Interrupting the social processes linked with initiation of injection drug use: Results from a pilot study

Strike, Carol; Rotondi, Michael; Kolla, Gillian; Roy, Élise; Rotondi, Nooshin Khobzi; Rudzinski, Katherine; Balian, Raffi; Guimond, Tim; Penn, Rebecca; Silver, R.B.; Millson, Margaret; Sirois, K.; Altenberg, Jason; Hunt, Neil

doi:10.1016/j.drugalcdep.2014.01.004

Cited by 49 publications

(58 citation statements)

References 38 publications

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“…This is somewhat surprising since studies show that most PWID are assisted with their first injection (range: 68–88%; Crofts et al, 1996; Rotondi et al, 2014). In addition, qualitative and quantitative research indicates that people who transition into drug injection are typically socialized into it by established PWID who describe injection to non-injectors, inject in front of non-injectors, and even encourage drug injection (Hunt et al, 1998; Khobzi et al, 2008; Mars et al, 2014; Simmons et al, 2012; Stillwell et al, 1999; Strike et al, 2014). The role of established PWID in facilitating injection initiation has not been extensively studied.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with initiating someone into illicit drug injection

Bluthenthal¹,

Wenger²,

Chu³

et al. 2014

Drug and Alcohol Dependence

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Aims Most people who inject drugs (PWID) were first initiated into injection by a current PWID. Few studies have examined PWID who assist others into drug injection. Our goal is to describe the prevalence of and risk factors for initiating someone into injection in the last 12 months. Methods We recruited a cross-sectional sample of PWID (N=605) in California from 2011 to 2013. We examined bivariate and multivariate risk factors for initiating someone into injection with a focus on behaviors that might encourage injection initiation such as injecting in front of non-PWID, describing how to inject to non-PWID, and willingness to initiate someone into drug injection. Results Having initiated someone into injection was reported by 34% of PWID overall and 7% in the last 12 months. Forty-four PWID had assisted 431 people into injection in the past year. Factors independently associated with initiating someone into injection in the last 12 months were having injected any person in past month – referred to as being a street doctor‟ -- (Adjusted Odds Ratio [AOR]=3.49; 95% confidence interval [CI]=1.72, 7.08), having described how to inject to non-injectors (2.76; 95% CI=1.28, 5.93), self-reported likelihood of initiating someone in the future (AOR=6.37; 95% CI=3.12, 13.01), and non-injection powder cocaine use in past month (AOR=4.40; 95% CI= 1.90, 10.19). Conclusion Active PWID are important in facilitating the process of drug injection uptake. Interventions to reduce initiation should include efforts to change behaviors and intentions among PWID that are associated with injection uptake among others.

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Section: Introductionmentioning

confidence: 99%

Factors associated with initiating someone into illicit drug injection

Bluthenthal¹,

Wenger²,

Chu³

et al. 2014

Drug and Alcohol Dependence

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“…Instead, the research to date suggests that exposure to injecting and initiation may be associated in multiple ways: injection-naive persons may observe injection or hear PWID speak positively about it [19,24,37]; PWID may act as sources of injection education [19,28]; and PWID may also directly assist individuals with injection during their initiation events [39,45].…”

Section: Pathways To Initiation By People Who Inject Drugsmentioning

confidence: 99%

“…Indeed, individuals who inject drugs will not necessarily experience all or even some of these behaviors or conditions prior to their initiation of injecting. By contrast, there is a nearconsensus across scientific studies that exposure to injection drug use is a key risk factor for injection initiation (though it appears an insufficient cause in isolation) [19,21,24,[40][41][42][43][44]. The growing understanding of these mechanisms has two major implications for the prevention of HIV and viral hepatitis.…”

Section: Implications For Preventing Injection Drug Use Initiationmentioning

confidence: 99%

“…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.…”

Section: Risk Factors For Injection Initiatesmentioning

confidence: 99%

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

et al. 2017

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“…Third, to address the growing injection epidemic, we will need to develop and implement prevention strategies that interrupt the process of injection initiation. For these interventions to be successful, they should address both those who are susceptible to injection initiation-as is the case with the Sniffers Intervention [16]-and established PWID who assist in injection initiation-as is the case with 'Break the Cycle' and 'Change the Cycle' interventions [17,18]. However, neither type of intervention has been tested rigorously in randomized controlled trials.…”

mentioning

confidence: 99%