The Nature and Implications of Lifestyle Transitions for Persistent Heroin Use

While existing research has tended to focus on specific drug user groups, the current paper explores how people who use heroin might move between such groups over time. Building on previous research that has identified types of heroin-using lifestyles, we investigate the nature and extent of lifestyle transitions from one type to another. In doing so, we examine the implications that lifestyle transitions might have for drug use as well as harm-reduction strategies and treatment. The research was based on a sample of 51 people who use heroin interviewed for a study into persistent heroin use, 38 of whom provided data relating to transitions between heroin-using lifestyles. Participants in the study explained changes in their lifestyles through three distinct narrative themes: grabbing onto ‘hooks for change’, ‘taking an opportunity’, and ‘losing control’. The findings also show how, through case studies, the nature and implications of lifestyle transitions can be wide ranging. While such explanations for change have been identified in criminological and substance use literature, they have not, to our knowledge, been used to understand changes within heroin-using careers. Further theoretical work to develop these concepts and advance understanding of persistent heroin use is encouraged, as is using these concepts to inform policy and practice.