Interventions to prevent the initiation of injection drug use: A systematic review

Preventing Injection Drug use Initiation: State of the Evidence and Opportunities for the Future

“…We can therefore state with some confidence that the prioritization of the prevention of injection initiation, as called for by experts over a decade ago [1], has edged closer to reality. However, important issues remain, largely related to the low levels of access that drug-using populations currently have to a range of HIV prevention interventions including opioid substitution therapy, medically supervised injection facilities, and needle and syringe programs [64], as well as the lack of development, evaluation, and scale-up of interventions to prevent injection initiation [18]. A prevention strategy that does not unintentionally undermine the twin goals of harm reduction and prevention of injection initiation is therefore needed.…”

“…Interventions to prevent the initiation of injection drug use: a systematic review Werb et al [18] 2014 BChange the Cycle^intervention Strike et al [19] 2015 Next steps in research on injection initiation incidence and prevention Bluthenthal and Kral [20] 2015 US NIDA Avant Garde Award: BCombined prevention to reduce initiation into injecting drug use^Forthcoming 2015 US NIDA Avenir Award: BPreventing injecting by modifying existing responses^Werb et al [21] 2015 US NIDA R01: BPreventing injection initiation: the Change the Cycle randomized controlled trial^Forthcoming be persistent [36]. Therefore, preventing transitions into injecting should address both the need to prevent people from seeking out injecting and the need to prevent PWID from initiating others into this behavior.…”

Diferencias de género en la gravedad de la adicción

“…En nuestro estudio se detecta un mayor porcentaje de hombres que se inyectan. Esto podría ser debido a que las mujeres se inyectan básicamente con sus parejas, mientras que los hombres tendrían una red de familiares y amigos que consumen más amplia (Werb et al, 2013).…”

Post-war prevention: Emerging frameworks to prevent drug use after the War on Drugs

“…Nevertheless, over the past decade, increasing efforts to overcome this challenge and ensure the ethical engagement of PWUD in research on a variety of drug-related issues have been undertaken, most notably in HIV prevention trials and harm reduction intervention development. 53–58 Efforts to extend this approach to drug prevention have, however, been limited, 59 though the waning of the War on Drugs presents an opportunity.…”

“…A related concern is that developing prevention programming without the inclusion of PWUD has the potential to replicate previous failed efforts relying on moral sanctioning to prevent entry into drug use. As standards for ethical engagement of PWUD are established and formalized in related fields (i.e., harm reduction intervention development and disease prevention trials), failing to establish similar standards for drug prevention would likely expand the already substantial gap in effectiveness between prevention work (shown to be largely ineffective 59 ) and other modes of responding to problematic drug use, which have yielded a range of tangible improvements in health and social outcomes among PWUD. 74–79 A secondary challenge is that, unlike the development of interventions to reduce drug-related harms, which can provide tangible health or social benefits for PWUD participating in such research (i.e., access to treatment for infectious disease, implementation of supervised injection facilities), few obvious advantages for PWUD involvement in drug prevention work exist.…”