Dr. Miriam Boeri's Research

DRUG USE RESEARCH

Title: “Reconceptualizing Early- and Late-Onset: A Life Course Analysis of Older Heroin Users.” The Gerontologist. (in press) 2008.
Authors: Boeri, Miriam W., Claire E. Sterk and Kirk W. Elifson.
Abstract:
Our knowledge regarding older users of illicit drugs is limited despite their increasing numbers. In this paper we apply a life course perspective to gain a further understanding of older adult drug use, specifically contrasting early- and late-onset heroin users. Design and Methods: Qualitative data were collected from 29 older heroin users. Life course analysis focused on the users’ experiences across the life span. Results: The findings suggest that those aging-into heroin use (late-onset) are disadvantaged compared to those who are maturing-in (early-onset) except in areas of health. Implications: We propose that conceptualizing the use of heroin and other illicit drugs among older adults based on their life course trajectory will provide insights for social and health services, including drug treatment.

Title: “Polydrug Use among Ecstasy Users: Separate, Synergistic and Indiscriminate Patterns.” Journal of Drug Issues 38(2):517-42, 2008.
Authors: Boeri, Miriam W., Claire E. Sterk and Masuma Bahora.
Abstract:
The main objective of this paper is to explore poly-drug use among young adult ecstasy users. This phenomenon of using multiple substances within a specific time period is multi-faceted. In this paper, we focus on the various patterns of poly-drug use and the reasons for combining multiple drugs among ecstasy users. Using a mixed-methods design, we conducted interviews with young adults who used ecstasy and other illicit drugs in the past 90 days. Based on the qualitative analyses, we define three distinct types of poly-drug experiences: separate, synergistic, and indiscriminate use. While separate and synergistic poly-drug use tended to be intentional, indiscriminate poly-drug use often was unintentional. These findings show the importance of recognizing poly-drug use as a common phenomenon. The findings presented here suggest other areas for further research aimed at identifying risk and protective behaviors and risk reduction strategies.

Title: “A Third Model of Triangulation: Continuing the Dialogue with Rhineberger, Hartmann and Van Valey.” Journal of Applied Social Science 1(1): 52-48, 2007.
Author: Boeri, Miriam Williams.
Abstract:
In an article in this journal, Rhineberger, Hartmann, and Van Valey (2005), discussed the mixed methods approach known as triangulation, arguing that the meaning and uses of triangulation need to be consistently applied and more adequately described in published articles. The authors presented two models of triangulation found in their extensive literature review. In this paper, I review triangulation designs used in applied research and propose a third and distinct model called the “iterative model.” This model employs triangulation to gain increasing clarity and understanding of the complex issues involved in applied social research. Clearly defined and collectively understood models of triangulation help applied researchers better integrate triangulated sources and convey their methods across disciplinary boundaries.

Title: “Baby Boomer Drug Users: Career Phases, Social Control and Social Learning Theory.” Sociological Inquiry 76(2): 264-291.
Authors: Boeri, Miriam Williams, Claire E. Sterk and Kirk W. Elifson.
Abstract:
Social control and self-control theories have influenced social research and public policy regarding drug use and abuse. While some researchers propose an integration of these theories, others argue that these theories are incompatible. Earlier models of drug use phases indicate that social environment affects self-control, which contradicts the assumption made in self-control theory that self-control is stable over time. In this article we used life course and grounded theory methods to analyze the in-depth life histories of 65 active heroin or methamphetamine users who are part of the cohort known as baby boomers. Interviews with drug users having a long history of drug use allow us to examine drug patterns over the life course. Based on social roles and control over drug use, we developed a four-phase typology comprised of controlled users, marginal users, hustlers, and junkies that accounts for the variation found in our sample of baby boomer drug users. The study participants' identity and self-concept are employed as descriptive illustrative themes. The typology presented here can assist in evaluat-ing drug users for treatment, as well as developing public health interventions and policymaking.

Title: “Rolling Beyond Raves: Ecstasy Use Outside the Rave Setting.” Journal of Drug Issues, 2005.
Authors: Boeri, Miriam Williams, Claire E. Sterk and Kirk W. Elifson.
Abstract:
In this paper, we explore settings of ecstasy use other than those that are part of the rave scene. Little is known about its use in other settings. Data from young adult (18-25 years old) active ecstasy users were collected using surveys (N=158) and qualitative in-depth interviews (N=66). Recruitment involved targeted and theoretical sampling. Data analysis was guided by the constant comparison method, common in grounded theory. Our findings indicate that ecstasy use has extended to social settings beyond raves including dance/music venues, bars in inner city neighborhoods, neighborhood cruising sites, and private residences. Users may attend multiple settings, and it is common for use practices to be transmitted across settings. An understanding of emerging social settings of ecstasy use and the associated use patterns provides baseline information for the development of effective and appropriate prevention and intervention programs, including drug treatment, as well as for policy makers.

