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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

Kim Akrigg, Luke Cox Orcid Logo, Luke A. Turnock, Andrew Richardson, Timothy Piatkowski

Drugs: Education, Prevention and Policy, Volume: 33, Issue: 1, Pages: 91 - 102

Swansea University Author: Luke Cox Orcid Logo

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DOI (Published version): 10.1080/09687637.2025.2481292

Abstract

IntroductionInsulin 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 practi...

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Published in: Drugs: Education, Prevention and Policy
ISSN: 0968-7637 1465-3370
Published: Informa UK Limited 2026
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa70009
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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.MethodSemi-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.ResultsThe study involved an international cohort of 14 participants (13 men, 1 woman, aged 25-45, M&#x2009;=&#x2009;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.DiscussionThis research underscores the importance of community-care in harm reduction and challenges individualised models of risk management. 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spelling 2026-01-23T11:55:42.1474754 v2 70009 2025-07-21 If you find me on the floor, stick some sugar in my mouth: The social production (and protection) of insulin risk among IPED communities 9811ac84cad867903c385bf7086dfd2d 0000-0001-7625-4603 Luke Cox Luke Cox true false 2025-07-21 EAAS IntroductionInsulin 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.MethodSemi-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.ResultsThe study involved an international cohort of 14 participants (13 men, 1 woman, aged 25-45, 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.DiscussionThis 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. Journal Article Drugs: Education, Prevention and Policy 33 1 91 102 Informa UK Limited 0968-7637 1465-3370 community care; image and performance enhancing drugs; insulin; risk environment; social protection 2 1 2026 2026-01-02 10.1080/09687637.2025.2481292 COLLEGE NANME Engineering and Applied Sciences School COLLEGE CODE EAAS Swansea University Another institution paid the OA fee The author(s) reported there is no funding associated with the work featured in this article. 2026-01-23T11:55:42.1474754 2025-07-21T15:11:26.3863673 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Kim Akrigg 1 Luke Cox 0000-0001-7625-4603 2 Luke A. Turnock 3 Andrew Richardson 4 Timothy Piatkowski 5 70009__34811__cf2ad8d5af9d4dbfa1ce3f23acd0862f.pdf 70009.pdf 2025-07-21T15:13:34.3230508 Output 1098138 application/pdf Version of Record true © 2025 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution License. true eng http://creativecommons.org/licenses/by/4.0/
title If you find me on the floor, stick some sugar in my mouth: The social production (and protection) of insulin risk among IPED communities
spellingShingle If you find me on the floor, stick some sugar in my mouth: The social production (and protection) of insulin risk among IPED communities
Luke Cox
title_short If you find me on the floor, stick some sugar in my mouth: The social production (and protection) of insulin risk among IPED communities
title_full If you find me on the floor, stick some sugar in my mouth: The social production (and protection) of insulin risk among IPED communities
title_fullStr If you find me on the floor, stick some sugar in my mouth: The social production (and protection) of insulin risk among IPED communities
title_full_unstemmed If you find me on the floor, stick some sugar in my mouth: The social production (and protection) of insulin risk among IPED communities
title_sort If you find me on the floor, stick some sugar in my mouth: The social production (and protection) of insulin risk among IPED communities
author_id_str_mv 9811ac84cad867903c385bf7086dfd2d
author_id_fullname_str_mv 9811ac84cad867903c385bf7086dfd2d_***_Luke Cox
author Luke Cox
author2 Kim Akrigg
Luke Cox
Luke A. Turnock
Andrew Richardson
Timothy Piatkowski
format Journal article
container_title Drugs: Education, Prevention and Policy
container_volume 33
container_issue 1
container_start_page 91
publishDate 2026
institution Swansea University
issn 0968-7637
1465-3370
doi_str_mv 10.1080/09687637.2025.2481292
publisher Informa UK Limited
college_str Faculty of Science and Engineering
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hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
document_store_str 1
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description IntroductionInsulin 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.MethodSemi-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.ResultsThe study involved an international cohort of 14 participants (13 men, 1 woman, aged 25-45, 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.DiscussionThis 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.
published_date 2026-01-02T05:31:42Z
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