A qualitative exploration of the impact of cultural and social factors on heroin use in Shetland (Scotland)

In order to gain a greater understanding of the impact of social and cultural factors on patterns of heroin use and use-related behaviors, in-depth interviews were carried out with 12 heroin users in Shetland. Analysis revealed the existence of a small, highly organized and highly covert heroin subculture. Within this group, users were predominantly older, and their use was reported as being relatively self-controlled and unproblematic in nature, especially by comparison to the heroin use associated with deprived urban areas. There were indicators, however, that this situation seemed to have entered a phase of change, reflected by descriptions of an increasing number of younger, less controlled heroin users. Within the theoretical framework of drug, set and setting, the importance of drug-using norms and rules among heroin users in both regulating and maintaining patterns of use, even through periods of change, was identified. Shetland, with its relative affluence, small size and geographical isolation constitutes an unusual setting for research into heroin use, which customarily has been viewed as an urban phenomenon. Thus it offers the opportunity to gain insight into the nature of heroin use and associated behaviors from a relatively novel perspective.