TRANSITIONS IN PATTERNS OF HEROIN ADMINISTRATION - A STUDY OF HEROIN CHASERS AND HEROIN INJECTORS

A community sample of 408 heroin users was interviewed about changes i n their predominant route of heroin administration. Clear preferences for specific routes of drug administration were evident. Two predomina nt routes of administration were found: injection (54%) and 'chasing t he dragon' (44%). More than a third of the sample had changed their pr edominant route of administration (a 'transition'). Most commonly, onl y one transition was reported, from chasing to injecting. However, tra nsition to injection was not inevitable: the majority of 'chasers' had never moved to regular injecting despite often using at high doses fo r many years. Modelling suggests that many chasers give up heroin with out moving to injecting. The results indicate, however, a continuing r isk of switching from chasing to injecting for those who continued to use. Women were less likely to move from chasing to injecting. Some he roin users had made the transition from injection to chasing; 28 (16%) of the current chasers had previously been regular heroin injectors. This change in route is less well-known and to our knowledge has not b een previously investigated. Multiple transitions in route were uncomm on; predominant route of administration, once established appears robu st. Harm reduction interventions directed towards changing the risk be haviours of heroin users should take account of the different routes o f current administration and the potential for future transitions with in continued drug use.