Heroin Use, Dependence, and Attitudes to Treatment in Non-Treatment-Seeking Heroin Users: A Pilot Study

Abstract

Much research examining heroin users utilizes treatment samples; non-treatment-seeking heroin users are not well understood. It is unclear whether this group can avoid impaired control or negative sequelae commonly observed in treatment-seeking populations. During 2000 and 2001, we recruited 69 non-treatment-seeking heroin users with no treatment history. Heroin use, management strategies, treatment attitudes, and risk behaviors were assessed; the DSM-IV checklist and severity of dependence scale were completed. Study limitations and implications for heroin use and its treatment are discussed. This study was funded by Prince Charles Hospital Foundation.

RÉSUMÉ

Une grande partie de la recherche examinant les utilisateurs d’héroïne ulitise les échantillons d’utilisateurs sous traitement; le groupe d’utilisateurs d’héroïne qui ne cherchent pas à se faire traiter ne sont pas bien compris. C’est incertain si ce group peut éviter le contrôle réduit ou les conséquences négatives souvent observé dans les populations qui cherchent le traitement. Pendant les années 2000–2001, nous avons engagé 69 utilisateurs d’héroïne qui ne cherchent pas à se faire traiter et qui n’ont aucune histoire de traitement. L’utilisation de l’héroïne, les stratégies de gestion, les attitudes envers le traitement et les comportments de risques ont été évalués; la liste de contrôle du DSM-IV et l’échelle de la Sévérité de Dépendence ont été accomplies. Les limitations de l’étude et les implications par rapport à l’usage de l’héroïne et son traitement sont discutées. Cette étude a été subventionnée par le Prince Charles Hospital Foundation.

RESUMEN

Mucha investigacion que examina a los usuarios de heroina utiliza personas que estan en tratamientos como modelos; usuarios que no buscan un tratamiento no son bien comprendidos. No esta claro si este grupo evade daño, el control o secuelas negativas comunmente observadas en populaciones que buscan un tratamiento. Durante 2000–2001, nosotros recrutamos 69 usuarios de heroina que no habian buscado un tratamiento y sin historia de tratamiento previo. Fueron valorados el uso de heroina, estrategias de direccion, actitudes hacia tratamientos, y comportamientos riesgosos; El DSM-IV lista de puntos de chequeo y la escala de severidad de dependencia fueron completadas. Limitacion de estudios e implicaciones en el uso de la heroina y su tratamiento son discutidos. Este estudio fue respaldado por el Prince Charles Hospital Foundation.

Keywords :

• heroin dependence
• heroin users
• substance-related disorders
• community samples
• hidden populations
• drug-related harms
• perceptions of control
• patient acceptance of health care
• methadone
• treatment need

THE AUTHORS

Dr. Angela J. Dean is Postdoctoral Research Fellow, supported by the National Health and Medical Research Council Research Fellow; a Lecturer, School of Medicine, University of Queensland; and is currently based at Kids in Mind Research, Mater Child and Youth Mental Health Service. Her research interests include treatment outcomes studies for opioid dependence, management of aggressive behaviors, and co-occurring substance use and mental health problems.

Professor John B. Saunders is a consultant physician in internal medicine and addiction medicine, with appointments at the Universities of Queensland and Sydney (Australia) and with several private hospital groups. His research interests include screening and early diagnosis, brief interventions, and drug dependence treatments. He is Editor-in-Chief of the Drug and Alcohol Review, Vice-President of the International Society of Addiction Medicine, a member of WHO's Expert Advisory Panel on Mental Health and Substance Abuse, and was Co-Chair of the DSM V Substance Use Disorders Workgroup from 2003 to 2007.

Associate Professor James Bell is a physician specializing in addiction medicine. He was a leading figure in the establishment of the Australasian Chapter of Addiction Medicine within the Royal Australasian College of Physicians, and is currently Chair of the chapter. His main research interest has been the treatment of opioid dependence. Bell is currently Director of The Langton Centre, a specialist treatment and research centre, and Director, Drug and Alcohol Program, South-Eastern Sydney Illawarra Health Service