Injection drug use is a key risk factor for overdose death, so preventing people from initiating injection drug use would reduce the unacceptably high death toll due to the opioid overdose epidemic. At present, though, there are no approaches to preventing people from starting to inject drugs that are both effective and scalable. However, scientific evidence suggests that people who already inject drugs are often asked to facilitate the entry of others into drug injecting. Preventing this phenomenon could ultimately lead to fewer cases of injection drug use initiation.

The overall goal of the PRIMER study is therefore to investigate whether a range of existing interventions such as medication-assisted treatment for opioid use disorder, harm reduction access, and alternatives to the incarceration of people who inject drugs may have a secondary preventive impact on the likelihood that they are asked to assist in injection drug use initiation events.