Scapegoating, self-confidence and risk comparison: The functionality of risk neutralisation and lay epidemiology by injecting drug users

This paper investigates the competing rationalities of scientific and lay epidemiology and how the tension between the two impacts on the efficacy of health promotion messages for injecting drug users (IDUs). It proposes that behaviours, which may be difficult to understand when viewed at an individual level, are, in fact, rational within particular cultural contexts. The study used qualitative semi-structured interviews with 60 heroin users. A number of different types of risk neutralisation were observed in this group of interviewees, including: scapegoating, self-confidence and risk comparison. Interviewees commonly used lay epidemiology to justify and rationalise their risk neutralisation strategies. The paper provides concrete examples of the ways in which this group of IDUs neutralise risk through the use of these strategies. The findings illustrate how many of the psychological constructs surrounding the perception of risk which focus on individual behaviour are fundamentally simplistic and often unhelpful in understanding the behaviours of this group of people. It is concluded that some ‘risk’ behaviours are often functional and rational within the context of prohibitionist drug policies which create an environment in which the IDU often has little real agency to reduce the risks associated with their drug use.