Initial Heroin Use Patterns Predict 5-Year Relapse: Results from a Longitudinal Cohort Study in Shanghai, China
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Initial Heroin Use Patterns Predict 5-Year Relapse: Results from a Longitudinal Cohort Study in Shanghai, China Ruihua Li 1 & Tianzhen Chen 1 & Haifeng Jiang 1,2 & Na Zhong 1 & Jiang Du 1 & Zhibin Li 3 & Yan Zhao 1 & Haiming Sun 1 & Zhikang Chen 1 & Chuanwei Li 4 & Min Zhao 1,2,5,6 Accepted: 2 October 2020/ # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract
People start to use heroin in different patterns. This study identified three initial heroin use patterns in a heroin use cohort: No-factor initial pattern (with no factors of initial heroin use), Single-factor initial pattern (with 1 of 3 factors of initial heroin use), and Multiple-factor initial pattern (with 2 or 3 factors of initial heroin use). The cumulative heroin relapse rate was 53.3%, 62.4%, and 72.7% respectively for Nofactor, Single-factor, and Multiple-factor initial patterns during the 5-year follow-up. The adjusted hazard ratio (AHR) was 1.401 (95% CI: 1.091–1.799, p = 0.008) in Single-factor initial pattern and 2.381 (95% CI: 1.546–3.668, p < 0.001) in Multiplefactor initial pattern compared to No-factor initial pattern. This study added new evidence to the impact of initial heroin use on long-term relapse risk, which suggested that initial heroin use patterns should not be neglected. Keywords Heroin . Prospective study . Relapse . Trajectory
Ruihua Li and Tianzhen Chen contributed equally to this work.
* Min Zhao [email protected]
1
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Road, Shanghai 200030, China
2
Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
3
Jiading Mental Health Center, Shanghai, China
4
Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, Jiangsu Province, China
5
Institute of Psychological and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
6
CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai, China
International Journal of Mental Health and Addiction
According to World Drug Report 2019, there were estimated to be over 50 million opioids users around the world (UNODC 2019). Heroin, derived from the opium poppy plant, is a typical representative of opioids (UNODC 2019). In China, although the current epidemic of illicit substances has changed to some extent, heroin still occupies a certain proportion of more than 35% (Su et al. 2019; CNNCC 2019). Apart from heroin dependence, a series of severe harms including heroin overdose, infectious disease, such as hepatitis C (HCV) and human immunodeficiency virus (HIV), and even suicide attempt still draws much close attention (Zhou et al. 2016; Su et al. 2018; Zhong et al. 2019). Heroin is highly addictive and is also highly apt to relapse (Hser et al. 2015; Wang et al. 2017), which underlies the severe harms of heroin use. Studies showed that a major part of heroin users had a fluctuating trajectory with high risk of relapse (Hser et al. 2015; Te
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