An estimated one quarter of patients participating in opioid replacement therapy in the greater Sydney area participated in this study of heroin dependence. The study has enabled a more complete understanding of the childhood and adult experiences of this population. Participants had experienced high levels of childhood maltreatment, parental substance use, and parental conflict. Unsurprisingly, mental health problems, early substance use, criminal activity, and multiple dependence diagnoses were also highly prevalent. It has also highlighted key differences between males and females, and identified clinically relevant correlates of multiple substance dependence for both sexes. The inclusion of demographic, child maltreatment and clinical variables presents, to our knowledge, the most comprehensive modelling of multiple substance dependence amongst dependent heroin users to date. Of note for both sexes was the increase in clinical and other problems as the number of dependence diagnoses increased, whereas earlier onset of cannabis use was associated with higher numbers of dependence diagnoses.
