Abstract
BackgroundBlue lights are sometimes placed in public washrooms to discourage injection drug use. Their effectiveness has been questioned and concerns raised that they are harmful but formal research on the issue is limited to a single study. We gathered perceptions of people who use injection drugs on the effects of blue lights with the aim of informing harm reduction practice.MethodsWe interviewed 18 people in two Canadian cities who currently or previously used injection drugs to better understand their perceptions of the rationale for and consequences of blue lights in public washrooms.ResultsParticipants described a preference for private places to use injection drugs, but explained that the need for an immediate solution would often override other considerations. While public washrooms were in many cases not preferred, their accessibility and relative privacy appear to make them reasonable compromises in situations involving urgent injecting. Participants understood the aim of blue lights to be to deter drug use. The majority had attempted to inject in a blue-lit washroom. While there was general agreement that blue lights do make injecting more difficult, a small number of participants were entirely undeterred by them, and half would use a blue-lit washroom if they needed somewhere to inject urgently. Participants perceived that, by making veins less visible, blue lights make injecting more dangerous. By dispersing public injection drug use to places where it is more visible, they also make it more stigmatizing. Despite recognizing these harms, more than half of the participants were not opposed to the continued use of blue lights.ConclusionsBlue lights are unlikely to deter injection drugs use in public washrooms, and may increase drug use-related harms. Despite recognizing these negative effects, people who use injection drugs may be reluctant to advocate against their use. We attempt to reconcile this apparent contradiction by interpreting blue lights as a form of symbolic violence and suggest a parallel with other emancipatory movements for inspiration in advocating against this and other oppressive interventions.
Highlights
Blue lights are sometimes placed in public washrooms to discourage injection drug use
Blue lights could compound the risk of injecting in public washrooms by increasing the probability that people who use injection drugs will miss the target vein and inject into surrounding tissue and by promoting other unsafe practices such as deep vein injecting [16]
All participants knew about the practice of blue lights being installed in public bathrooms, and 16 described situations in which they had personally attempted to inject in a blue-lit bathroom
Summary
Blue lights are sometimes placed in public washrooms to discourage injection drug use Their effectiveness has been questioned and concerns raised that they are harmful but formal research on the issue is limited to a single study. A qualitative study from the United Kingdom of people who use injection drugs' experiences with blue lights suggested that, while blue lights do make it more difficult for them to find their veins, for some this would not deter attempted injection. Potential reasons for this lack of deterrent effect included scarcity of alternative injection locations and confidence in their injecting ability [15]. In one of our study sites, the existence of a supervised injection facility (SIF) provides an alternative to injecting in washrooms, and the existence of blue lights in nearby washrooms may influence people who use drugs' decision-making about visiting the SIF
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