Drug users' involvement in the drug economy: implications for harm reduction and HIV prevention programs

The purpose of this article is to explore individual and social characteristics associated with drug users' involvement in the drug economy among a sample of low-income heroin and cocaine users (n = 1,288) in Baltimore, Maryland. The study sample had participated in a network-oriented intervention study of human immunodeficiency virus (HIV) risk behaviors among drug users. Of the sample, 44% (n = 569) held at least one role in the drug economy, performing an average of 1.17 roles. A significantly higher percentage of those involved in the drug economy reported being daily drug users (60.6% vs. 40.2%), injecting heroin daily (36.0% vs. 21.8%), injecting speed daily (23.6% vs. 14.7%), and snorting heroin daily (18.3% vs. 13.4%). In terms of social networks, those involved in the drug economy reported a significantly larger social network (9.98 vs. 8.97), greater percentage of active drug users in their social network (47% vs. 44%), greater percentage of daily drug users in their social network (40% vs. 33%), and larger drug support networks (6.7 vs. 5.6). The study indicates the far-reaching influence of drug use on many aspects of their lives, including their involvement with the drug economy. Reducing drug users' frequency of use could have the consequence of decreasing this involvement. Being a part of the drug economy exposes drug users to many risks, but also places them in a position to influence others. Examining drug users' social networks could provide insight into the composition of their immediate social environment and could inform HIV prevention programs.