title: Understanding prolonged cessation from heroin use: findings from a community-based sample.
abstract: BACKGROUND
  There is abundant literature describing heroin initiation, co-morbidities, and treatment. Few studies focus on cessation, examining the factors that motivate and facilitate it.
  
  
  METHODS
  The CHANGE study utilized mixed methods to investigate heroin cessation among low-income New York City participants. This paper describes findings from qualitative interviews with 20 former and 11 current heroin users. Interviews focused on background and current activities, supports, drug history, cessation attempts, and motivators and facilitators to cessation.
  
  
  RESULTS
  Participants found motivation for cessation in improved quality of life, relationships, and fear of illness, incarceration and/or death. Sustained cessation required some combination of treatment, strategic avoidance of triggers, and engagement in alternative activities, including support groups, exercise, and faith-based practice. Several reported that progress toward goals served as motivators that increased confidence and facilitated cessation. Ultimatums were key motivators for some participants. Beyond that, they could not articulate factors that distinguished successful from unsuccessful cessation attempts, although data suggest that those who were successful could describe more individualized and concrete-rather than general-motivators and strategies.
  
  
  CONCLUSIONS
  Our findings indicate that cessation may be facilitated by multifaceted and individualized strategies, suggesting a need for personal and comprehensive approaches to treatment.
authors: a Director, Center for Evaluation and Applied Research , The New York Academy of Medicine , New York , NY.
authors: Linda
authors: L
authors: Weiss
authors: Jonathon
authors: J
authors: Gass
authors: James E
authors: JE
authors: Egan
authors: Danielle C
authors: DC
authors: Ompad
authors: Claudia
authors: C
authors: Trezza
authors: David
authors: D
authors: Vlahov
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology; D055030:Drug Users / Q000523:psychology*; D005195:Family Relations; D005239:Fear; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006556:Heroin Dependence / Q000175:diagnosis / Q000191:economics / Q000208:ethnology / Q000523:psychology / Q000534:rehabilitation*; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009519:New York City / Q000453:epidemiology; D011203:Poverty / Q000191:economics / Q000523:psychology*; D011788:Quality of Life; D012944:Social Support
keywords: abstinence; cessation; heroin; methadone; recovery; treatment