research, including in the areas of public health, epidemiology, and criminology. Previous reviews about social networks and drugs have lacked a focus on the use of sociometric network analysis for illicit drugs research across disciplines. The current scoping review aimed to provide an overview of the sociometric network analysis methods used in illicit drugs research and to assess how such methods could be used for future research.

METHODS

A systematic search of six databases (Web of Science, ProQuest Sociology Collection, Political Science Complete, PubMed, Criminal Justice Abstracts, and PsycINFO) returned 72 relevant studies that met the inclusion criteria. To be included, studies had to mention illicit drugs and use whole social network analysis as one of their methods. Studies were summarized quantitatively and qualitatively using a data-charting form and a description of the studies' main topics.

RESULTS

Sociometric network analysis in illicit drugs research has grown in popularity in the last decade, using mostly descriptive network metrics, such as degree centrality (72.2%) and density (44.4%). Studies were found to belong to three study domains. The first, drug crimes investigated network resilience and collaboration patterns in drug trafficking networks. The second domain, public health, focused on the social networks and social support of people who use drugs. Finally, the third domain focused on the collaboration networks of policy, law enforcement, and service providers.

CONCLUSION

Future illicit drugs research using whole network SNA should include more diverse data sources and samples, incorporate mixed and qualitative methods, and apply social network analysis to study drug policy.

The phenomics and genetics of addictive and affective comorbidity in opioid use disorder

Opioid use disorder (OUD) creates significant public health and economic burdens worldwide. Therefore, understanding the risk factors that lead to the development of OUD is fundamental to reducing both its prevalence and its impact. Significant sources of OUD risk include co-occurring lifetime and current diagnoses of both psychiatric disorders, primarily mood disorders, and other substance use disorders, and unique and shared genetic factors. Although there appears to be pleiotropy between OUD and both mood and substance use disorders, this aspect of OUD risk is poorly understood. In this review, we describe the prevalence and clinical significance of addictive and affective comorbidities as risk factors for OUD development as a basis for rational opioid prescribing and OUD treatment and to improve efforts to prevent the disorder. We also review the genetic variants that have been associated with OUD and other addictive and affective disorders to highlight targets for future study and risk assessment protocols.

Antisocial Personality Disorder as a Risk Factor for Opioid Use: The Dual Mediating Roles of Antisocial Attitudes and Self-Control

Antisocial personality disorder is a risk factor for opioid use. There is a dearth of research which examines self-control and moral disengagement as potential mediators of this relationship. This study utilized data from the Pathways to Desistance study in analyses. Generalized structural equation modeling was utilized to test for mediation of the relationship between antisocial personality disorder and opioid use. Bootstrapped standard errors were computed so that a Clogg Z test could be estimated to determine if identified mediation effects significantly differed. Results indicated that a likely diagnosis of antisocial personality disorder increased risk for opioid use. Inclusion of moral disengagement and self-control into the model resulted in attenuation of this effect to non-significance and reduced the magnitude of the effect by around 45%. The contribution of both constructs to the total indirect effect did not significantly differ and only the total indirect effect was significant.

Social norms associated with nonmedical opioid use in rural communities: a systematic review

Prescription and illicit opioids were involved in over 42,000 deaths in the USA in 2016. Rural counties experience higher rates of opioid prescribing and, although opioid prescribing rates have fallen in recent years, the rate of decline is less in rural areas. The sociocultural context of rural life may impact opioid misuse in important ways; however, little research directly explores this possibility. We performed a systematic review of English-language manuscripts in U.S. context to determine what is known about social networks, norms, and stigma in relation to rural opioid misuse. Of nine articles identified and reviewed, two had only primary findings associated with social networks, norms, or stigma, five had only secondary findings, and two had both primary and secondary findings. The normalization of prescription opioid use along with environmental factors likely impacts the prevalence of opioid misuse in rural communities. Discordant findings exist regarding the extent to which social networks facilitate or protect against nonmedical opioid use. Lastly, isolation, lack of treatment options, social norms, and stigma create barriers to substance use treatment for rural residents. Although we were able to identify important themes across multiple studies, discordant findings exist and, in some cases, findings rely on single studies. The paucity of research examining the role of social networks, norms, and stigma in relation to nonmedical opioid use in rural communities is evident in this review. Scholarship aimed at exploring the relationship and impact of rurality on nonmedical opioid use is warranted.

The Salience of Antisocial Personality Disorder for Predicting Substance Use and Violent Behavior: The Moderating Role of Deviant Peers

Deviant peer association and antisocial personality disorder are risk factors for drug use and violent offending. However, there has yet to be research that focuses on how deviant peer association may moderate the impact of antisocial personality disorder on these outcomes. Data from Wave 10 of the Pathways to Desistance dataset were used in analyses. Negative binomial regression was used to estimate the effects of covariates on violent offending. Ordered logistic regression was used to estimate the effects of covariates on substance use outcomes. Results indicated that deviant peer association moderated the impact of antisocial personality disorder on violent offending frequency and marijuana use frequency. The direction of this interaction effect was positive for marijuana use. The direction of this moderation was negative for violent offending, indicating that antisocial personality disorder–diagnosed individuals commit fewer violent offenses at similar levels of deviant peer association as nonafflicted participants.

Network-Based Research on Rural Opioid Use: an Overview of Methods and Lessons Learned

PURPOSE OF REVIEW

The purpose of this paper is to provide a thorough overview of methods used for recruitment, network data collection, and network data management in a network-based study of rural people who use drugs (PWUD) and to offer methodological recommendations for future research on rural drug use.

RECENT FINDINGS

The Social Networks among Appalachian People (SNAP) study recruited a cohort of 503 rural PWUD via respondent-driven sampling (RDS) and has retained more than 80% of eligible participants over 7-9 years. SNAP has yielded important methodological insights, including that (1) RDS referral was non-random and disproportionately involved kin and (2) interviewer-administered questionnaires were successful in eliciting accurate name and age information about network members. The SNAP experience suggests that RDS was a successful recruitment strategy for rural PWUD and questionnaires administered by community-based interviewers in the context of a Certificate of Confidentiality could elicit detailed data on PWUD risk networks.

Injection-related hepatitis C serosorting behaviors among people who inject drugs: An urban/rural comparison

Although previous research has focused on injection drug use behaviors in both urban and rural settings, few have drawn direct comparisons between adjacent rural and urban areas. Using data from the National HIV Behavioral Surveillance study as well as original data collected in a similar fashion, we compare the risk behaviors of people who inject drugs (PWID) in San Juan, Puerto Rico, with those of PWID in nearby rural areas. Specifically, we examine whether one's own hepatitis C (HCV) infection status can be used to predict whether one asked their most recent co-injection partner about their HCV status. Acquiring such information allows injectors to seek out co-injection partners of concordant status as a way to minimize the risk of viral transmission. Results indicate that urban PWID with a known HCV+ status were more likely to know their last co-injector partner's HCV status than were their peers with a negative or unknown HCV status. However, this relationship was not present in the rural data. These findings suggest that there are different risk norms in rural and urban PWID communities and that interventions successful in one type of community may not be so in others.