Barriers to Safer Injection Practices Faced by People Who Use Injection Drugs, in Vancouver and Abbotsford, B.C.

Shannon Grant, Tracy Tan, Alexis Crabtree, Gareth Mercer, Robert Horan, Jane A. Buxton. UBCMJ 2013 4(2):10-13.

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ABSTRACT
Objective: Obstacles are often put in place to discourage users of injection drugs from using public facilities to inject. These include
frequent security patrols, locked washroom facilities, and blue lights designed to obstruct the visualization of veins. Unfortunately, these
interventions may have the unintended consequence of increasing the risks inherent to injecting drugs. We discuss these barriers and
argue that they should be addressed to mitigate risk.
Methods: We interviewed 18 individuals who were previous or current users of injection drugs, with the goal of discussing the placement
of blue lights in public washrooms and its impact on their ability to safely inject.
Results: Interviewees described the factors involved in selecting a location to inject. Factors that negatively influenced comfort tended
to increase the likelihood of missing veins and of the need for multiple tries. These factors included: person–related factors, such as the
presence of authority figures or uninvolved members of the public; environmental factors, such as the level of light and temperature; and
personal issues such as the depth, size, or condition of veins.
Conclusions: While harm reduction education and the discussion of intentional barriers to the safe use of injection drugs are certainly
beneficial, many physical and societal obstacles prevent users of injection drugs from using their preferred, often safer methods.
KEYWORDS: harm reduction, injection drug use, public injection