Processes of Recovery from Heroin Dependence: Relationship to Treatment, Social Changes and Drug Use

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Abstract
Forty people of a representative sample of 128 heroin users, first interviewed in 1969, reported to be abstinent from opiates at follow-up in 1976/77. Twenty-five of them were interviewed a third time in 1977/78 and asked for a urine sample without prior notification. The validity of their self-reports about abstinence and the reliability of answers about recovery were found to be high. Abstinence from opiates was not replaced by dependence on other drugs. All the 40 abstinent people were followed-up in 1979 using Home Office records. According to the data only 1 person had relapsed, 39 having abstained for more than 6 years. The transition from dependence to abstinence was only a clear cut change in 4 cases and usually had an intermediary stage with an increase in the use of other drugs and/or occasional use of opiates. Half of the abstinent group (21) became abstinent without inpatient treatment and social stabilization usually preceded the cessation of opiate dependence. The other half (19) became abstinent in institutions. They felt unable to achieve a controlled gradual reduction and to manage physical withdrawal without inpatient treatment. The problems in developing a new identity were more acute in this group and social changes and stabilization usually occurred after their physical withdrawal from opiates.