Abstract
Injecting is an important cause of viral and bacterial infection among drug users and is also associated with increased risk of overdose and severe dependence. 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 attention has been paid to reducing injecting (rather than drug use) as a policy objective. This paper reviews a range of 'route transition interventions' (RTIs) that can be used to reduce injecting and its associated harms. Two points for intervention are distinguished: preventing injecting among existing non-injecting drug users and promoting the transition away from injecting among current injectors. Targets for basic research and programme evaluation are discussed. In particular, it is argued that the time is now right for regional or national case studies that investigate how injecting can be reduced.