Preventing Injection by Modifying Existing Responses

A global, evidence-based approach to prevent injection drug use initiation

PRIMER (Preventing Injecting by Modifying Existing Responses) is a multi-country mixed methods study with the aim of identifying whether specific interventions and factors influence the risk that individuals begin injecting drugs.

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.

PRIMER pools qualitative and quantitative data from cohorts of people who use drugs across seven different cities: Vancouver, Canada; San Diego, USA; Tijuana, Mexico; Paris, Marseille, Bordeaux and Strasbourg, France.

PRIMER is the largest study of injection drug use initiation (n = 3,850) and is the first to examine structural responses to preventing injection initiation. Findings can potentially improve the development and scaling up of interventions to reduce transitions into injection drug use.

PRIMER is primarily supported by the U.S. National Institute on Drug Abuse via an Avenir Award. Additional support comes from the Canadian Institutes of Health Research and the Government of Ontario’s Ministry of Research, Innovation and Science.

Read about our Team

Read about our Rationale

Read about our Findings

A global, evidence-based approach on drug use.


© 2019 PRIMER