Occasional and Controlled Heroin Use Not a Problem?

There is a popular belief that the pharmacological properties of heroin draw users inexorably towards regular dependent use and personal degeneration. However, there is evidence that some people manage long-term use without falling into chaotic, or even dependent, using patterns. These users tend to be excluded from studies of drug use, which typically draw participants from treatment services or from the criminal justice system, and little is known either about the risks that they face or the methods they use to manage their heroin use. This report is based on a study of users who manage their long-term heroin use. It documents the users' perception of their heroin use as non-problematic and outlines how they controlled the drug - such as not-injecting, limiting the days on which they used heroin and not buying the drug if they did not have the money - and their reasons for controlling its use. The report also discusses the circumstances surrounding the users' initiation into drug use, particularly heroin, and examines the influence of cultural, social and economic factors on their habit. Occasional and controlled heroin use suggests that sustained heroin use does not necessarily lead to dependency and, where it does, it does not always cause major problems. The authors argue that much public and policy understanding of heroin use in grounded in inaccurate and narrow stereotypes and suggest that the techniques used by non-problematic heroin users could be used to inform conventional treatment services for those with drug problems that are out of control.