High Purity Heroin Use Among Women in Karaj, Iran: A Pilot Study

Objective: High purity heroin use is a new epidemic health concern among Iranian drug-using women in recent years. However, the nature and initial factors associated with this serious health problem have not been studied yet. Methods: To understand this issue, a cross-sectional study was conducted and sixty treatment and nontreatment seekers who met the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision (DSM.IV-TR) criteria for drug dependence with mean age of 28.7 (± 8.3) years were recruited from 16 addiction clinics and drop-in centers (DICs) in Karaj, Iran. First, demographics, and details of drug use and risky behaviors were collected based on items elicited from Addiction Severity Index (ASI). Then, initial factors associated with high purity heroin use were collected by interviewing and applying a researcher-made questionnaire. Data was statistically analyzed by descriptive methods of statistics, chi-square, and Student’s independent t-test in SPSS software. Results: Initiation of high purity heroin use was facilitated by family/relatives factor (66.7%), curiosity (60.1%), peers (54%), desire to experience rapid physical effects of high purity heroin compared with other opioids (50.1%), and treatment of general medical problems such as colic pain (33%). Chi-square test showed that non-treatment seekers were younger (less than 35 years) (66.6% vs. 56%, p ≤ 0.001) and mostly living with drug-dependent friends (26% vs. 3.3%, p ≤ 0.001) compared with treatment seekers. No relation was found among other factors. Conclusions: Factors facilitating the initiation of high purity heroin use revealed in this study have not been fully addressed by current drug treatment services in Iran. To design comprehensive treatment programs, further studies on larger samples with more women are necessary.