Transition to and away from injecting drug use among young drug users in Tehran,Iran: A qualitative study

Background: iran has a large population of non-injection opioid users potentially at risk of initiation of drug injection. objective:weimplementedaqualitative study to characterize the factors facilitating transitionfromnon-injectiondruguse (nidu) to injection drug use (idu) and vice versa. materials and methods:we conducted 42 in-depth interviews among purposefully selected groups of injecting and non-injecting drug users and health workers,in 2011 in tehran,iran. the interviews were audio-recorded,transcribed and coded using opencode 3.6 software. results: the predominant factor for transition from nidu to idu was a high level of drug dependence. idu decreased the cost associated with drug use by several fold in the short-term. the influence of other injectors,either by learning directly from,encouraged by,feeling coerced by,or identifying with a lifestyle was also mentioned as a causal factor in the transition to idu. pleasure-seeking or desire to experience an immediate rush were rarely reported; rather,themes of the need to maintain functionality,reduce pain,and overcome financial difficulties emerged. vein damage and other idu-related physical health problems,as well as pressure from family were reasons for reverse transition (idu to nidu). conclusions: new harm reduction approaches could focus on blocking the transition from nidu to injection and promoting the return to less harmful routes of administration. © 2016,mazandaran university of medical sciences.