Observations Only Connect

When networks can teach us about drug use

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39496.537396.59 (Published 21 February 2008) Cite this as: BMJ 2008;336:420
  1. Nicholas A Christakis, professor of medical sociology, Harvard Medical School, and attending physician, Mt Auburn Hospital, Cambridge, Massachusetts
  1. christakis{at}hcp.med.harvard.edu

Ideas and habits related to the use of legal and illegal drugs can spread from person to person to person

When doping scandals burst on the scene in professional sports—cycling, cricket, football, and, most recently, US baseball and, in Britain, the Dwain Chambers case—they often elicit wide ranging, sanctimonious commentary regarding fair play, role models for young people, and corruption, not to mention preposterous news headlines. Yet such scandals can provide a valuable new way of understanding the clinical and public health aspects of licit and illicit drug use.

The December 2007 Mitchell Report in the United States examined the use of performance enhancing drugs in major league baseball—a scandal that continues to reverberate this month with high profile Congressional hearings and implausible denials by professional athletes. The report highlights many standard explanations for the widespread use of these drugs, but it also alludes to one that warrants much broader attention: the role of social networks. Human beings are influenced by the behaviour of others to whom they are connected, and this influence flows through social networks, like electricity in a power grid.

This perspective, …

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