Title: “'Hell I’m an Addict, but I Ain’t No Junkie:' An Ethnographic Analysis of Aging Heroin Users." Human Organization 63(2): 236-245.
Authors: Boeri, Miriam Williams. 2004.
Abstract:
Although the numbers of drug users over the age of 35 is growing at a faster rate than other age groups, there remains a gap in knowledge of how people age with drug use. This study focuses on heroin users who were born between 1945 and 1965, hence who are members of the baby boom cohort. Based on questionnaires and in-depth interviews with 38 active heroin users in Atlanta, Georgia, variations in their heroin use were explored through modified grounded theory methods, including constant comparison. Numerical and narrative data revealed a typology of the active heroin users in the baby boomer generation. The two salient dimensions of the typology are the level of control over heroin use and the users’ social roles, specifically the status the users allocated to their social role as a heroin user. The typology includes: (1) controlled occasional users; (2) weekend warriors; (3) habitués; (4) marginal users; (5) problem addicts; (6) using dealers/runners; (7) using hustlers/sex workers; (8) junkies; and (9) relapsing addicts. Increased insight into the heterogeneity among current baby boomer heroin users is relevant when designing comprehensive prevention and intervention programs.

Paper presented at the Southern Sociological Society Annual Meeting (2004)

Title: “Baby Boomer Drug Users under the Social Control Self-Control Lens.”
Authors: Boeri, Miriam Williams, Claire E. Sterk and Kirk W. Elifson.
Abstract:
Both social control and self-control theories are used by sociologists and criminologists to explain drug use and abuse. Traditionally, social control theorists highlight the social bonding processes that hinder individuals from engaging in criminal behaviors. The recent popularity of self-control theory, especially in criminal justice arenas, forces investigators to look for causes stemming from the individual rather than the environment, resulting in punitive and/or medical solutions. A focus on environmental causes, such as changes in the social structure, leads to entirely different explanations. In this paper we apply components of social control theories and self-control theory to the everyday lives of 65 baby-boomers who are long-term, intermittent or new users of heroin or methamphetamine. During the analyses of the data, we developed a comprehensive typology of drug users based on social roles and self-control, which illustrates the variation of drug users and explains changes in drug use over time. This model can help treatment, prevention and policy initiatives and be used to better evaluate aging drug users.

Paper presented at the American Sociological Association 98th annual Meeting (2003)

Title: Maturing In (or Into) Drug Use: A Life Course Analysis of Aging Drug Users
Authors: Miriam Boeri, Kennesaw State University, Kirk Elifson, Georgia State University, Claire Sterk, Emory University, Rollins School of Public Health
Abstract:
Instead of "maturing out" of drug use, many drug users who were young adults or adolescents in the sixties and seventies are continuing drug use, or returning to drug use, in greater numbers than predicted. In addition, some older drug users (age 35 and older) are new users who started after age 30. According to national statistical data, the over age 35 age group is the fastest growing population of drug users. Yet, very little is known about aging drug users, and less is known about older adults who start illegal drugs at a late age. This study looks at survey and in-depth interviews on baby boomers who are currently using heroin and methamphetamine (the "hard" drugs). Using a life course perspective, we focus on evidence of a cohort and/or period effect on baby boomer drug users. Findings support earlier research on the influence of depression on drug use and show that involvement with the criminal justice system and treatment for older adult drug users is made problematic by the influence of cohort and period effects. These results add to our knowledge of aging substance abusers and provide a starting point for more research on this population.

Papers presented at the Society for the Study of Social Problems annual Meeting (2003)

