Heroin availability and aggregate levels of use: secular trends in an urban black cohort.

The influence of heroin availability on the aggregate level of use of this drug was investigated for a normal Black cohort (born between 1952 and 1957) who grew up in Harlem (New York City). Data obtained on the second and third waves of a panel study were used to estimate annual rates of heroin initiation and cessation from the mid-1960s through 1983. The aggregated time-series variables indicated that initiation into heroin use was largely confined to adolescence and that cessation rates exhibited substantial year-to-year fluctuations with no apparent relationship to either chronological age or calendar year. Respondents born before 1955, however, had much higher rates of heroin use than those born in later years. Temporal trends in initiation and cessation were uncorrelated with changes in the purity of heroin sold in New York City between 1973 and 1983, suggesting that aggregate levels of heroin use in this sample were little affected by changes in supply. More speculatively, cohort differences in lifetime prevalence may reflect varying availability at the times younger and older cohorts entered adolescence. This possibility could not be directly tested because of the absence of reliable purity data going back sufficiently far in time.