Factors associated with recent-onset injection drug use among drug users in Pakistan

Irene Kuo, Salman Ul-Hasan, Tariq Zafar, Noya Galai, Susan G. Sherman, Steffanie A. Strathdee

Research output: Contribution to journalArticlepeer-review


Seventy-two recent-onset injection drug users and 241 non-injection drug users were recruited in Quetta and Lahore, Pakistan, in 2003. Trained interviewers administered questionnaires regarding drug use behaviors and perceived changes in drug cost/supply. Logistic regression identified independent correlates of recent-onset injection. In Lahore, a perceived increase in drug cost was associated with higher odds of recent-onset injection, with no association in Quetta. Recent-onset injection was also associated with family history of drug use, group drug use, and sharing snorting/chasing tools. Changes in perception of the drug supply may be associated with recent-onset injection drug use. Familial/social influences were also associated with recent-onset injection, suggesting peer-led interventions could discourage transition to injection drug use.

Original languageEnglish
Pages (from-to)853-870
Number of pages18
JournalSubstance Use and Misuse
Issue number5
StatePublished - Apr 2007
Externally publishedYes

Bibliographical note

Funding Information:
The authors acknowledge funding from the National Institute on Drug Abuse in the form of an administrative supplement to grant DA09225 and from a National Scholars Research Award grant DA15291. We also thank the following staff members of the Nai Zindagi organization, who are dedicated to the provision of drug treatment and harm reduction services to the drug users in Pakistan, for the conduct of this study: Ghaznafar Imam and Ahmed Bakhsh at the Nai Zindagi main office; interviewers Jawad Akhtar, Dr. Faisal Khan, Syed Nauman, Muhammad Aslam, Mohammad Zulfiqar, Dr. Sharfiq, Amir Rehman, Syed Abdul Ali, Dr. Ziauddin, Dr. Rozi Kakar, Ihsan Danish, Ghazanfar Ali; and laboratory directors Shahid Abassi and Mateen Izhar. We would also like to thank the study participants, without whom this study would not be possible.


  • "Chasing the dragon"
  • Drop-in-centers
  • Drug cost
  • Drug supply
  • Group drug use
  • Harm reduction
  • Heroin
  • Injection drug use
  • Injection initiation
  • Pakistan
  • Snorting
  • Trafficking routes
  • Transit route

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health
  • Medicine (miscellaneous)


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