Title: Boomers Using Hard Drugs: A Life Course Perspective
Authors: Miriam W. Boeri, Emory University, Claire E. Sterk, Emory University, and Kirk W. Elifson, Georgia State University
Abstract:
Instead of “maturing out” of drug use, many older drug users who were young adults or adolescents in the sixties and seventies are continuing drug use, or returning to drug use, in greater numbers than before. In addition, some older drug users (age 35 and older) are new users who started after age 30 (late-onset users). According to national epidemiological data, the 35 and older age group is the fastest growing population of drug users. Yet, little is known about aging drug users, and less is known about older adults who start illegal drugs later in life. The authors in this study employ a life course perspective on data drawn from a larger cross-sectional study in Atlanta, Georgia. Based on face-to-face structured surveys and taped in-depth interviews with 71 baby boomers who are currently using heroin and methamphetamine, the authors investigate how drug use is affected by age and age of onset, focusing on salient themes that emerge from the interview data. Our analyses show that the drug using adults may be early-onset, late-onset, or interrupted onset users. We identified four types of users based on use patterns and social roles: controlled users; problem users; dealers/sex workers; and addicts/junkies or relapsing addicts. New insights from this study indicate that mental health problems, involvement with the criminal justice system, and perception or success of drug treatment is substantially influenced by age and age of onset of drug use. These results add to our knowledge of aging substance abusers and provide a starting point for more research on this population.

Title: Recent Rave Research and Health Implications: An Ethnographic Exploration of Raves, Heavy Users of Ecstasy, and Health-Related Issues
Authors: Claire E. Sterk, Emory University, Miriam W. Boeri, Emory University, Zaid Graham, Georgia State University, and Kirk W. Elifson, Georgia State University, Johanna Boers, Emory University
Abstract:
In the past decade, scholarly studies on ecstasy have focused on the Rave scene. Many of the recent published works describe the Rave culture in terms of peace, love, unity, and respect (PLUR), and study samples are primarily composed of white, middle-class Ravers, former ecstasy users, or ecstasy users who use relatively infrequently. This paper reviews ten recent Rave/ecstasy articles to compare their findings with our on-going ethnographic study of current “heavy” ecstasy users. Implications for health related risks are explored. We performed preliminary ethnographic fieldwork at Raves and other dance venues attended by young people in a large metropolitan area. Face-to-face survey and in-depth interviews were conducted with 50 youth aged 18-25 who reported using ecstasy at least four times in the last 90 days. Targeted sampling and theoretical sampling methods were used to ensure diversity among respondents. We find that the Rave scene has changed in the last few years, and ecstasy is being used more frequently and in higher doses than previous research indicates. In addition, the use of other drugs, particularly methamphetamine, is increasingly used at Raves, often in combination with ecstasy. Users are generally aware that the ingredients in various ecstasy pills are unknown, and many youth are relying on online websites to determine pill content. Other “club drugs,” such as GHB or Ketamine, used alone or in combination with ecstasy appear to produce greater adverse health outcomes than the use of ecstasy alone. Increases in the frequency and dosage of ecstasy (multiple pills at one time) and poly-drug use have implications for harmful mental and physical health effects. The social learning behaviors of youth who use ecstasy at Raves as well as other social settings allows for drug cultures to be transferred from one setting to another and hard drugs to infiltrate the Rave scenes. Implications of these findings on heavy and extreme users of ecstasy suggest that health policies and services should take into account the changing scenes in the Rave culture and the social interaction between users of harder drugs with ecstasy users.

Title: The Ecstasy Culture: New Ethnographic Findings on the Sex and Ecstasy Link," Claire E. Sterk, Emory University, Miriam W. Boeri, Emory University, Kirk W. Elifson, Georgia State University, and Zaid Graham, Emory University
Abstract:
The use of ecstasy has been associated primarily with the Rave scene, a social context that promotes peace, love, unity, and respect (PLUR) culture. Although Ravers view ecstasy as the “hug drug,” they typically report that ecstasy is not linked to sex. Yet gay club attendees have long associated ecstasy with sexual activities, and several recent studies examining gay populations attending circuit parties found an association between the use of ecstasy and high-risk sexual behaviors. The new Hip Hop culture promotes ecstasy as a sexual drug; for example, a popular hip-hop song states “X makes the sex spectacular.” Reasons for these varied experiences remain unexplored. This present study examined attitudes, perceptions, and behaviors in different social settings of ecstasy us in order to explore the influences of the “setting” on the “set” of the ecstasy user. In addition, we focus on the implications of diverse attitudes and patterns of ecstasy use on risky sexual behaviors. Preliminary ethnographic fieldwork was conducted in three different social settings: Raves, gay clubs, and Hip Hop clubs. Face-to-face survey and in-depth interviews were conducted with 50 club attendees aged 18-25 who reported using ecstasy at least four times in the last 90 days. Targeted sampling was used to recruit respondents from different segments, and theoretical sampling methods were used to ensure diversity of each sub-sample. Our ethnographic study with current users of ecstasy suggest that differences in perceptions of ecstasy as a sex drug depends on the social context of use. Preliminary findings point towards two plausible links between use of ecstasy and risky sexual behaviors: first, the frequency, dosage, and combination of drugs used affects sexual functioning in males; second, social/cultural influences, resulting from the “set” and “setting” interaction, affects the psychological and physiological performance of sexual behaviors. The social context of ecstasy sue must be considered when examining its association with high-risk sexual behaviors. Drug/Sex/HIV education and intervention should be informed by the diverse contexts of ecstasy use.

