A qualitative study of methamphetamine initiation among Chinese male users: Patterns and policy implications

China is a major producer and distributor of methamphetamine (meth) worldwide. Within the last two decades, China has seen rapid growth in meth use, especially among young men. However, patterns of Chinese male users' initiation of meth is rarely explored. To address this void in the literature, this study adopts China's mian'zi culture to explore Chinese male meth users' initiation patterns qualitatively. Semi-structured interviews were conducted with 35 male meth users from seven Chinese compulsory drug treatment institutions. Thematic analysis was applied to data analysis. Most participants reported their beginning to use meth as a strategy or approach to handling peer influence stemming from structured social networking. The motivation to have fun with friends, colleagues, or business fellows to maintain these people's mian'zi, together with the curiosity about meth and lack of understanding that meth is a potentially addictive drug, contribute to male users' meth initiation. Moreover, we found that most male meth users' initiation occurs in enclosed locations, such as nightclubs, karaoke rooms, hotels, and private residences because these locations were considered "safe." Additionally, some participants initiated meth use because they perceived it could be a way of harm reduction from heroin or alcoholism. However, such perception neglects the harmful outcomes of the concomitant use of meth with other drugs or alcohol. We suggested social support programs for young Chinese men who are located in high-risk social networking where meth use is accepted as a way of interaction. Up-to-date drug education on meth is also necessary for school students, and mass media could play its role in educating the public about potential risks of meth use.