Abstract
BackgroundHealth promotion strategies ultimately rely on people perceiving the consequences of their behaviour as negative. If someone is indifferent towards death, it would logically follow that health promotion messages such as safe using messages would have little resonance. This study aimed to investigate attitudes towards death in a group of injecting drug users (IDUs) and how such attitudes may impact upon the efficacy/relevance of 'safe using' (health promotion) messages.MethodsQualitative, semi-structured interviews in Geelong, Australia with 60 regular heroin users recruited primarily from needle and syringe programs.ResultsOver half of the interviewees reported having previously overdosed and 35% reported not engaging in any overdose prevention practices. 13% had never been tested for either HIV or hepatitis C. Just under half reported needle sharing of some description and almost all (97%) reported previously sharing other injecting equipment. Many interviewees reported being indifferent towards death. Common themes included; indifference towards life, death as an occupational hazard of drug use and death as a welcome relief.ConclusionMost of the interviewees in this study were indifferent towards heroin-related death. Whilst interviewees were well aware of the possible consequences of their actions, these consequences were not seen as important as achieving their desired state of mind. Safe using messages are an important part of reducing drug-related harm, but people working with IDUs must consider the context in which risk behaviours occur and efforts to reduce said behaviours must include attempts to reduce environmental risk factors at the same time.
Highlights
Health promotion strategies rely on people perceiving the consequences of their behaviour as negative
Safe using messages are an important part of reducing drug-related harm, but people working with injecting drug users (IDUs) must consider the context in which risk behaviours occur and efforts to reduce said behaviours must include attempts to reduce environmental risk factors at the same time
Sixty heroin users were interviewed over a six week period in April/May 2000 at two needle and syringe programme (NSP) sites in Geelong, Australia
Summary
Health promotion strategies rely on people perceiving the consequences of their behaviour as negative. If someone is indifferent towards death, it would logically follow that health promotion messages such as safe using messages would have little resonance. This study aimed to investigate attitudes towards death in a group of injecting drug users (IDUs) and how such attitudes may impact upon the efficacy/relevance of 'safe using' (health promotion) messages. Injecting drug users (IDUs) experience higher rates of death and poorer health than their non-injecting peers. IDUs are between 6 and 20 times more likely to die than their non-heroin-using peers of the same age and gender [1]. Death due to suicide among heroin users occurs at 14 times the rate of matched peers [2]. At the time of this study, the number of deaths attributed to opioid overdose in Victoria had risen from 49 in 1991 to 331 in 2000.
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