Standing at the Crossroads: A Grounded Theory of Early-Stage Desistance From Heroin Careers in Malta

Evidence suggests that individuals affected by problematic heroin use can desist at various points in their drug-using career. Drawing on a doctoral study that developed a non-linear four-stage model of desistance from heroin careers within the Maltese context, this paper focuses on exploring the contingencies that are in place during the initial pre-desistance stage. The study adopted an evolved grounded theory methodology. Semi-structured interviews were conducted with twenty-two participants, fourteen identifying as male and eight as female, who had desisted from heroin careers for a minimum of five years. Findings show that a series of setbacks encountered after committing to a heroin career can create profound ambivalence, leading to pivotal reckoning moments that prompt individuals to consider change. Importantly, the emergence of hope that desistance is possible appears to play an instrumental role in initiating the desistance process.