Heroin use, ethnicity and the environment: the case of the London Bangladeshi community.

Abstract

To describe the emergence of heroin use in the London Bangladeshi community, to delineate its key features and generate hypotheses to account for these. Analysis of all reports of treatment-related episodes to a central data base. Detailed interviews with 21 Bangladeshi heroin users and a comparison group. Treatment centres in three London boroughs with large Bangladeshi populations. For young Bangladeshi men living in London, the prevalence of problematic heroin use has increased from negligible levels in the early 1990s to levels proportionally higher than in the white population of the same age and sex. The proportion of first episode reports has remained constant during this time. Bangladeshi heroin use has certain distinct features: users are nearly all male, and are apparently less disadvantaged than comparable white users. They also have much greater contact with their non-drug-using families. Because the population of Bangladeshis continues to grow, the epidemic may continue to grow in step with this. However, Bangladeshis may represent a group of heroin users with a good prognosis, and treatment services should, arguably, be aiming for better outcomes for them. Greater involvement of families may help to achieve this.