Skip to main content

Advertisement

SpringerLink
Log in

The CHANGE Study: Methods and Sample Description for a Cross-Sectional Study of Heroin Cessation in New York City

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

The CHANGE (Cessation of Heroin: A Neighborhood Grounded Exploration) Study aimed to understand factors associated with the initiation and maintenance of sustained heroin cessation from the perspective of users themselves and specifically set out to document the correlates of natural recovery. The CHANGE Study was a case-control study conducted in New York City from 2009 to 2011. Cases were former heroin users, abstinent for 1–5 years in the past 5 years. Controls used heroin at least weekly during the past 5 years and were (1) continuous heroin users without a quit attempt of ≥2 weeks’ duration or (2) relapsed heroin users who were currently using and had a quit attempt of ≥2 weeks’ duration during the past 5 years. Recruitment and data collection methods are described along with limitations and a brief description of the study sample. In contrast to many studies of drug use and cessation, the CHANGE Study was designed to model success (i.e., initiation and maintenance of heroin cessation) and not failure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014. http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabsPDFWHTML2013/Web/HTML/NSDUH-DetTabsTOC2013.htm.  Accessed 9 Jan 2015.

  2. Darke S. The life of the heroin user: typical beginnings, trajectories and outcomes. Cambridge (UK): Cambridge University Press; 2011.

    Book  Google Scholar 

  3. Degenhardt L, Whiteford HA, Ferrari AJ, et al. Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010. Lancet. 2013; 382(9904): 1564–1574.

    Article  PubMed  Google Scholar 

  4. Degenhardt L, Charlson F, Mathers B, et al. The global epidemiology and burden of opioid dependence: results from the global burden of disease 2010 study. Addiction. 2014; 109(8): 1320–1333.

    Article  PubMed  Google Scholar 

  5. Mark TL, Woody GE, Juday T, Kleber HD. The economic costs of heroin addiction in the United States. Drug Alcohol Depend. 2001; 61(2): 195–206.

    Article  CAS  PubMed  Google Scholar 

  6. Inocencio TJ, Carroll NV, Read EJ, Holdford DA. The economic burden of opioid-related poisoning in the United States. Pain Med. 2013; 14(10): 1534–1547.

    Article  PubMed  Google Scholar 

  7. Hser YI, Anglin D, Powers K. A 24-year follow-up of California narcotics addicts. Arch Gen Psychiatry. 1993; 50(7): 577–584.

    Article  CAS  PubMed  Google Scholar 

  8. Hser YI, Hoffman V, Grella CE, Anglin MD. A 33-year follow-up of narcotics addicts. Arch Gen Psychiatry. 2001; 58(5): 503–508.

    Article  CAS  PubMed  Google Scholar 

  9. Vaillant GE. A 20-year follow-up of New York narcotic addicts. Arch Gen Psychiatry. 1973; 29(2): 237–241.

    Article  CAS  PubMed  Google Scholar 

  10. Simpson DD, Joe GW, Lehman WEK, Sells SB. Addiction careers—etiology, treatment, and 12-year follow-up outcomes. J Drug Issues. 1986; 16(1): 107–121. Win.

    Google Scholar 

  11. Biernacki P. Pathways from heroin addiction: recovery without treatment. Philadelphia: Temple University Press; 1986.

    Google Scholar 

  12. Nurco DN, Cisin IH, Balter MB. Addict careers. I. A new typology. Int J Addict. 1981; 16(8): 1305–1325.

    CAS  PubMed  Google Scholar 

  13. Waldorf D, Biernacki P. Natural recovery from heroin-addiction—review of the incidence literature. J Drug Issues. 1979; 9(2): 281–289.

    Google Scholar 

  14. Waldorf D, Biernacki P. The natural recovery from opiate addiction—some preliminary findings. J Drug Issues. 1981; 11(1): 61–74.

    Google Scholar 

  15. Stall R, Biernacki P. Spontaneous remission from the problematic use of substances—an inductive model derived from a comparative-analysis of the alcohol, opiate, tobacco, and food obesity literatures. Int J Addict. 1986; 21(1): 1–23.

    CAS  PubMed  Google Scholar 

  16. Hubbard RL, Craddock SG, Anderson J. Overview of 5-year followup outcomes in the drug abuse treatment outcome studies (DATOS). J Subst Abuse Treat. 2003; 25(3): 125–134.

    Article  PubMed  Google Scholar 

  17. Hser YI. Predicting long-term stable recovery from heroin addiction: findings from a 33-year follow-up study. J Addict Dis. 2007; 26(1): 51–60.

    Article  PubMed  Google Scholar 

  18. Darke S, Ross J, Teesson M, et al. Factors associated with 12 months continuous heroin abstinence: findings from the Australian Treatment Outcome Study (ATOS). J Subst Abuse Treat. 2005; 28(3): 255–263.

    Article  PubMed  Google Scholar 

  19. Darke S, Ross J, Mills KL, Williamson A, Havard A, Teesson M. Patterns of sustained heroin abstinence amongst long-term, dependent heroin users: 36 months findings from the Australian Treatment Outcome Study (ATOS). Addict Behav. 2007; 32(9): 1897–1906.

