Initiation Stories: An Examination of the Narratives of People Who Assist with a First Injection
BACKGROUND:
Research
in the area of initiation to injection drug use that focuses on the perspective
of initiators, or those who help with a first injection, is rare.
OBJECTIVE:
To
explore the process of initiation to injection drug use from the point of view
of initiators.
METHODS:
Semi-structured,
in-depth qualitative interviews were conducted at a harm reduction program in
Toronto, Canada. Twenty participants who had injected drugs in the last
30 days and who reported ever having initiated another person to injection
drug use were recruited. A narrative analytic approach was used to explore the
spectrum of narratives surrounding their experiences initiating others to
injection drug use.
RESULTS:
Initiation
events arise in a complex interplay of individual circumstances and social contexts.
People who inject may assist with a first injection for a variety of reasons,
from conceding to social pressure, to wanting to help reduce a perceived risk
of harm, to assisting because it provides a sense of pride at possessing a
skill or of having helped someone achieve a desired state, to assisting to
obtain drugs or to cope with withdrawal, or a mix of several of these reasons
at once. Conclusions/Importance: Narratives reveal that preventing all
instances of initiation is unrealistic. Combining elements from existing
interventions that focus on enhancing reluctance to assist with initiation with
safer injection training has the potential to reduce initiations and perhaps
reduce injection related harm for novices if initiation occurs.
- 1 Dalla Lana School of Public Health , University of Toronto , Toronto , Canada.
- 2 Centre for Addiction and Mental Health , Toronto , Canada.
- 3 Service de toxicomanie , Université de Sherbrooke , Longueuil , Canada.
- 4 COUNTERfit Harm Reduction Program , South Riverdale Community Health Centre , Toronto , Canada.
- 5 KCA , Faversham , United Kingdom.
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