Long-Term Heroin Careers: Narratives of Persistence

  • James Morgan

    Student thesis: Doctoral Thesis

    Abstract

    This thesis seeks to understand persistence in long-term heroin careers. This includes thick description of the processes and micro level interactions experienced by heroin users. In addition, it aims to account for variation found within heroin careers as well as differences between the careers of heroin users. Semi-structured interviews were conducted with a sample of 51 people who had used heroin daily for at least three years. The sample was recruited from a Tier 2 drugs project in a major city in South Wales. The interviews were biographical and focused on specific periods within participants’ heroin careers. The interviews covered periods when heroin was being used daily, and times when participants were abstinent or only using occasionally. The principal aim of the study was to understand variation both within and between heroin careers. It was anticipated that long careers in heroin might feature periods where the drug is not being used.

    Participants’ accounts revealed various motivations to use heroin. These included enjoying the ‘buzz’ gained from heroin use, self-medication and avoiding withdrawal symptoms due to physical dependency. Respondents did not feel they were in control of their heroin use at certain points in their heroin careers. From participant’s narratives, the stigma of surrounding heroin affected losing control of heroin use.

    Participants also revealed that persisting as a heroin user could be, at times, difficult. Those who became comfortable and competent committing crimes and negotiating stigma successfully adapted to the difficulties presented to heroin users. Analysis of these participants’ narratives showed that a peculiar set of resources are needed to persist. Bourdieu’s (1977) theory of practice was used as a framework to explain how some participants felt that they gained mastery as heroin users while others did not. The findings of this study were presented through three typologies, categorising aspects of participants’ heroin use: a typology of lifestyles where heroin is being used every day; a typology of lifestyles where heroin is either not being used or being used occasionally; and a typology of heroin careers.

    This thesis contributes to debates concerning drug policy in several ways. The first contribution concerns a paradox. The study found that early career heroin users were often responsible for the largest share of criminal behaviour, but are also the hardest to treat. Some other research findings suggest that heroin-assisted treatment might be of use to this group. The second point suggests that many older participants would struggle with the emphasis on sobriety of the recovery movement, but would benefit from specially tailored harm reduction. Thirdly, participants’ narratives indicated that pharmacological therapies should be more flexible in order to cater for the complex needs of heroin users.

    This study benefited from recruiting heroin users who were mostly coming towards the end of their careers. This group were keen to participate in order to help others avoid their mistakes. They were also able to describe long and varied heroin careers. Due to limitations relating to qualitative methods and retrospective accounts, longitudinal mixed methods studies might compliment these findings.
    Date of Award2017
    Original languageEnglish
    SupervisorFiona Brookman (Supervisor) & Katy Holloway (Supervisor)

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