Towards an holistic understanding of injecting drug use: An overview of needle fixation

Aims. To establish the existence of needle fixation and provide a theoretic al explanation for the phenomenon. Method. By searching published literatur e using electronic searches, consulting a National Drug Library (ISDD) and snowballing from reference lists in publications related to addiction. Find ings. Needle fixation as a phenomenon has been mentioned in the literature since at least 1929 but there is only one published paper devoted to it. Ne edle fixation is a conditioned response but with a number of different seco ndary gains which maintain the practice. These include ritual, substitution of non psychoactive substances in the absence of drugs, pain, sexual pleas ure and status. Conclusions. Needle fixation should be taken seriously beca use of the concern about blood borne viruses among injecting drug users and the need to reduce the practice of injecting. A greater understanding of t he problem will help in treatment of injecting drug users.