Illicit drug initiation among institutionalized drug users in China.

AIMS: To examine the circumstances and correlates associated with initiation of illicit drug use among institutionalized drug users in China.
DESIGN: Cross-sectional, retrospective study. SETTINGS: Six compulsory drug cessation programs in Yunnan Province and Gunagxi Zhuang Autonomous Region of China. PARTICIPANTS: A gender-stratified random sample of 833 drug users (88% males and 12% females) enrolled in compulsory drug cessation programs in November 1996. MEASUREMENTS: Circumstances of illicit drug initiation (age, type of drugs, routes of drug administration, social setting, source of drugs, reasons for drug use), the risk behaviors and risk perceptions prior to drug initiation.
FINDINGS: The majority of participants initiated drug use with heroin (90%). Initial drugs were frequently administered through sniffing/snorting (55%) and smoking cigarettes mixed with a drug (38%). First drug use occurred most commonly at a friend's home (65%) and in the company of other drug users (83%). Drugs were generally provided free for first-time use by other drug users (72%). Reasons for first drug use included experimentation (90%), being lured into drugs by other people (44%) and relaxation (42%). Most drug users had a history of regular cigarette smoking (89%), alcohol consumption (49%) and deviant behaviors (51%) prior to their drug initiation. The majority perceived that their friends (90%) and neighbors (88%) used illicit drugs.
CONCLUSIONS: The findings are similar to studies in western countries with respect to the pattern and correlates of illicit drug initiation, and underscore the need for drug prevention efforts in China.