Aims.To establish the existence of needle fixation and provide a theoretical explanation for the phenomenon. Method. By searching published literature using electronic searches, consulting a National Drug Library (ISDD) and snowballing from reference lists in publications related to addiction. Findings. Needle fixation as a phenomenon has been mentioned in the literature since at least 1929 but there is only one published paper devoted to it. Needle fixation is a conditioned response but with a number of different secondary gains which maintain the practice. These include ritual, substitution of non psychoactive substances in the absence of drugs, pain, sexual pleasure and status. Conclusions. Needle fixation should be taken seriously because of the concern about blood borne viruses among injecting drug users and the need to reduce the practice of injecting. A greater understanding of the problem will help in treatment of injecting drug users.
Issues conveniently considered together as needle fixation are current among injecting drug users and may be relevant to the inability of some drug users to change from injecting drug use.
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