Abstract
The importance of the first use of heroin and other opioids in developing drug dependence of the opioid type was discussed. Seven major factors were clinically observed to influence first heroin use. The factors are diminished self-esteem, interpersonal strivings, proselytizing, ignorance of opioid effects, pleasure, transquilization and pain. More than one factor is usually operative in a particular instance. Ready availability of heroin or other opioids is usually essential to first use, even when the described factors are present. An understanding of these determinants should improve educational efforts aimed at prevention of opioid drug use.
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