Through their eyes: A community's perception of injection drug users and subsequent harm reduction strategies

Heroin and other illicit drug use are a significant public health issue. Injection drug use is of particular concern with its connection to HIV and Hepatitis C transmission. Beyond the severe health consequences, the depletion of social resources, productivity loss, increased crime, mental and physical disabilities and the potential of involvement in other illegal activities exist. Community perceptions regarding injection drug use and the possible needle exchange programs were examined through a qualitative study which included more than 20 key informant and in-depth interviews conducted in a southern California area. Key informant and in-depth interviews targeted local law enforcement, faith communities, pharmacies, faith/non faith-centered rehabilitation centers. Interviews were transcribed and content analyzed for emerging theses using grounded theory methods. Interview questions explored community perceptions around of the basic components of a needle exchange programs, challenges, benefits and placement of a local needle exchange program and efficacy of such programs. Themes emerged around lack of clarity and understanding of what needle programs encompass and consist of, and needle exchange program's influence on drug use. Findings indicate that there are still strides to be made in communities regarding harm reduction programs, including needle exchange programs. It is important for programs to inform community members with complete and accurate information about “best practices”, program outcomes and successes of recovering users. Themes emerging from this qualitative study can be useful in the planning efforts of public health programs.