title: 30-year trajectories of heroin and other drug use among men and women sampled from methadone treatment in California.
abstract: BACKGROUND
  This study examines 30-year trajectories of heroin and other drug use among men and women who were in methadone maintenance treatment in California in the late 1970s and interviewed in 1978-1981.
  
  
  METHODS
  Nearly half (N=428; 46.8%) of the original study sample (N=914) was deceased. Of the remaining 486 subjects, 343 (44.3% female) completed a follow-up interview in 2005-2009 (70.6% of those not deceased). Average age at follow-up was 58.3 (SD=4.9) years for males and 55.0 (SD=4.1) years for females. Longitudinal data was obtained on their drug use, treatment participation, and criminal justice status over the follow-up period. Trajectory group modeling was used to identify distinctive trajectory groups based on monthly averages of heroin and other drug use per year; group differences were examined.
  
  
  RESULTS
  Four heroin and five alcohol and other drug (AOD) trajectory groups were identified. A greater proportion of women (60%) were in the "rapid decrease" heroin group (odds of use less than 10% by 10 years following initiation of use) as compared with the other groups. More rapid decrease of heroin use was associated with increases in AOD use, whereas a gradual decrease in heroin use was associated with a gradual decrease in AOD use. More school problems and earlier age at onset of heroin use and first arrest were associated with more persistent heroin use.
  
  
  CONCLUSIONS
  Heroin-use trajectories were linked with changes in AOD use. Childhood antecedents of heroin-use trajectories were identified as well as gender differences.
authors.affiliation: UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA 90025, USA. grella@ucla.edu
authors.forename: Christine E
authors.initials: CE
authors.lastname: Grella
authors.forename: Katherine
authors.initials: K
authors.lastname: Lovinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000188:drug therapy; D002140:California; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000188:drug therapy*
chemical_list: D009294:Narcotics; D008691:Methadone