Heroin use in Northern Ireland, 2000

The study represents one of the first research investigations into heroin use in Northern Ireland.¹ The two year study was carried out between 1997-1999 and used qualitative research methods to collect data.

The sample included 43 current or former users of heroin who had used heroin (injected or chased) in Northern Ireland. Current users were categorised as those who had used within the two month period before the interview. In contrast to other studies, however, one third of the sample identified themselves as coming from middle or upper-income backgrounds. Most respondents were male (n=36) and their ages ranged from 18 to 48.

The overall study examined patterns of drug taking, health issues (eg hepatitis C), risk behaviours associated with injection practices (eg lending and borrowing injection equipment), experiences with drug treatment, drug lifestyle activities and related issues. A more detailed explanation of the findings can be found in the full report.

Main findings

Initiation

The majority of respondents (n=26) initiated heroin use in other countries; the remainder initiated in Northern Ireland.
The average age of initiation into heroin use was 19 years for people who first used in Northern Ireland and 20 years for those who initiated elsewhere.
Four respondents reported that they had not intended to use heroin but did so after their drug of choice was not available.
A few respondents alluded to the importance of heroin use by friends as a factor that influenced their own initiation.
Thirty percent (n=13) of the respondents had initiated heroin use through injection. About half (n=21) of the sample initiated through chasing, 12% (n=5) initiated through snorting/sniffing and 7% (n=3) through smoking (non-chasing).

Drug use history and polydrug use

Heroin was the preferred drug of choice for most of the respondents. Others preferred a second drug in addition to heroin.
98% of respondents had consumed cannabis at some stage and 35% of the sample (n=15) had used cannabis daily during the six month period prior to the interview.
90% had snorted cocaine and 63% of the sample had injected cocaine.
With the exception of cannabis, most respondents did not use these other drugs on a regular basis.
Most respondents had, at some stage, used another drug to substitute for heroin when that drug was not available.

Risk behaviours

The majority of respondents reported great difficulties in obtaining new needles/syringes to be used for injecting heroin and other drugs.
Needles are intended to be used one time only. However, the lack of available needles contributed greatly to multiple injections with the same needle.
Some respondents reported that they used bleach to disinfect needles and other injection equipment, while a few had never heard that bleach should be used to clean equipment.
Previous studies conducted elsewhere have found that younger injecting drug users (IDUs) with shorter injection careers engage in more risk behaviours than older IDUs. The present study found that experienced injectors also engaged in considerable risk behaviours for HIV and hepatitis B and C.
Nearly all of the injectors in the present study had, at some point, shared needles/syringes with another IDU. The scarcity of new needles/syringes in Northern Ireland contributed greatly to the lending and borrowing of this equipment.

Treatment history

Fourteen people were categorised as former users, ie had deliberately chosen to abstain from heroin and had been clean for at least two months prior to the interview.
Some current and former users had never had any contact at all with a drug treatment service.
The reasons why respondents chose to avoid drug treatment varied. Some feared that work or relationships with family would be threatened because treatment entry implies a semi-public acknowledgement of heroin use.
The majority of respondents had, at one time, sought treatment for heroin use but either opted out when they inquired about the programme or left treatment shortly after they had been admitted.

Getting clean

Several respondents reported that they had deliberately abstained from heroin at some point, although most of this group eventually relapsed.
Data drawn suggest that relapse into heroin use was associated with the continued connection to the lifestyle of a heroin user. Obtaining funds to purchase heroin, locating suppliers, negotiating the "score" and anticipating withdrawal were all considered to be important lifestyle aspects.

Experiences with (and attitudes towards) methadone

Most respondents had tried methadone, although considerably fewer had taken methadone under the care of a physician or through a methadone programme.

Notifications

Thirty three respondents were asked whether they believed that they had been officially registered as a drug addict in Northern Ireland. Of this group, 10 respondents indicated that they were registered as addicts at the time of the interview. Eight indicated that they had never been registered and the remainder (n=15) were uncertain.

For more information on the research contact:

Karen McElrath,
School of Sociology and Social Policy,
Queens University Belfast,
BT7 1LQ.
Tel: 028 9027 3551
Fax: 028 9027 3943
Email: k.mcelrath@queens-belfast.ac.uk

Reference

McElrath K. Heroin use in Northern Ireland. Belfast: Queens University, 2000.

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