The Relationship between Initial Route of Heroin Administration and Speed of Transition to Daily Heroin Use

Lindsey A. Hines*, Michael Lynskey, Katherine I. Morley, Paul Griffiths, Michael Gossop, Beverly Powis, John Strang

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

15 Citations (Scopus)
343 Downloads (Pure)


The effect of heroin administration route on speed of transition to regular use is unknown. This paper aims to determine whether the speed of transition from initiation of heroin use to daily heroin use differs by route of administration (injecting, chasing/inhaling or snorting).
Privileged access interviewer survey of purposively selected sample of 395 current people who use heroin (both in and not in treatment) in London, UK (historical sample from 1991). Data on age and year of initiation, time from initiation to daily use and routes of administration were collected by means of a structured questionnaire. Generalised ordered logistic models were used to test the relationship between route of initial administration of heroin and speed of transition to daily heroin use. Analyses were adjusted for gender, ethnicity, daily use of other drug(s) at time of initiation, year of initiation and treatment status at interview.
After adjustment, participants whose initial administration route was injecting had a 4.71 (95% confidence interval 1.34-16.5) increase in likelihood of progressing to daily use within 1-3 weeks of initiation, compared to those whose initial administration route was non-injecting.
The speed of transition from first use to daily heroin use is faster if the individual injects heroin at initiation of use. Those who initiate heroin use through injecting have a shorter time frame for intervention before drug use escalation.
Original languageEnglish
Pages (from-to)633-638
Number of pages6
JournalDrug and Alcohol Review
Issue number5
Early online date3 May 2017
Publication statusPublished - Sept 2017


  • drug addiction
  • drug administration routes
  • heroin
  • heroin abuse
  • injecting drug use


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