The first hit: circumstances surrounding initiation into injecting

Abstract

Initiation into injecting is a crucial event for continued reproduction of an injecting drug using (IDU) population and for exposure to blood-borne viruses, but little is known about how this happens. Three hundred young injectors were interviewed in Melbourne by peer workers within the first few years of beginning to inject, about the circumstances surrounding their initiation. Most had indications of social disruption, including having left school early, unemployment, family disruption, homelessness and incarceration. First drug injected was most often amphetamines (average age 16 years), most having already used amphetamines by a different route of administration, but with a steady movement thereafter to heroin as the drug of choice. The most common scenario was one in which injecting was unplanned but the person was active in bringing about the initiation. Most identified a significant other who initiated them (few of whom were dealers), and over half had subsequently initiated others into injecting, on average 0.6 per year; after 5 years 237 young injectors had initiated at least 420 others. Those who initiated multiple others were more likely to be unemployed, to inject multiple drugs and to have dealt. Modelling injecting as a communicable phenomenon, where appropriate, may help estimate population dynamics among IDUs. Peer education programmes are likely to be the most effective harm reduction approach among new injectors.

Drug Injection Among Street Youths in Montreal: Predictors of Initiation

“…54 Finally, youths might simply try injection out of curiosity about a drug or the ritual and paraphernalia involved. 12,49,52,55 With respect to tattoos, we can only speculate about the reasons for this association. For example, in some studies, drug users have reported that they would not start to inject because of their fear or dislike of needles.…”

“…Indeed, some studies have shown that women are mostly initiated by a partner or a lover, while men are often initiated by male friends. 49,50,52,[59][60][61] In our study, youths were asked who carried out their first injection. Only 3% of girls and 7% of boys reported that their initiator was a lover; the majority reported that it was a friend or an acquaintance (72% and 60%, respectively).…”

“…12 Others may inject because it is the most prevalent route of administration in their area for the drug they want to try or because they perceive that it is the best route given the quality and purity of the drug available in the local market. 10,12,45,[49][50][51][52][53] In fact, the drug market and other socioenvironmental determinants have been shown to influence drug use patterns among youths. 54 Finally, youths might simply try injection out of curiosity about a drug or the ritual and paraphernalia involved.…”

Attitudes of intravenous drug users in London towards the provision of drug consumption rooms

“…This may be because first-time injectors typically require assistance, and this is not permitted by most DCRs. Crofts et al (1996) reported that only 12% of IDUs injected themselves the first time; Kermode et al (2007) reported that 94.5% of IDUs in their study were injected by someone else first time. They also found that the majority had helped someone else inject for the first time.…”

Effects of Cocaine in Rats Exposed to Heroin

“…It is not clear, however, whether a 'most' typical pattern of co-use actually exists, and experimental evidence relating to this issue is scarce (Leri et al, 2003;Benswick et al, 2001; Kidorf and Stitzer, 1993). Furthermore, a pattern of co-use may reflect regional means of drug administration (Diaz et al, 1994;Gossop et al, 2000) determined by nonpharmacological factors such as socioeconomical status (Crofts et al, 1996;Dunn and Laranjeira, 1999), age (Carneiro et al, 1999;Griffiths et al, 1992;Dinwiddie et al, 1996), or gender (Doherty et al, 2000;Benswick et al, 2001). Thus, it is very difficult to study the pharmacological basis of co-use of heroin and cocaine by analyzing patterns of use at the population level.…”