The Importance of Perceived Safety, Stigma and Pleasure for Solitary Injecting

Abstract

Many people who inject drugs (PWID) inject when they are alone which increases the risk for drug-related mortality, and the majority of overdose-related deaths occur among solitary users in residential environments. Drawing on qualitative data from interviews with 80 PWID in Norway, this study explores the complex practices of solitary injecting. The analysis illustrates that the risk environments in which they participated involved high levels of distress, fear and stigma that made them prefer solitary injecting. This involved a perceived notion of safety from an unpredictable social environment. Stigma was described as causing additional harms and they therefore wanted to hide their drug-using practices. Finally, injecting drug use involved contextual pleasures that were maximised by injecting alone. The study illustrates how the risk environment the PWID inhabited caused additional harms, by which solitary injections was rationalized, despite its increased mortality risks. Future harm-reduction initiatives should reflect this important aspect.