Peer Influence in Initiation to Heroin Use

• Published date: 01 April 2021
• DOI: 10.1177/0022042620979628
• Author: Barbara J. Costello,Michael Stein,Bradley J. Anderson
• Date: 01 April 2021
• Subject Matter: Articles

https://doi.org/10.1177/0022042620979628

Journal of Drug Issues

2021, Vol. 51(2) 319 –335

© The Author(s) 2020

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/0022042620979628

journals.sagepub.com/home/jod

Article

Peer Influence in Initiation

to Heroin Use

Barbara J. Costello1, Bradley J. Anderson2,

and Michael Stein2,3

Abstract

Much research on heroin initiation shows that most people use heroin initially with friends or

family. However, there is little research examining why those who use heroin would initiate

others to its use, and conversely, whether and why one might try to prevent initial heroin

use in others. Following recent work on peer influence on crime and delinquency, we test

the hypothesis that those with higher levels of self-control are less likely to initiate others to

heroin use and are more likely to try to prevent others from using for the first time. The sample

included 370 persons entering an opioid withdrawal program. We find that those with low self-

control are more likely to initiate others, but there is no relationship between self-control and

trying to prevent initiation. We further investigate self-reported motives for initiating others,

and find a mix of self-interested and more altruistic motives for initiating others.

Keywords

peer influence, self-control theory, heroin initiation, positive peer pressure

Most people who begin using or misusing opioid drugs acquire these substances from friends and

family members. Most misuse of prescription opioids is the result of the use of medications that

were not prescribed for those misusing them (Rawson et al., 2007; Szalavitz, 2016), and approxi-

mately two thirds of those misusing these drugs acquire them in some way from friends or family

members (Lankenau et al., 2012; Lipari & Hughes, 2017; Rigg et al., 2018). Those who misuse

opioids and other prescription drugs typically have a history of using or abusing other illicit drugs

(Mui et al., 2014), and are likely to be enmeshed in drug-using social networks (Carlson et al.,

2016; Harocopos et al., 2016).

Studies of heroin use show even higher rates of initiation from friends or family members.

All of the participants in two small studies of heroin users, one group of American female ado-

lescents (Eaves, 2004) and another study of Indian males (Kermode et al., 2009), reported being

initiated to heroin by a friend or family member. A study of young users of heroin in Baltimore

found that over 98% of them first used with friends or family, typically in a small group or party

setting (Gandhi et al., 2006). Similar results were obtained from a sample of heroin users in

1The University of Rhode Island, Kingston, USA

2Butler Hospital, Providence, RI, USA

3Boston University School of Public Health, MA, USA

Corresponding Author:

Barbara J. Costello, Department of Sociology and Anthropology, The University of Rhode Island, Kingston,

RI 02822, USA.

Email: Costello@uri.edu

979628JODXXX10.1177/0022042620979628Journal of Drug IssuesCostello et al.

research-article2020

320 Journal of Drug Issues 51(2)

Calcutta, India, with 90% of first use occurring in a small group of friends (Chowdhury & Sen,

1992). Studies specifically focusing on injecting heroin and other drugs1 also find very high

rates of initiation by others who inject drugs (Goldsamt et al., 2010; Simpson et al., 2020;

Wenger et al., 2016; Werb et al., 2016). One study of persons who inject heroin found only 10%

reporting being initiated by someone other than family or friends or being self-taught how to

inject (Day et al., 2005).

Criminological research has similarly documented that people who use drugs are likely to be

enmeshed in social networks of others who use drugs, and this holds for criminal and deviant

behavior other than drug use as well. This pattern is one of the best-documented findings in

criminology (Costello & Hope, 2016; Shaw & McKay, 1942; Sutherland, 1947; Warr, 2002). In

addition, there is strong empirical support for versatility in crime and deviant behavior such as

drug use (Delisi, 2003; Gottfredson & Hirschi, 1990; Mazerolle & McPhedran, 2018). This refers

to the fact that those who engage in deviant behaviors at higher rates tend not to specialize in any

form of deviant or criminal behavior, and that offenders tend to engage in a variety of both legal

and illegal substance misuse in addition to crime.

This evidence suggests that heroin use and dependence may have the same causes as the use

and misuse of other intoxicating substances and criminal behavior more generally. One of these

causes is likely contact with friends and family who promote, condone, or simply provide the

opportunity for individuals to use drugs. However, the research literature in criminology rarely

cites the literature on drug misuse and dependence, much of which has a medical focus. Similarly,

the literature focused on drug use and dependence rarely cites the research in criminology that is

focused on the peer effect. Neither body of literature has adequately addressed the question of

why those who use heroin would initiate others to its use, and conversely, whether and why one

might try to prevent initial heroin use in others.

The purpose of the current study is to investigate these issues. Drawing on prior research on

motives of both positive and negative peer influence (Costello & Zozula, 2018), and drawing on

Gottfredson and Hirschi’s (1990) general theory of crime, we hypothesize that those with lower

self-control will be more likely to initiate others and less likely to report trying to prevent others

from first use. We also examine the motives for initiating others and predict that those motives

will be more self-interested than other-directed.

Extent and Motives of Peer Influence

In the literature on both drug use and crime and deviance more generally, there is ample evi-

dence of homophily—That is, people who engage in crime or drug use are likely to have peers

(friends, family, or romantic partners) who engage in the same behaviors (Kandel, 1996; Li

et al., 2017). Some of the earliest criminological theories were designed in part to explain this

pattern (Shaw, 1931; Shaw & McKay, 1942; Sutherland, 1947). Despite the existence of clear

evidence of homophily, however, there has been a great deal of debate over the reasons for this

pattern. Historically, differential association and social learning theories claimed to explain the

correlation, with the argument that deviant peers cause deviant behavior by teaching norms

conducive to the behavior (Burgess & Akers, 1966; Sutherland, 1947). Control theorists gener-

ally argued that the correlation could be explained by self-selection (Hirschi, 1969), or that the

magnitude of the relationship was artificially inflated by asking respondents to report on the

behavior of their peers (Gottfredson & Hirschi, 1990). The self-selection versus socialization

debate has continued for many years, with much research suggesting that both play a role

(Kandel, 1978). Starting around the mid-1990s, researchers began exploring alternative expla-

nations for the peer effect, such as friends simply providing the opportunity for deviance

(Desmond et al., 2012; Hoeben & Weerman, 2016; Osgood & Anderson, 2004; Osgood et al.,

1996). Scholars have noted the wide range of possible explanations for the peer effect and the