Preventing and curtailing injecting drug use: a review of opportunities for developing and delivering 'route transition interventions'

Injecting is an important cause of viral and bacterial infection among drug users and is also associated with increased risk of overdose and severe de pendence. Even when aggregate numbers of illicit drug users remain constant , significant health and social benefits may be achieved by a reduction in the prevalence and/or frequency of injecting. Yet, to date, little attentio n has been paid to reducing injecting (rather than drug use) as a policy ob jective. This paper reviews a range of 'route transition interventions' (RT Is) that can be used to reduce injecting and its associated harms. Two poin ts for interventions' are distinguished: preventing injecting among existin g non-injecting drug users and promoting the transition away from injecting among current injectors. Targets for basic research and programme evaluati on are discussed. In particular, it is argued that the time is now right fo r regional or national case studies that investigate how injecting can be r educed.