NDARC Monograph No. 49 (2003)

Key Points

  • Over the past decade heroin use and its associated harms have emerged as a major public health issue in Australia.
  • About one in four heroin users will go on to develop dependence on the drug. Heroin dependence adversely affects public health and order out of all proportion to the number of people who use the drug. The major harms associated with heroin dependence include heroin overdose, blood borne viruses, psychopathology, and the effects of prescription drugs.
  • Longitudinal studies of treatment outcome for heroin users in Australia are needed to guide more effective treatment interventions and public health responses.
  • Longitudinal designs provide the optimal strategy for examining the effectiveness of treatment interventions and determining the influence of key variables on outcomes. Recent advances in longitudinal research methodology have made high quality treatment outcome studies with long term follow-ups feasible.
  • Longitudinal studies conducted overseas have shown that existing treatments for heroin and other drug users can effectively reduce drug use and dependence. These studies have established that it is feasible to conduct longitudinal research with dependent heroin users, in that longitudinal cohorts can be maintained over several years.
  • Methodological issues and differences between different settings limit the generalisability of previous cohort studies. To gain an understanding of the burden imposed by heroin use in Australia, longitudinal studies of Australian heroin users are essential.
  • Heroin use and dependence are associated with a constellation of problems, each of which is of interest when assessing treatment outcome. Longitudinal data on heroin and other drug use, route of administration, criminality, psychiatric comorbidity, mortality, physical health status, and the economic burden of heroin use are essential to determine the impact of treatment and the long term patterns and consequences of heroin use.
  • ATOS offers an unparalleled opportunity to maintain a large cohort of Australian heroin users, and improves significantly on the research methodologies used in previous treatment outcome studies. Extending the ATOS follow-up period beyond 12 months would allow essential data on longer term treatment outcomes and the burden imposed by heroin use in Australia to be obtained.



Nicky Henderson, Joanne Ross, Shane Darke, Maree Teesson, Michael Lynskey
Date Commenced
01 Jul 2003
Resource Type