Heroin use among female adolescents: The role of partner influence in path of initiation and route of administration

This study examined heroin initiation and route of administration among 16 female adolescents in the greater Baltimore Metropolitan area. Participants were more than twice as likely to be introduced to heroin by a male friend or boyfriend (IHM) than introduced to heroin by other means (IHO). The majority of IHM females were introduced by a male friend rather than a romantic partner. No relationship was found between path of initiation (IHM, IHO) and initial route of administration (inhalation, smoking, injecting) or history of injection (ever injected, never injected). The effect of opposite-gender peer influence in the initiation of female adolescent heroin use is discussed along with how the current findings may influence treatment and prevention efforts. A statistically significant relationship was found for initial route of administration and for history of injection. Ninety-four percent of participants reported initiation of heroin use by inhalation, while an alarming 75% of participants reported injecting heroin at some time during their history of use. Participants were no more likely to be introduced to injection by a boyfriend or male friend than by other means. The finding that the majority of females first try heroin through inhalation is consistent with an increased use of heroin by this method among young people in recent years. However, the majority of users in this study used heroin through injection at least once in their addict career, a route of administration associated with increased health and safety risks. Potential explanations for the progression from snorting to injection are presented as well as implications for the delivery of prevention and treatment services.