title: Why some injection drug users lick their needles: a preliminary survey.
abstract: BACKGROUND
  Injection drug users (IDUs) with poor hygiene practices are at risk for infection with their commensal flora. One example of a poor hygiene practice is licking the needle prior to injecting the drug. There are few published reports addressing the proportion of IDUs who lick their needles prior to injection and no prior studies evaluating the reasons for this practice.
  
  
  METHODS
  We conducted face-to-face interviews with 40 IDUs admitted to the internal medicine service at our institution. We collected data regarding whether the subject licked the needle before injecting drugs, whether the subject licked the injection site before or after injecting drugs, and the reasons they report for doing so.
  
  
  RESULTS
  Thirteen (32.5%, 95% CI, 18.6-49.1) of 40 subjects reported licking their needles prior to injecting. Reasons included ritualistic practices, cleaning the needle, enjoying the taste of the drug, checking the "quality" of the drug, and checking that the needle was in usable condition.
  
  
  CONCLUSIONS
  In our study, approximately one-third of IDUs licked their needles prior to injecting. More data are needed to demonstrate whether the practice of needle licking significantly increases a person's risk for infection with oropharyngeal flora. Medical providers should ask patients about specific practices surrounding injection drug use, and educate drug users about avoiding unhygienic injection practices.
authors.affiliation: Beth Israel Medical Center, Division of Infectious Diseases, First Avenue at 16th Street, 19 Baird Hall, New York, NY 10003, USA. mdeutsch@chpnet.org
authors.forename: Meredith
authors.initials: M
authors.lastname: Deutscher
authors.forename: David C
authors.initials: DC
authors.lastname: Perlman
mesh_terms: D000328:Adult; D004866:Equipment Contamination; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D009519:New York City; D018570:Risk Assessment; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D011795:Surveys and Questionnaires