Attitudes of novice heroin injectors towards non-injecting routes of administration to prevent the transmission of blood borne viruses

Abstract

This study aimed to investigate attitudes towards and experiences with heroin use, by means other than injecting, in the West Australian city of Perth. As part of a major study of hepatitis C, injecting and the prevention of hepatitis C, a study group of 65 current drug injectors were invited to describe their experiences with heroin chasing, smoking or snorting and to discuss their attitudes towards the suggestion that using heroin by non-injecting methods could be utilised as a prevention strategy for hepatitis C. Experience with non-injecting (smoking or chasing) for the study group was limited, with less than half having initiated heroin use by non-injecting means and none having sustained the practice. Attitudes towards the promotion of non-injecting methods were largely negative. A small proportion of the study group expressed support for using non-injecting methods for health reasons, the majority being dismissive of the idea. The major barriers from the injectors’ perspective were seen to be related to cost and drug effect. A pre-existing barrier in Australia to using non-injecting methods is the predominance of salt of heroin, which does not lend itself to chasing or smoking. The results of this investigation are discussed in terms of the barriers to the promotion of non-injecting drug use and methods by which such barriers might be overcome to encourage a cultural change from heroin injection to non-injecting means of administration.