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Abstract
Background: Needle fixation has the potential to undermine harm-reduction efforts and may affect up to one-quarter of all injecting drug users (IDUs). Being largely ignored in the extant literature, the majority of research on this phenomenon has been carried out exclusively in Cardiff, Wales. Objectives: The current exploratory study examined the applicability of needle fixation in a population of Australian IDUs to determine whether Australian IDUs were familiar with the behaviors and secondary gains that have been found to be associated with needle fixation and are assessed by the needle fixation profile (NEFPRO). Methods: A mixed-method design utilizing semi-structured interviews and questionnaire data was employed. Results: Australian IDUs were aware of or had experience with the behaviors and secondary gains that have been found to be associated with needle fixation. A number of other behaviors and secondary gains associated with injecting were discussed by participants during the semi-structured interviews. Conclusions/Importance: This study offers preliminary support for the use of NEFPRO as a clinical and research tool within Australia. To ensure that all avenues toward harm reduction are being explored, it would be fruitful to engage in further research concerning the cross-cultural representations of needle fixation specifically as well as the general influence of needle fixation in perpetuating injecting drug use.
THE AUTHORS
Scott Hinton is a clinical psychologist who received his bachelor's in psychology and master's in clinical psychology from the Central Queensland University. Throughout his career, Scott has maintained an interest in the field of addictions, especially psychotherapeutic treatment of addictions. For the past six years, Scott has worked for a government outpatient drug and alcohol treatment service in a regional town in Queensland, Australia.
Dr. Tania Signal comes originally from New Zealand where she received her PhD in psychology from Waikato University, working within the animal behavior and welfare research centre. In 2003, she moved to Australia and took up a lectureship at Central Queensland University. Now an associate professor, she has developed a comprehensive research program investigating a range of maladaptive behaviors ranging from interpersonal violence, deliberate harm to animals to substance abuse. Tania is a member of the Australian Animal Studies Group, the Queensland Centre for Domestic & Family Violence, the Appleton Institute, and a Charter Scholar Member of the Animals & Society Institute (USA). She is also on the editorial panel for the international journals, Society & Animals and Human-Animal Interaction Bulletin, and regularly reviews for a number of international journals in psychology and education.
Dr. Vanessa Ghea successfully completed a Certificate in Nursing in 1992. In 1997, she completed bachelor in arts degree (honors) majoring in psychology. In 2003, she was awarded her PhD in the area of health psychology. Vanessa is currently registered as a psychologist (general registration) with the Psychologists Board of Australia (AHPRA) and holds full membership of the Australian Psychological Society. She has been practicing and teaching as a psychologist since February 1998, with key interests in the area of health psychology and population health and well-being. Vanessa currently maintains a successful private clinical practice.
GLOSSARY
Blood-borne viruses: Viruses that are transmitted from the blood of one person to the blood of another person. Can occur when IDUs share injecting equipment. Of particular concern among IDUs are the hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV).
Harm reduction: Strategies and actions that are designed to reduce the adverse health, social, and economic consequences of drug use. For instance, transitioning to non-injecting routes of drug administration.
Injection-related infection: Infections that can occur during the process of injecting. Examples include cellulitis, abscesses, and thrombophlebitis. Injection-related infections can result from using non-sterile injecting equipment, injecting tablets, injecting frequently, poor hygiene practices such as not cleaning the skin adequately prior to injecting, and booting/flushing (i.e., after injecting the drug, the injector repeatedly draws blood into the syringe and injects it back into the vein).
Injection-related injury: Injuries that can occur during the process of injecting. Examples include bruising, scarring, swelling, collapsed veins, and arterial hemorrhage. Injection-related injury can result from poor injection technique, repeated injecting in the same site, use of a barbed or blunt needle, or missed veins.
Needle fixation: A behavioral pattern of repeatedly injecting in response to a subjective sense of compulsion. Needle fixation is believed to arise out of a process of classical and operant conditioning, and has been found to be associated with various behaviors (i.e., flushing and injecting non-psychoactive substances) and secondary gains (i.e., sexual satisfaction and pain).