    Article  PubMed  Google Scholar 

  20. Darke S, Mills KL, Ross J, Williamson A, Havard A, Teesson M. The ageing heroin user: career length, clinical profile and outcomes across 36 months. Drug Alcohol Rev. 2009; 28(3): 243–249.

    Article  PubMed  Google Scholar 

  21. Klingemann HK, Sobell LC. Introduction: natural recovery research across substance use. Subst Use Misuse. 2001; 36(11): 1409–1416.

    Article  CAS  PubMed  Google Scholar 

  22. Preble E, Casey JJ. Taking care of business—heroin users life on street. Int J Addict. 1969; 4(1): 1–24.

    Google Scholar 

  23. Granfield R, Cloud W. Social context and “natural recovery”: the role of social capital in the resolution of drug-associated problems. Subst Use Misuse. 2001; 36(11): 1543–1570.

    Article  CAS  PubMed  Google Scholar 

  24. Bischof G, Rumpf HJ, Meyer C, Hapke U, John U. Stability of subtypes of natural recovery from alcohol dependence after two years. Addiction. 2007; 102(6): 904–908.

    Article  PubMed  Google Scholar 

  25. Sobell LC, Ellingstad TP, Sobell MB. Natural recovery from alcohol and drug problems: methodological review of the research with suggestions for future directions. Addiction. 2000; 95(5): 749–764.

    Article  CAS  PubMed  Google Scholar 

  26. Burman S. The challenge of sobriety: natural recovery without treatment and self-help groups. J Subst Abuse. 1997; 9: 41–61.

    Article  CAS  PubMed  Google Scholar 

  27. Chiauzzi EJ, Liljegren S. Taboo topics in addiction treatment. An empirical review of clinical folklore. J Subst Abuse Treat. 1993; 10(3): 303–316.

    Article  CAS  PubMed  Google Scholar 

  28. Graeven DB, Graeven KA. Treated and untreated addicts—factors associated with participation in treatment and cessation of heroin use. J Drug Issues. 1983; 13(2): 207–218.

    Google Scholar 

  29. Klingemann HK. The motivation for change from problem alcohol and heroin use. Br J Addict. 1991; 86(6): 727–744.

    Article  CAS  PubMed  Google Scholar 

  30. Price RK, Risk NK, Spitznagel EL. Remission from drug abuse over a 25-year period: patterns of remission and treatment use. Am J Public Health. 2001; 91(7): 1107–1113.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  31. Biernacki P. Recovery from opiate addiction without treatment: a summary. NIDA Res Monogr. 1990; 98: 113–119.

    CAS  PubMed  Google Scholar 

  32. Weiss L, Ompad D, Galea S, Vlahov D. Defining neighborhood boundaries for urban health research. Am J Prev Med. 2007; 32(6 Suppl): S154–S159.

    Article  PubMed Central  PubMed  Google Scholar 

  33. O’Brien CP. Drug addiction and drug abuse. In: Brunton LL, Lazo JS, Parker KL, eds. Goodman & Gilman’s the pharmacological basis of therapeutics. 11th ed. New York: McGraw-Hill; 2006.

    Google Scholar 

  34. Weiss L, Gass J, Egan JE, Ompad DC, Trezza C, Vlahov D. Understanding prolonged cessation from heroin use: findings from a community-based sample. J Psychoactive Drugs. 2014; 46(2): 123–132.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Fox AD, Anderson MR, Bartlett G, Valverde J, Starrels JL, Cunningham CO. Health outcomes and retention in care following release from prison for patients of an urban post-incarceration transitions clinic. J Health Care Poor Underserved. 2014; 25(3): 1139–1152.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Fox AD, Maradiaga J, Weiss L, Sanchez J, Starrels JL, Cunningham CO. Release from incarceration, relapse to opioid use and the potential for buprenorphine maintenance treatment: a qualitative study of the perceptions of former inmates with opioid use disorder. Addict Sci Clin Pract. 2015; 10(1): 2.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Hser YI, Evans E, Grella C, Ling W, Anglin D. Long-term course of opioid addiction. Harv Rev Psychiatry. 2015; 23(2): 76–89.

    Article  PubMed  Google Scholar 

  38. Nurco DN, Cisin IH, Balter MB. Addict careers. III. Trends across time. Int J Addict. 1981; 16(8): 1357–1372.

    CAS  PubMed  Google Scholar 

  39. Nurco DN, Cisin IH, Balter MB. Addict careers. II. The first ten years. Int J Addict. 1981; 16(8): 1327–1356.

    CAS  PubMed  Google Scholar 

  40. Winick C. Maturing out of narcotic addiction. Bull Narc. 1962; 14(1): 1–7.

    Google Scholar 

  41. Smith WG, Ellinwood EH, Vaillant GE. Narcotic addicts in the mid-1960’s. Public Health Rep. 1966; 81(5): 403–412.

    Article  PubMed Central  PubMed  Google Scholar 

  42. Vaillant GE. Twelve-year follow-up of New York narcotic addicts. II. The natural history of a chronic disease. N Engl J Med. 1966; 275(23): 1282–1288.

