Heroin cessation strategies: What do former users say?

Considerable literature has been devoted to short-term heroin cessation, primarily as related to treatment and incarceration. Some dated information describes spontaneous recovery from heroin. Data are sparse on the correlates of sustained heroin cessation, particularly in street-recruited samples. We explored self-reported tools and strategies that supported sustained cessation among 151 former heroin users. The sample was 34.4% female, 57.0% black, 36.4% Hispanic and the mean age was 46.2 (SD=7.8). On average, participants had not used heroin in 2.5 years (SD=1.3, range=0.3-5.4), their “duration” of heroin use (age at last use – age at first use) was 44.1 years (SD=7.9, range=26.8-62.1); 76.8% reported heroin as their lifetime drug of choice. When asked what was most important tool or strategy used to quit, 58.9% said they made a conscious decision to quit; other quit strategies included help from a family member (9.3%), methadone (4.6%), unspecified drug treatment (4.0%), marijuana use (4.0%), going cold turkey (3.3%), crack/cocaine use (3.2%) and help from a friend (2.6%) or acquaintance (2.7%). About half (54.3%) reported using a pharmaceutical-based therapy during their most recent cessation attempt of whom 81.7% found it helpful; opiate replacement therapies (ORT) were most common (methadone-95.1%, buprenorphine-12.2%, and LAAM-1.2%). These preliminary data suggest that internal motivation is an important strategy for heroin cessation. Further, ORT was common but not ubiquitous in this sample of former heroin users and was not the most important cessation strategy for most. More research is needed to understand effective quit strategies among those who have sustained cessation.