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To determine predictors of injection drug use cessation and subsequent relapse among a cohort of injection drug users (IDUs).

IDUs in Baltimore, MD were recruited through community outreach in 1988–1989. Among IDUs with at least three follow-up visits, parametric survival models for time to injection cessation (≥6 months) and subsequent relapse were constructed.

Of 1327 IDUs, 94.8% were African American, 77.2% were male, median age was 34 years, and 37.7% were HIV-infected. Among 936 (70.5%) subjects who ceased injection, median time from baseline to cessation was 4.0 years. Three-quarters subsequently resumed injection drug use, among whom median time to relapse was 1.0 year. Factors independently associated with a shorter time to cessation were: age <30 years, stable housing, HIV seropositivity, methadone maintenance treatment, detoxification …