For health promotion policy purposes, switches towards and away from injecting as well as switches towards or away from an opiate are of great importance. The Asian Harm Reduction Network embarked upon a multi-site research conducted in four countries in Asia including Iran to gain insight in drug careers of young people and the impact of the environment. This article is the abridged synthesis of Tehran research report on description of the typical circumstances surrounding initial drug use in young people.

It was a qualitative research whose data were gathered through analysis of existing data; interviews with key informants; focus group discussions with family members, PUD (Person using drugs), service providers, policy makers, law enforcement officers; and a quantitative survey with 281 PUDs.

Drug careers of young people tend to be dynamic and changeable. 26% switched towards an opiate and 50% of the respondents switched towards injecting at some stage in one's career. Expectedly, the occurrence of positive switches is low, compared to negative counterparts, yet maybe not as low as one might have expected. Shifts from one drug to the other as well as from one mode of intake to the other occur regularly and sometimes very quickly. More than 40% of the respondents switched to injecting after having used other modes of intake for more than five years.

Effectively targeting the period between the onset of drug use and switching to injecting for secondary prevention and harm reduction interventions might help PUDs.