Understanding Prolonged Cessation from Heroin Use: Findings from a Community-Based Sample

Abstract

Background: There is abundant literature describing heroin initiation, co-morbidities, and treatment. Few studies focus on cessation, examining the factors that motivate and facilitate it.

Methods: The CHANGE study utilized mixed methods to investigate heroin cessation among low-income New York City participants. This paper describes findings from qualitative interviews with 20 former and 11 current heroin users. Interviews focused on background and current activities, supports, drug history, cessation attempts, and motivators and facilitators to cessation. Results: Participants found motivation for cessation in improved quality of life, relationships, and fear of illness, incarceration and/or death. Sustained cessation required some combination of treatment, strategic avoidance of triggers, and engagement in alternative activities, including support groups, exercise, and faith-based practice. Several reported that progress toward goals served as motivators that increased confidence and facilitated cessation. Ultimatums were key motivators for some participants. Beyond that, they could not articulate factors that distinguished successful from unsuccessful cessation attempts, although data suggest that those who were successful could describe more individualized and concrete—rather than general—motivators and strategies. Conclusions: Our findings indicate that cessation may be facilitated by multifaceted and individualized strategies, suggesting a need for personal and comprehensive approaches to treatment.

Keywords:

• abstinence
• cessation
• heroin
• methadone
• recovery
• treatment

FUNDING

This study was funded by the National Institutes of Health Grant #DA022123.

The authors would like to thank the participants for their time and insights and for letting us listen to their personal stories. The authors would also like to thank Ebele Benjamin and Vincent Edwards for assistance with recruitment and study coordination and Shannon Blaney for assistance with data analysis.

Notes

1. Pseudonyms are used throughout to protect the confidentiality of participants.