Objectives: Monitoring characteristics of heroin users has always been a priority concern because of their public health impact. Few studies have examined initiation and progression patterns of adolescent heroin users. Knowledge about characteristics of heroin use in adolescents admitted to specialized inpatient units, may allow professionals to treat these better. Therefore, in the present study, we aimed to evaluate sociodemographic and clinical characteristics of adolescent heroin users admitted to a special inpatient unit.
Methods: This retrospective study reviewed demographic and clinical characteristics of heroin users hospitalized to Child and Adolescent Substance Abuse Treatment and Support Center (known as CEMATEM) at Bakirkoy Mental Hospital in Istanbul during year of 2011.
Results: The mean age of the subjects at admission for treatment was 16.95±1.08 (range: 14-18) years and 90.9% (n=40) were male. Of patients, 14 (31.8%) were immigrant and 30 (68.2%) left school. Most patients were in the middle socioeconomic status. Of patients, 36 (81.8%) committed one and 22 (50.0%) had two and more crimes. Percent of family history for substance and alcohol use were 45.5% and 31.8%, respectively. Twelve patients (27.3%) had at least one previous suicide attempt and 29 (65.9%) engaged in self-harm. Heroin was used by 54.6% of patients as third and fourth substance. Most common administration route of heroin at admission time was inhalation (61.4%), followed by injection (29.5%). Mean duration of heroin use was 22.5 months. Mean number of substances used before heroin was 1.95. Cannabis was most common first and second substance (n=23, 52.3%; n=13, 29.5%; respectively), and last substance before heroin use (n=19, 43.2%). Most common last substance was heroin for 59.1% of patients. After heroin, most commonly used substance was cocaine (n=9), which was found not to be used before heroin. Mean starting age of first substance and heroin use were 13.37±1.43 and 15.08±1.17 years, respectively. Transition from first substance to heroin was seen most commonly in second year (34.1%). In inpatients with heroin use, cannabis was the most commonly used substance, followed by ecstasy and solvents/inhalants.
Conclusions: We should be aware of possible heroin use risk for male adolescents, who use two substances at a time including cannabis for at least one year. In addition, it should be remembered that of adolescent heroin users, approximately half of this population might commit crimes and one-fourth had suicide attempt and self-harm. Further qualitative-quantitative studies are necessary to allow us to acknowledge and understand more about this young population in order to develop treatment modalities and to decrease the impact of heroin use on public health.