The Relative Influence of Injunctive and Descriptive Social Norms on Methamphetamine, Heroin, and Injection Drug Use Among Homeless Youths: The Impact of Different Referent Groups

• Author: Elizabeth Bowen,Rohan Das,Eric Rice,Jaih Craddock,Anamika Barman-Adhikari
• Published date: 01 January 2018
• Date: 01 January 2018
• DOI: 10.1177/0022042617726080
• Subject Matter: Articles

https://doi.org/10.1177/0022042617726080

Journal of Drug Issues

2018, Vol. 48(1) 17 –35

© The Author(s) 2017

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DOI: 10.1177/0022042617726080

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Article

The Relative Influence of Injunctive

and Descriptive Social Norms

on Methamphetamine, Heroin,

and Injection Drug Use Among

Homeless Youths: The Impact of

Different Referent Groups

Anamika Barman-Adhikari1, Jaih Craddock2, Elizabeth Bowen3,

Rohan Das4, and Eric Rice2

Abstract

The current study assessed the relative influence of both injunctive and descriptive norms

in the context of different referent groups (i.e., family, street peers, home-based peers, and

staff members) on past 30-day methamphetamine, heroin, and injection drug use behaviors of

homeless youth. Cross-sectional data (N = 911) were collected from three drop-in centers

in Los Angeles, California. The study consisted of two parts: a social network interview and a

computerized self-administered survey. Multivariate logistic regression models examined the

association of objection to drug use from referent groups (injunctive norms; that is, street-

based peers, home-based peers, relatives, staff members) and drug use of referent groups

(descriptive norms) with youths’ substance use behaviors. Multivariate results indicated that the

role of injunctive and descriptive norms varied across the three substance use behaviors and by

referent group. Findings indicate the need to carefully consider the diversity of homeless youths’

networks in designing substance use interventions.

Keywords

social networks, perceived norms, descriptive norms, injunctive norms, referent groups, hard

drug use

Introduction

Hard Drug Use Among Homeless Youths

More than 1 million young people experience homelessness annually in the United States, meaning

they do not have a safe, stable place to stay at night (Rahman, Turner, & Elbedour, 2015). Although

the age range denoted by “youth” varies in policy mandates and research studies, the category of

1University of Denver, CO, USA

2University of Southern California, Los Angeles, USA

3State University of New York, Buffalo, USA

4Creighton University, Lincoln, NE, USA

Corresponding Author:

Anamika Barman-Adhikari, School of Social Work, University of Denver, 2148 S. High St., Denver, CO 80208, USA.

Email: anamika.barmanadhikari@du.edu

726080JODXXX10.1177/0022042617726080Journal of Drug IssuesBarman-Adhikari et al.

research-article2017

18 Journal of Drug Issues 48(1)

homeless youth can include adolescents below age 18 as well as emerging adults aged 18 to 25 years

(Arnett, 2014; Rahman et al., 2015). For these young people, homelessness is associated with high-

risk behaviors, including hard drug use. Homeless youth report elevated rates of hard drug use,

including street opioids such as heroin, prescription opioids, and stimulants such as cocaine, crack,

and methamphetamines (Hudson et al., 2009; Nyamathi, Hudson, Greengold, & Leake, 2012;

Wenzel, Tucker, Golinelli, Green, & Zhou, 2010). For example, studies have reported lifetime rates

of use ranging from 24% to 69% for methamphetamine and 12% to 15% for heroin among homeless

youths (Nyamathi et al., 2012; Salomonsen-Sautel et al., 2008; Uhlmann et al., 2014; Walls & Bell,

2011). Injection drug use (IDU) is a particular concern for homeless youths. Research has indicated

that approximately 40% of homeless youths have injected drugs, and IDU is associated with health

concerns including overdose and hepatitis C and HIV transmission (Kerr et al., 2009).

Given the high prevalence of hard drug use among homeless youths and the potential health,

social, and legal consequences of such use, it is critical to develop a better understanding of the

context of homeless youths’ drug use and associated factors. This study applies social network

theory to understand how different types of social network norms, along with individual-level

demographic and socioeconomic variables, are associated with recent methamphetamine use,

heroin use, and IDU among homeless youth. This information can be used to inform network-

level prevention interventions for this population.

Individual Correlates of Drug Use Among Homeless Youth

A vast majority of the literature on heroin or methamphetamine use and IDU has been focused on

either adult users (Davey-Rothwell, 2006; Knowlton, Hua, & Latkin, 2005; Latkin et al., 2009)

or young men who have sex with men (Halkitis, Palamar, & Mukherjee, 2007; Reback, Larkins,

& Shoptaw, 2004; Shoptaw et al., 2006). Fewer studies have tried to assess hard drug use specifi-

cally among homeless youth. In these studies, methamphetamine use has been associated with

individual-level correlates including older age (Nyamathi et al., 2012; Rawson, Gonzales, Obert,

McCann, & Brethen, 2005); identifying as lesbian, gay, or bisexual (Das-Douglas, Colfax, Moss,

Bansberg, & Hahn, 2008; Salomonsen-Sautel et al., 2008); lower levels of education (Wood

et al., 2008); sexual abuse (Marshall et al., 2009; Nyamathi et al., 2012); and having a history of

foster care (Nyamathi et al., 2012).

IDU and heroin use among homeless youth have been correlated with sexual minority status

(Noell & Ochs, 2001), psychiatric illness such as depression (Hadland et al., 2011), supporting

oneself via the street economy or survival sex (Walls & Bell, 2011), and engagement in other

sexual risk behaviors (Heerde & Hemphill, 2016). Although the problems associated with meth-

amphetamine and heroin use and IDU among homeless young people have been studied, signifi-

cant gaps exist in the research literature. In particular, the social context within which these hard

drug use behaviors occur is still underresearched and warrants explication, to design more con-

textually responsive interventions for homeless youth.

Social Network Norms of Substance Use

A rich body of literature supports the idea that perceptions of social norms are among the fore-

most influences on many types of behaviors, including substance use (Eisenberg, Toumbourou,

Catalano, & Hemphill, 2014; Latkin et al., 2009). Social norms can be defined as perceptions and

beliefs regarding what behaviors are considered typical or acceptable in a given group (Kincaid,

2004). Whereas substantial research has linked social network norms to HIV sexual behavior

among homeless youth (Barman-Adhikari, Hsu, Begun, Portillo, & Rice, 2017; Rice, Barman-

Adhikari, Milburn, Monro, &, 2012), less attention has been given to the relationship between

their social network properties and methamphetamine, heroin, and IDU behaviors.