This study examines the relationship between personal networks and polysubstance use among people who use drugs (PWUD) in a medium sized city in the Midwest. A large body of work has demonstrated that personal relationships have an ambivalent association with substance use. On the one hand, a supportive network is associated with safer drug use practices and dramatically improves the outlook for recovery. However, individuals whose personal networks are composed of co-drug use partners are more likely to engage in risky practices. We argue that this notion of “supportive” social contacts and “risky” social contacts is ultimately incomplete: risky behaviors are introduced and further developed in a social context, often with the people who provide emotional support. We argue that personal networks with more multiplex relationships (where co-drug use and confiding fuse) are harmful because they combine norms of trust and reciprocity with drug use. We use data from the Rural Health Cohort (RHC) study to test this idea. The sample consists of 120 adult PWUD in a medium sized city located in southeastern Nebraska who were recruited using respondent-driven sampling. Participants listed up to nine confidants and nine co-drug use partners, indicating any overlap between the two networks. Our results demonstrate that multiplex ties are as strongly associated with polysubstance use as simple co-drug use relationships. As the drug crisis has increasingly shifted to underserved populations outside large urban centers, this paper represents an important advance in our understanding of the current drug crisis.

本研究调查了中西部一个中等城市吸毒者 (PWUD) 的个人网络与多种物质使用之间的关系。大量研究表明，人际关系与物质使用之间存在矛盾的关联。一方面，支持网络与更安全的药物使用实践相关，并显着改善康复前景。然而，个人网络由共同吸毒伙伴组成的个人更有可能从事危险行为。我们认为，这种“支持性”社会接触和“风险”社会接触的概念最终是不完整的：风险行为是在社会环境中引入并进一步发展的，通常是在提供情感支持的人身上。我们认为具有更多多重关系的个人网络（共同吸毒和信任融合）是有害的，因为它们将信任和互惠规范与吸毒结合在一起。我们使用来自农村健康队列 (RHC) 研究的数据来检验这个想法。该样本由位于内布拉斯加州东南部一个中等城市的 120 名成人 PWUD 组成，他们是使用受访者驱动抽样招募的。参与者列出了多达九名知己和九名共同吸毒伙伴，表明这两个网络之间存在任何重叠。我们的结果表明，多重关系与多物质使用的关系与简单的共同药物使用关系一样密切。随着毒品危机越来越多地转移到大城市中心以外服务不足的人群，本文代表了我们对当前毒品危机理解的重要进展。