| Summary: | This thesis describes the results of a longitudinal study of regular illicit drug users in Edinburgh, Scotland. Subjects were recruited using the method of 'snowballing'. An initial group of 115 regular users of illicit substances was interviewed using a semi-structured schedule. It was found that multiple substance use was the norm with many individuals reporting adverse consequences resulting from their use of licit and illicit drugs. Concern about HIV infection affected the drug taking behaviour of injectors, but in contrast, had little influence upon the sexual behaviour of both injectors and non-injectors. Sixty-three percent (n = 72) of respondents were reinterviewed approximately 18 months after the initial interview, in order to assess patterns of behaviour change. It was hypothesised that level of involvement in drug-using lifestyles at first interview and repondents' cognitions about their current and future use would be predictive of behaviour change at the time of follow-up. Drug involvement variables, such as length of drug using career, opiate use and having an income from drug dealing, discriminated significantly between users who 'reduced' in terms of the nature and level of their use, and those who 'progressed' or remained 'static'. Cognitions about use, such as perceptions of being addicted and desire to stop, discriminated 'statics' from the 'reducers' and 'progressors'. Results from this study show that drug use behaviour change has multiple predictors at personal, social and environmental levels. These predictors are as varied and complex as those of drug initiation suggested in the retrospective data. Further studies of predictors of change should facilitate the identification of those new users who are 'at risk' of progression, which would have important implications for both primary and secondary prevention.
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