Distribution of intravenous injection of heroin in France

Heroin use depends on numerous routes of administration. This substance can be ingested, sniffed (nasal route), injected, or smoked (pulmonary route). For each individual, these routes are not interchangeable or equivalent in terms of risks, as well as they do not lead to similar consequences. When it comes to heroin, each route of administration presents risks and can result in specific pathologies.

The intravenous injection appears to be the most dangerous of all. In France, the intravenous injection is most prominent, whereas in other European countries alternative modes, less risky in terms of public health, have emerged.

Considering a given period and a given geographical area, why do users “choose” a specific mode of administration, whereas others “choose” another one for the same substance?

That question has been debated throughout surveys and publications; the international book review provide information about determining factors likely to favour or block off the transition between whatever heroin-related route of administration. 

The main determining factors can be listed as follows: 

• the effects users are searching for; 
• the making-up, the purity degree, and the form of heroin available; - the cost of the substance; 
• the consumption habits in whatever group the user is belonging to.