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A 33-Year Follow-up of Narcotics Addicts
Yih-Ing Hser, PhD;
Valerie Hoffman, PhD;
Christine E. Grella, PhD;
M. Douglas Anglin, PhD
Arch Gen Psychiatry. 2001;58:503-508.
Background This study examined longitudinal patterns of heroin use, other substance
use, health, mental health, employment, criminal involvement, and mortality
among heroin addicts.
Methods The sample was composed of 581 male heroin addicts admitted to the California
Civil Addict Program (CAP) during the years 1962 through 1964; CAP was a compulsory
drug treatment program for heroin-dependent criminal offenders. This 33-year
follow-up study updates information previously obtained from admission records
and 2 face-to-face interviews conducted in 1974-1975 and 1985-1986; in 1996-1997,
at the latest follow-up, 284 were dead and 242 were interviewed.
Results In 1996-1997, the mean age of the 242 interviewed subjects was 57.4
years. Age, disability, years since first heroin use, and heavy alcohol use
were significant correlates of mortality. Of the 242 interviewed subjects,
20.7% tested positive for heroin (with additional 9.5% urine refusal and 14.0%
incarceration, for whom urinalyses were unavailable), 66.9% reported tobacco
use, 22.1% were daily alcohol drinkers, and many reported illicit drug use
(eg, past-year heroin use was 40.5%; marijuana, 35.5%; cocaine, 19.4%; crack,
10.3%; amphetamine, 11.6%). The group also reported high rates of health problems,
mental health problems, and criminal justice system involvement. Long-term
heroin abstinence was associated with less criminality, morbidity, psychological
distress, and higher employment.
Conclusions While the number of deaths increased steadily over time, heroin use
patterns were remarkably stable for the group as a whole. For some, heroin
addiction has been a lifelong condition associated with severe health and
social consequences.
From the Drug Abuse Research
Center, Neuropsychiatric Institute, University of California, Los
Angeles.
Corresponding author: Yih-Ing Hser, PhD, UCLA Drug Abuse Research
Center, 1640 S Sepulveda Blvd, Suite 200, Los Angeles, CA 90025 (e-mail: yhser{at}ucla.edu).
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