    Article  CAS  PubMed  Google Scholar 

  43. Vaillant GE. A 12-year follow-up of New York narcotic addicts. 3. Some social and psychiatric characteristics. Arch Gen Psychiatry. 1966; 15(6): 599–609.

    Article  CAS  PubMed  Google Scholar 

  44. Vaillant GE. A twelve-year follow-up of New York narcotic addicts: IV. Some characteristics and determinants of abstinence. Am J Psychiatry. 1966; 123(5): 573–585.

    Article  CAS  PubMed  Google Scholar 

  45. Vaillant GE. A twelve-year follow-up of New York narcotic addicts. I. The relation of treatment to outcome. Am J Psychiatry. 1966; 122(7): 727–737.

    Article  CAS  PubMed  Google Scholar 

  46. Vaillant GE. The natural history of narcotic drug addiction. Semin Psychiatry. 1970; 2(4): 486–498.

    CAS  PubMed  Google Scholar 

  47. Waldorf D. Natural recovery from opiate addiction—some social-psychological processes of untreated recovery. J Drug Issues. 1983; 13(2): 237–280.

    Google Scholar 

  48. Tsuang MT, Lyons MJ, Meyer JM, et al. Co-occurrence of abuse of different drugs in men: the role of drug-specific and shared vulnerabilities. Arch Gen Psychiatry. 1998; 55(11): 967–972.

    Article  CAS  PubMed  Google Scholar 

  49. Blazer DG, Wu LT. The epidemiology of substance use and disorders among middle aged and elderly community adults: national survey on drug use and health. Am J Geriatr Psychiatry. 2009; 17(3): 237–245.

    Article  PubMed Central  PubMed  Google Scholar 

  50. Palamar JJ, Ompad DC. Demographic and socioeconomic correlates of powder cocaine and crack use among high school seniors in the United States. Am J Drug Alcohol Abuse. 2014; 40(1): 37–43.

    Article  PubMed  Google Scholar 

  51. Coffin PO, Galea S, Ahern J, Leon AC, Vlahov D, Tardiff K. Opiates, cocaine and alcohol combinations in accidental drug overdose deaths in New York City, 1990–98. Addiction. 2003; 98(6): 739–747.

    Article  PubMed  Google Scholar 

  52. Darke S, Marel C, Mills KL, et al. Patterns and correlates of non-fatal heroin overdose at 11-year follow-up: findings from the Australian Treatment Outcome Study. Drug Alcohol Depend. 2014; 144: 148–152.

    Article  PubMed  Google Scholar 

  53. U.S. Census Bureau. Poverty thresholds 2009; 2010. https://www.census.gov/hhes/www/poverty/data/threshld/thresh09.html. Accessed 11 Jan 2015.

  54. Cicero TJ, Ellis MS, Surratt HL, Kurtz SP. The changing face of heroin use in the United States: a retrospective analysis of the past 50 years. JAMA Psychiatry. 2014; 71(7): 821–826.

    Article  PubMed  Google Scholar 

  55. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set (TEDS): Table 2.2. Admissions aged 12 and older, by race/ethnicity according to primary substance of abuse: 2012; 2013. http://www.samhsa.gov/data/sites/default/files/TEDS2012N_Web/TEDS2012NTbl2.2.htm. Accessed 11 Jan 2015.

Download references

Acknowledgments

This study was funded by a grant from the National Institute on Drug Abuse (DA022123). DCO was also supported by the NIDA-funded Center for Drug Use and HIV Research (CDUHR—P30 DA011041). JJP is also supported by a grant from NIDA (K01 DA038800).

Author information

Authors and Affiliations

  1. College of Global Public Health, New York University, 41 East 11th Street, Room 730, New York, NY, 10003, USA

    Danielle C. Ompad

  2. Center for Drug Use and HIV Research, New York University College of Nursing, New York, NY, USA

    Danielle C. Ompad & Joseph J. Palamar

  3. Center for Health, Identity, Behavior and Prevention Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, NY, USA

    Danielle C. Ompad & Jiayu Wang

  4. Center for Evaluation and Applied Research, New York Academy of Medicine, New York, NY, USA

    Ebele O. Benjamin & Linda Weiss

  5. Department of Population Health, New York University Langone Medical Center, New York, NY, USA

    Joseph J. Palamar

  6. Boston University School of Public Health, Boston, MA, USA

    Sandro Galea

  7. School of Nursing, University of California, San Francisco, San Francisco, CA, USA

    David Vlahov

Authors
  1. Danielle C. Ompad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ebele O. Benjamin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Linda Weiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Joseph J. Palamar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sandro Galea
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jiayu Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. David Vlahov
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Danielle C. Ompad.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ompad, D.C., Benjamin, E.O., Weiss, L. et al. The CHANGE Study: Methods and Sample Description for a Cross-Sectional Study of Heroin Cessation in New York City. J Urban Health 92, 955–965 (2015). https://doi.org/10.1007/s11524-015-9973-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-015-9973-0

Keywords

Search

Navigation