Differences in severity of heroin dependence by route of administration: the importance of length of heroin use

FRANÇAIS :
Une étude exploratoire menée chez 900 héroïnomanes espagnols a pour objectif d'évaluer la gravité de la dépendance à l'héroïne en fonction de la voie d'administration. On ne relève pas de différence dans la gravité de la dépendance chez les anciens héroïnomanes usagers depuis plus de 5 ans, mais par contre on observe des variations chez ceux qui ont moins de trois ans de toxicomanie.
ENGLISH:
To explore differences in the severity of heroin dependence by route of administration, we interviewed 909 heroin users in three Spanish cities. Dependence was measured with the severity dependence scale (SDS). No major differences in the severity of heroin dependence were detected among users with 5 or more years of heroin use (long-term users), but differences were found among newer users (SDS mean scores, 7.3 in heroin injectors; 7.9 in smokers and 4.6 in sniffers; P = 0.006), especially those with fewer than 3 years of use. Similar differences by route of administration were found when frequency of heroin use (days/month) was considered rather than severity of dependence. However, in the latter case major differences were also found among long-term users. These findings suggest that the route of administration probably influences the rate of progression to dependence but has little influence on the long-run level of dependence. They also help explain some aspects of the transition between routes of heroin administration, which is occurring in different areas. (Author' s abstract) (Author's abstract.)