title: The characteristics of heroin users entering treatment: findings from the Australian treatment outcome study (ATOS).
abstract: The current study aimed to describe the characteristics (demographics, drug use, mental and physical health) of entrants to treatment for heroin dependence in three treatment modalities; and to compare these characteristics with heroin users not in or seeking treatment. Participants were 825 current heroin users recruited from Sydney, Adelaide and Melbourne: 277 entering methadone/buprenorphine maintenance treatment (MT), 288 entering detoxification (DTX), 180 entering drug-free residential rehabilitation (RR) and 80 not in treatment (NT). Treatment entrants were generally long-term heroin users with previous treatment experience. The majority of the sample (55%) were criminally active in the month preceding interview. Injection-related health problems (74%) and a history of heroin overdose (58%) were commonly reported. There were high degrees of psychiatric co-morbidity, with 49% reporting severe psychological distress, 28% having current major depression, 37% having attempted suicide and 42% having a lifetime history of post-traumatic stress disorder. Personality disorders were also prevalent, with 72% meeting criteria for antisocial personality disorder and 47% screening positive for borderline personality disorder. Striking similarities were noted between the non-treatment and treatment groups in length of heroin use career, drug use and treatment histories.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Ross
authors.forename: Maree
authors.initials: M
authors.lastname: Teesson
authors.forename: Shane
authors.initials: S
authors.lastname: Darke
authors.forename: Michael
authors.initials: M
authors.lastname: Lynskey
authors.forename: Robert
authors.initials: R
authors.lastname: Ali
authors.forename: Alison
authors.initials: A
authors.lastname: Ritter
authors.forename: Richard
authors.initials: R
authors.lastname: Cooke
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D002047:Buprenorphine / Q000627:therapeutic use*; D015897:Comorbidity; D003415:Crime / Q000706:statistics & numerical data; D003710:Demography; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006304:Health Status; D006556:Heroin Dependence / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008658:Inactivation, Metabolic; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D010342:Patient Acceptance of Health Care; D012114:Residential Treatment; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology; D013405:Suicide / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D009294:Narcotics; D002047:Buprenorphine; D008691:Methadone