National Development Research Institutes, Inc., New York, NY 10010, United States.
Int J Drug Policy. 2010 May;21(3):179-85. doi: 10.1016/j.drugpo.2009.08.007. Epub 2009 Sep 27.
Research on heroin withdrawal has primarily been done clinically, thus focussing on symptom severity, physiological manifestations, and how withdrawal impairs normal functioning. However, there is little scientific knowledge on how heroin withdrawal affects injection behaviour. This paper explores how withdrawal episodes heighten unsafe injection practices and how some long-term injectors manage such risks.
We interviewed 32 injection drug users in New York City who had been injecting drugs for 8-15 years (21 HIV and HCV uninfected; 3 HIV and HCV infected; and 8 singly infected with HCV). We used in-depth life history interviews to inquire about IDUs' life history, injection practices and drug use behaviour over time. Analysis used grounded theory techniques.
Withdrawal can enhance risk by undermining IDUs' willingness to inject safely; increasing the likelihood of attending risky settings; raising the number of injection partners; and seeking ad hoc partners for drug or needle sharing. Some IDUs have developed practices to cope with withdrawal and avoid risky practices (examples include carrying clean needles to shooting galleries and sniffing rather than injecting). Strategies to avoid withdrawal include back up methods, resorting to credit, collaborating with others, regimenting drug intake, balancing drug intake with money available, and/or resorting to treatment.
Withdrawal periods can heighten risky injection practices. Some IDUs have applied strategies to avoid withdrawal or used practices to cope without engaging in risky practices. These behaviours might in turn help IDUs prevent an infection with hepatitis C or HIV.
对海洛因戒断的研究主要是临床研究，因此主要集中在症状严重程度、生理表现以及戒断如何影响正常功能上。然而，关于海洛因戒断如何影响注射行为，科学界知之甚少。本文探讨了戒断发作如何加剧不安全的注射行为，以及一些长期注射者如何管理这些风险。
我们采访了纽约市的 32 名注射吸毒者，他们的吸毒史为 8-15 年（21 名 HIV 和 HCV 未感染者；3 名 HIV 和 HCV 感染者；8 名 HCV 单一感染者）。我们使用深入的生活史访谈来询问 IDU 的生活史、注射实践和随时间推移的药物使用行为。分析采用扎根理论技术。
戒断可能会通过破坏 IDU 安全注射的意愿、增加去危险场所的可能性、增加注射伙伴的数量以及寻求临时的药物或针具共享伙伴来增加风险。一些 IDU 已经制定了应对戒断和避免危险行为的做法（例如，携带干净的针头去注射室，以及嗅而不是注射）。避免戒断的策略包括备用方法、诉诸信用、与他人合作、规律药物摄入、平衡药物摄入与可用资金，以及/或诉诸治疗。
戒断期可能会增加危险的注射行为。一些 IDU 已经应用了避免戒断的策略，或者使用了不涉及危险行为的应对方法。这些行为可能反过来帮助 IDU 预防丙型肝炎或 HIV 的感染。
