30-year trajectories of heroin and other drug use among men and women sampled from methadone treatment in California.

BACKGROUND: This study examines 30-year trajectories of heroin and other drug use among men and women who were in methadone maintenance treatment in California in the late 1970s and interviewed in 1978-1981.

METHODS: Nearly half (N=428; 46.8%) of the original study sample (N=914) was deceased. Of the remaining 486 subjects, 343 (44.3% female) completed a follow-up interview in 2005-2009 (70.6% of those not deceased). Average age at follow-up was 58.3 (SD=4.9) years for males and 55.0 (SD=4.1) years for females. Longitudinal data was obtained on their drug use, treatment participation, and criminal justice status over the follow-up period. Trajectory group modeling was used to identify distinctive trajectory groups based on monthly averages of heroin and other drug use per year; group differences were examined.

RESULTS: Four heroin and five alcohol and other drug (AOD) trajectory groups were identified. A greater proportion of women (60%) were in the "rapid decrease" heroin group (odds of use less than 10% by 10 years following initiation of use) as compared with the other groups. More rapid decrease of heroin use was associated with increases in AOD use, whereas a gradual decrease in heroin use was associated with a gradual decrease in AOD use. More school problems and earlier age at onset of heroin use and first arrest were associated with more persistent heroin use.

CONCLUSION: Heroin-use trajectories were linked with changes in AOD use. Childhood antecedents of heroin-use trajectories were identified as well as gender differences.