The 'do-it-yourself' New Zealand injecting scene: implications for harm reduction

Area of Science:

• Drug Policy
• Public Health
• Addiction Studies

Background:

• Krokodil, a homemade injectable opioid, causes severe harm among people who inject drugs (PWID) in Eurasia.
• The rise of illicit, injectable opiates presents challenges for harm reduction, particularly in restrictive regulatory settings.
• Limited access to Opioid Substitution Treatment (OST) exacerbates the risks associated with non-prescribed opioid use.

Purpose of the Study:

• To address the challenges of minimizing harm from home-produced injectable opioids in environments with restricted OST access.
• To explore potential harm reduction strategies and alternatives to OST for people who inject drugs using illicit opiates.
• To present a case study from New Zealand on the use of home-produced injectable opioids.

Main Methods:

• Review of existing literature on krokodil and harm reduction policies.
• Analysis of the challenges posed by restrictive regulatory environments on harm reduction initiatives.
• Case study examination of home-produced injectable opioid use in New Zealand.

Main Results:

• Restrictive policies limit the implementation of effective harm reduction strategies like OST.
• Alternative harm reduction approaches are needed in contexts where OST is unavailable or inaccessible.
• The New Zealand case provides insights into managing risks associated with illicit injectable opioid use.

Conclusions:

• Harm reduction policies must adapt to the realities of illicit injectable opioid use, even in restrictive settings.
• Exploring and implementing alternative harm reduction interventions is crucial for PWID when OST is limited.
• Further research into non-OST harm reduction strategies for users of home-produced opioids is warranted.