Remission and relapse in heroin users and implications for management: treatment control or risk reduction.

A general practice based study of 117 heroin users receiving minimal intervention for their drug use examines the patterns and frequency of use from onset to last medical contact. Patterns of abstinence and relapse, and episodes of dependent and nondependent use are defined and quantified, demonstrating variations between and within individuals over time. This evidence of both controlled heroin use and remission and relapse not related to intervention is discussed and contrasted with the continued fixed belief of the public and professionals that heroin use is continuous, incurable, and permanent. Implications for therapy, especially in a "post-AIDS" era, are discussed.