Does Heroin use Disorder Intervention ‘Work’? a Critical Review

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Authors : Monika Dos Santos


Abstract Of all the vice problems confronting South Africa and many other countries, the heroin dependence syndrome and its consequences pose some of the most serious challenges. While the treatment and management of heroin use disorders continues to be characterized by new developments, altering perspectives, and by controversies of one kind or another, the literature findings suggest that different treatment settings may be appropriate for different heroin users. People who are treated for heroin use disorders achieve a continuum of outcomes with respect to their heroin-taking behaviour and their heroin-related problems. Treatment response is thus not a simple matter of success or failure. As with many treatments, the assessment of outcome involves degrees of improvement, and these may have different meanings for different individual cases. Although there is a general acceptance of such goals as improved health, or reduction or elimination of heroin consumption, it is also necessary to be aware of the need for flexible goals that can be adapted to individual circumstances.


[1.] Alcoholics Anonymous (2001). Alcoholics Anonymous, 4th Ed. Alcoholics Anonymous World Service.

[2.] American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders - text revision. 4 Ed. Washington, DC:

[3.] American Psychiatric Association. Aziz, R. (1990). C.J. Jung’s psychology of religion and synchronicity. New York: The State University of New York Press. Callahan, E. (1980).

[4.] Alternative strategies in the treatment of narcotics addictions: A review. In The addictive behaviours (Ed. Miller, W.) Oxford: Pergamon. Corsini, R.J., & Wedding, D. (1995). Current psychotherapies, 5th Ed. Illinois: F.E. Peacock Publishers, Inc.

[5.] Dos Santos, M. & Van Staden, F (2008). Heroin dependence recovery. Journal of Psychology in Africa, 18(2), 327-338.

[6.] Dos Santos, M.M.L., Rataemane, T.S., Trathen, B., & Fourie, D. (2010). An approach to heroin use disorder intervention within the South African context: a content analysis study. Substance Abuse Treatment, Prevention and Policy,5: 13.

[7.] Einstein, S. (1966). The narcotics dilemma: Who is listening to what? International Journal of the Addictions, 1, 1-6.

[8.] Finnegan, F. (1995). The cognitive structure underlying heroin injecting behaviour. Journal of Drug Education, 25(3), 281-287.

[9.] Friedman, M. (1992). Buried alive: The biography of Janis Joplin. New York: Harmony Books.

[10.]   Ghodse, H. (1989). Drugs and addictive behaviour: A guide to treatment. Oxford: Blackwell Scientific Publications.

[11.]   Gossop, M. (2000). Living with drugs (5th Ed.). Aldershot: Ashgate Arena. Gossop, M. (2003). Drug addiction and its treatment. Oxford: Oxford University Press. Hayes, S.C., Barlow, D.H., & Nelson-Grey, R.O. (1999). The scientist practitioner: and research and accountability in the age of managed health care (2 Ed.). Boston: Allyn & Bacon.

[12.]   Kaplan. J. (1983). The hardest drug: Heroin and public policy. Chicago: The University of Chicago Press.

[13.]   Karam, E.G.; Yabroudi, P., & Melhem, N.M. (2002). Comorbidity of substance abuse and other psychiatric disorders in acute general psychiatric admissions: A story from Lebanon. Comprehensive Psychiatry, 43(6), 463-468.

[14.]   Kenny, M. (1999). Death by heroin - recovery by hope. Dublin: New Island Books.

[15.]   Kleber, H.D. (1981). Detoxification from narcotics. In Substance abuse (ed. Lowinson, J. & Ruiz, P.). Baltimore: Williams & Wilkins.

[16.]   Kohn, M. (1987). Narcomania on heroin. London: Faber & Faber Limited.

[17.]   Leggett. T. (2001). Rainbow vice: The drugs and sex industries in the new South Africa. Claremont: David Philip.

[18.]   Leshner, A.I. (1999). Drug abuse and mental disorders: Comorbidity is reality. NIDA Notes, 14(4), 3-4.

[19.]   Marlatt, A., & Gordon, J. (1985). Relapse prevention. New York: Guilford. Myers, B., & Parry, C.D. H. (2002).

[20.]   Report on audit of substance abuse facilities in Cape Town. Cape Town: Medical Research Council. Pearson, G. (1987). The new heroin users. Oxford: Basil Blackwell Ltd. Robins, L. (1993). Vietnam veterans’ rapid recovery from heroin addiction: A fluke or normal expectations? Addiction, 88, 1041-1054.

[21.]   Rodrigues-Llera, M.C., Domingo-Salvany, A., Brugal, M.T., Silva, T.C., Sanchez-Niubo, A., & Torrens, M. (2006). Psychiatric comorbidity in young heroin users. Drug and Alcohol Dependence, 84(1), 48-55.

[22.]   Rotgers, F., Morgenstern, J., & Walters, S.T. (2003). Treating substance abuse. London: The Guilford Press.

[23.]   Strang, J., Griffiths, P., Powis B., & Gossop, M. (1997). How constant is an individual’s route of heroin administration? Drug and Alcohol Dependence, 46, 115-118.

[24.]   Stevens, A., & Rafferty, J. (1994). Health care needs assessment: The epidemiologically based needs assessment reviews. Oxford: Radcliffe Medical.

[25.]   Teeson, M., Mills, K., Ross, J., Darke, S., Williamson, A., & Harvard, A. (2008). The impact of treatment 3 years outcome for heroin dependence: Findings from the Australian Treatment Outcomes Study (ATOS). Addiction, 103(1), 80-88.

[26.]   Terry, C.M. (2003). The fellas: Overcoming prison and addiction. Australia: Wadsworth Thomson Learning Inc.

[27.]   Vasile, D., Gheorghe, M.D., Civrea, R., & Paraschiv, S. (2002). Antisocial Personality Disorder - heroin dependence comorbidity. European Neuropsychopharmacology, 12, supplement 3, p. 392.

[28.]   Vietnam & America: A documented history. (1995). New York: Grove Press. Winick, C. (1962). Maturing out of narcotics addiction. UN Bulletin on Narcotics, 14, 1-7.