Injecting drug use and unstable housing: Scope for structural interventions in harm reduction

摘要

Evidence links unstable housing, and especially homelessness, with elevated health harm among drug users, including riskier drug injecting practices. We undertook 45 in-depth qualitative interviews with injecting drug users (IDUs) in Bristol and London in 2006. IDUs were recruited through drug user networks and drug agencies. Temporary accommodation and hostels for the homeless may provide a ‘safe haven’ from street-based drug use and public injecting environments, and are characterised as a retreat from the ‘chaos’ of the street. But hostels may also constitute ‘risk environments’ in facilitating drug using and risk networks, transitions to new patterns of use, including increased frequency of injecting. For some, homelessness was positioned as ‘safer’ than temporary housing with regards to managing drug use. Stable housing emerges as a key structural factor in creating enabling environments for health. We emphasise that temporary accommodation hostels have potential for harm-reduction interventions, but may also be associated with the production of risk related to drug use and injecting.