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If you find me on the floor, stick some sugar in my mouth: The social production (and protection) of insulin risk among IPED communities

Lookup NU author(s): Andrew RichardsonORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

Introduction: Insulin is used among image and performance enhancing drug (IPED) communities for its anabolic effects, but its use carries significant risks, with the acute danger being hypoglycaemia, which can be life-threatening if not properly managed. Within these communities, harm reduction practices and informal peer knowledge exchange play a critical role in the way substances are consumed. This qualitative study sought to understand these community practices regarding non-medical insulin use among people who use IPEDs. Method: Semi-structured interviews were conducted with people who use IPEDs, and specifically, insulin. Participants were asked about their risk practices, harm reduction strategies, and the community dynamics that shape their use of insulin. Our analysis centred on how social and material networks of peers, technologies, and information flows contribute to the social production and protection of risk. Results: The study involved an international cohort of 14 participants (13 men, 1 woman, aged25-45, M = 33.34) who used insulin for non-medical purposes. The analysis revealed two themes: Intersecting Risks, which encompassed the physical, psychosocial, and self-imposed risks associated with insulin use, and Social Protection of Risks, focusing on community-driven harm reduction strategies. People who use insulin actively construct risk through community-driven knowledge and informal education. Social protection is facilitated through peer networks, where harm reduction strategies are shared. Discussion: This research underscores the importance of community-care in harm reduction and challenges individualised models of risk management. It highlights the need for community-centred health interventions that recognise the relational dynamics of risk management among IPED-using communities

Publication metadata

Author(s): Akrigg K, Cox L, Turnock L, Richardson A, Piatkowski T

Publication type: Article

Publication status: Published

Journal: Drugs: Education, Prevention and Policy

Year: 2026

Volume: 33

Issue: 1

Pages: 91-102

Online publication date: 21/03/2025

Acceptance date: 10/03/2025

Date deposited: 07/01/2026

ISSN (print): 0968-7637

ISSN (electronic): 1465-3370

Publisher: Taylor & Francis

URL: https://doi.org/10.1080/09687637.2025.2481292

DOI: 10.1080/09687637.2025.2481292

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