The characteristics of heroin users entering treatment: findings from the Australian Treatment Outcome Study (ATOS)

The current study aimed to describe the characteristics ( demographics, drug use, mental and physical health) of entrants to treatment for heroin dependence in three treatment modalities; and to compare these characteristics with heroin users not in or seeking treatment. Participants were 825 current heroin users recruited from Sydney, Adelaide and Melbourne: 277 entering methadone/ buprenorphine maintenance treatment ( MT), 288 entering detoxification ( DTX), 180 entering drug- free residential rehabilitation ( RR) and 80 not in treatment ( NT). Treatment entrants were generally long- term heroin users with previous treatment experience. The majority of the sample ( 55%) were criminally active in the month preceding interview. Injection-related health problems ( 74%) and a history of heroin overdose ( 58%) were commonly reported. There were high degrees of psychiatric co- morbidity, with 49% reporting severe psychological distress, 28% having current major depression, 37% having attempted suicide and 42% having a lifetime history of post- traumatic stress disorder. Personality disorders were also prevalent, with 72% meeting criteria for antisocial personality disorder and 47% screening positive for borderline personality disorder. Striking similarities were noted between the non- treatment and treatment groups in length of heroin use career, drug use and treatment histories.