Paper presented at the American Sociological Association 97th annual Meeting (2002)

Title: "Hell, I'm an Addict, but I Ain't no Junkie:" An Ethnographic Analysis of the Older Heroin User's Career.
Authors: Miriam Boeri, Georgia State University, Kirk Elifson, Georgia State University, Department of SociologyClaire Sterk, Emory University, Rollins School of Public Health
Abstract:
The stages of a drug career are often modeled on heroin users. While progression in drug use is sometimes depicted as developmental, empirical evidence points towards various patterns of drug-using behavior. In this paper, we focus on the social roles and control of drug use among 38 current heroin users of the baby-boom cohort. Respondents were recruited using targeted, snowball, and theoretical sampling methods. A synthesis of symbolic interaction, social construction, and life course theories provided the framework for this analytical ethnography of the everyday lives of older heroin users. The grounded theory analysis of in-depth interviews and drug use surveys allowed a typology of the heroin career to emerge. This typology, which may be applied to users of other drugs, focuses treatment efforts on helping the user to maintain social roles as control of drug use is regained.

NEW RELIGIOUS MOVEMENTS/CULT RESEARCH

Roundtable Discussion at American Sociological Association 98th Annual Meeting (2003)

Sex and Cults: From Free-Sex to Sex-less
Discussion co-leader: Miriam Williams Boeri, Kennesaw State University
Abstract:
News of a new communal group makes spectacular headlines periodically with some focus on the group's sexual behaviors. The recently-famous Raelians are reported to practice a type of free-sex; the late members of Heaven's Gate were believed to adhere total sexual abstinence, which was seen as a motive for their practice of male castration; whereas the Children of God made news from time to time due to various sexual norms within the group that included sacred prostitution and sex with children. In mass media reports, these groups are called "cults." Although not all cults are religious or spiritually-oriented, cults are usually discussed in sociological literature as "new religious movements." This roundtable discussion includes all types of communal groups in a discussion of the range of sexual practices that are known to exist, with a focus on a sociological understanding of these groups' sexual behaviors and beliefs.
The idea of collective living arrangements with alternative social structures is not new to the American culture. During the nineteenth century, a number of such groups proliferated, such as the Shakers, Mormons and Oneidans. These communal groups experimented with a wide variety of sexual social structures. The Shakers practiced celibacy and channeled their sexual energies into frenzied dancing activities; the Mormons promoted the practice of polygyny; and the Oneidans allowed sexual relations with multiple partners, referred to as "complex marriages." In sociological literature, these nineteenth century groups are called "utopian communities."
A note on the term "cult:" According to Webster's New World Dictionary of the American Language (1960), the term cult means "devoted attachment to, or extravagant admiration for, a person, principle, etc., especially when regarded as a fad: as, the cult of nudism." Sociologically, according to Robbins (1998), the term "cult" has been employed to refer to innovative religious groups, while the term "sect" refers to groups that split off from mainstream religions. Bainbridge (1997) writes that "a cult movement is a deviant religious organization with novel beliefs and subcultures" (p. 24), but some scholars prefer to use the term "new religious movement" instead of cult. The terms cult and new religious movement are used interchangeably in this discussion.

Paper Presented at the Association for the Sociology of Religion 65th Annual Meeting (2003)

Title: Becoming Promiscuous: Examining The Social Re-Construction Of Identity In A New Religious Movement
Author: Miriam Williams Boeri, Emory University
Abstract:
According to social construction theory, during primary socialization human beings learn to accept a legitimate reality, to develop a sense of self and identity, and to act out behaviors according to accepted roles. Socialization, however, is ongoing, and the behaviors and attitudes that are part of a social identity must continually be maintained. Re-socialization involves a radical change in subjective reality, which includes replicating affective identification with new role models, new significant others, and a new legitimating social structure. Thus, identity is dependent on a self that has been constructed and re-constructed by a continual flow of social factors and events constraining, guiding, intimidating, encouraging, and working with the actor. In this paper, I look at the extreme changes in self and identity through the social re-construction of reality by membership in a Christian communal group that required sacred prostitution. Through content analysis of the group's literature and interviews with former members, this study explores the social re-construction of reality with its effects on female identity.