Risk Factors Associated with the Transition with Transition to Heroin Injection: A Street Addict Role Perspective

Abstract

The purpose of this paper is to identify characteristics of heroin sniffers likely to shift to injection by evaluating the street addict role theory as an informing theoretical framework to explain transition from heroin sniffing to injection. A nested case-control research design was used to identify 142 heroin sniffers who never had injected a drug (controls) and 146 recently transitioned injection drug users (cases) from a larger study of 600 African-American, Hispanic, and non-Hispanic white men and women who were street recruited from multiple communities known for high drug use. Univariate and multivariate logistic regression analyses were conducted to test the proposed hypotheses derived from the street addict role theory. Our findings partially support the utility of the street addict role perspective as an explanatory framework for understanding the role played by sociocultural factors in the transition to injection. This perspective can help contextualize this HIV-related behavior within the high risk social environment of heroin users. The development of effective prevention strategies for this group should be guided by a comprehensive understanding of the social environment where HIV-related risk behaviors occur.

Transition to and Away from Injecting Drug Use among Young Drug Users in Tehran, Iran: A Qualitative Study

“…Further, "lifestyle similarities" between a non-injector and an injector had resulted in the transition. Exposure to other IDUs as a factor influencing the transition to drug injection has been widely documented in other studies, as well (14,18,24,(28)(29)(30).…”

“…Other studies reported stress and experience of loss as a precipitating factor, as well (14,18). The loss or severe stress can lead to depression or decreased self-esteem, problems that drug users may seek a relief through injection drug use.…”

“…Long duration of drug use (18,19), more frequent drug use (14), higher amount of daily drug use (20) are indicators of a greater involvement with drug dependence. Increased drug dependency usually results in increasing the cost of the daily drug use and thus a motivation for shifting to injection.…”

“…The need to reduce drug expenses is more pronounced in those with scarce economic resources (e.g., homeless and unemployed people) (14,18,24).…”

“…Therefore, the window of opportunity to intervene after someone starts injecting drugs is short (12). Preventing initiation of injection and promoting the transition from injecting to non-injecting drug use can therefore be considered primary methods for preventing multiple infectious diseases and other health problems (13,14).…”