© 2006 The Royal College of Psychiatrists
© 2006 The Royal College of Psychiatrists
Injecting Illicit Drugs
Department of Psychiatry, Queen Elizabeth Psychiatric Hospital, Edgbaston, Birmingham B15 2QZ, email: e.j.day{at}bham.ac.uk
Richard Pates, Andrew McBride & Karin Arnold (eds)
Oxford: Blackwell, 2005, £35.00 pb, 200 pp. ISBN: 1-4051-1360-X
The use of illicit substances is a subject that generates considerable interest in both the general and medical media. The act of injecting is one of the core features of the ‘junkie’ in the minds of the general public, and has been popularised (and to some extent glamorised) by films such as Trainspotting. In the 1980s the association between injecting and the spread of HIV was the stimulus for increased interest in harm reduction strategies in the UK, and the impetus for an increase in funding for drug treatment services. Latterly, injecting has been discussed in the context of a rise in drug-related deaths, and there has been interest in providing injecting rooms as a harm reduction measure.
Users of illicit substances have a complex relationship with injecting as a form of drug administration. There is huge variability between the prevalence of injecting within the UK itself, with about half of the heroin users in London utilising this route compared with about a fifth in Birmingham. The pathway to injecting is not a straightforward one for many users, and is influenced by a complex mix of cultural pressures, market forces, physical health and psychological factors. The latter includes the user’s self-perception or sense of engagement in the drug scene, and the process may require a desensitisation to the process of injecting.
This interesting and varied book is therefore timely, particularly as the editors believe that it is ‘the first book ever compiled that focuses specifically on injecting drug use and the health consequences of this behaviour’. It gathers together the work of experts from a variety of backgrounds, and in doing so avoids presenting an overly medical focus on the subject. The book goes beyond the standard issues such as the spread of blood-borne viruses and the risk of overdose, and highlights historical, ethnographic and sociological perspectives on injecting. It accepts that ‘injectors’ are a heterogeneous group, and brings out the unique aspects of particular groups such as women and those in prison. Practical information is distilled from a large literature on safer injecting and individual harm reduction advice, and the issue of ‘needle fixation’ is comprehensively covered. The book ends with an interesting user perspective. It is a readable and informative book that will benefit anyone with an interest in public health or the treatment of drug misuse problems.
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