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1 John Campbell. 2 Poor UK survey Data Small area or location studies Glasgow accurate NEO data.

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Presentation on theme: "1 John Campbell. 2 Poor UK survey Data Small area or location studies Glasgow accurate NEO data."— Presentation transcript:

1 1 John Campbell

2 2

3 Poor UK survey Data Small area or location studies Glasgow accurate NEO data


5 Steroid use 'on par with heroin' 2007 Steroid use may be more than twice as common as official figures suggest, a leading expert has told the BBC. According to the British Crime Survey there are 42,000 regular anabolic steroid users in the UK. Drugs expert Jim McVeigh said there could be as many as 100,000. "Basically we're looking at numbers being on a par with heroin users," he added. One treatment centre in Merseyside reports that steroid use has rocketed in the last three years. Staff now treat four new steroid users for every new heroin user - a reversal of the situation in There is a particular problem with users aged under 25.

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7 7 New Registrations GDCC 2012 – 2013 (drugs injected)

8 Established in 2009 Drop in service – 1 evening per week Staffed by 2 workers and nurse ( supported by lead medical officer) Based in the GDCC and supported by Turning Point 8

9 To provide a specialised and accessible service. To raise the awareness of the risk of BBV (Blood borne virus) and related infections. To identify other harms and complications Provide alternatives to PIEDs use To improve injecting techniques To direct individuals to their local pharmacy needle exchanges for future transactions. 9


11 SUCCESSFUL UNSUCCESSFUL Referrals from other exchanges Gym buddies Dealers Forums Gym owners Supplement Stores Poster displays 11

12 Needles and paraphernalia provision, including water for injection. Consultations/assessments Discussions on; harmful doses, understanding labels and syringe markings Safer injecting advice and demonstrations Alternatives such as diet and exercise Wound identification Product identification Blood tests 12

13 13 Date Collected HIV NEG HEP B NEG HEP C NEG Test Declined No Abnormal U&E No Yes No Abnormal LFT No Yes No Yes No Abnormal Cholestrol No Yes No Yes No Abnormal Hormones Yes Repeat Test No


15 SIMILARITIESDIFFERENCES Stigma Method of administration Poly drug use How bought Dependency Self perception How bought Legality Self welfare Social status? Ratio of men to women No instant gratification 15

16 They are synthetically produced variants of the naturally occurring male sex hormone testosterone. Anabolic refers to muscle- building, and androgenic refers to increased male sexual characteristics. Steroids refers to the class of drugs. These drugs can be legally prescribed to treat conditions resulting from steroid hormone deficiency, such as delayed puberty, as well as diseases that result in loss of lean muscle mass, such as cancer and AIDS.


18 18 Natural Test production

19 Anabolic/Androgenic steroids : to increase bulk, strength and power Oestrogen-blockers: to block symptoms of feminisation Diuretics: to remove excess water Fat-burners: to remove excess fat and cut up Growth Enhancers: to promote new cell growth Post-cycle treatments: to stimulate natural testosterone production Injectable tanning agents: to stimulate pigmentation

20 Sustanon 250/Omnadren (sust) Testosterone Cypionate (cyp) Testosterone Enanthate (test) Testosterone Propionate (prop) Trenbolone (tren) Nandrolone (Deca Durabolin deca) Stanozolol solution (Winstrol winny) Methenolone (primobolan primo) Boldenone (equipoise) Various blends emerging

21 Testosterone Undecanoate (andriol) Oxymetholone (Anadrol/oxies) Oxandrolone (oxandrin - Anavar) Methandrostenolone (Dianabol d-bol) Stanozolol tablets (Winstrol winny) ORAL STEROIDS CAN BE MORE HARMFUL THAN INJECTABLES


23 Pharmaceutical grade Good quality but often low in strength and amounts Underground May be poor quality/unsterile often high concentrations Veterinarian Not designed for human use Counterfeit Often contain no active product and may be unsafe

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25 Miscellaneous Human Growth Hormone GHRP 2 & 6 CJC 1295 LR3 IGF -1 Insulin Melanotan 1&2 Fat Burners Ephedrine Clenbuterol T3 T4 ECA stack Anti-estrogen & PCT Human Chorionic Gonadotrophin Nolvadex (tamoxifen) Clomid Citrate Arimidex Letrozole Viagra

26 hGH (and the IGF-1 that is a result of its use) is the only substance that can actually initiate hyperplasia ( new cells). GH is produced by the pituitary, IGF-1 is produced primarily by the liver in response to GH It requires careful storage, handling and preparation Many newer peptides also work in a similar way

27 Melanotan is a hormone that stimulates melanin production Other reported benefits: weight loss increased libido healthy spot free skin

28 Stacking: taking several different steroids at the same time Cycling: taking multiple doses over a period of weeks or months, stopping, then starting again. Pyramiding: slowly increasing amount of steroids taken over 6- 12wks, then decreasing the amount slowly Addictive behavioural patterns are easily identifiable

29 29 Cost £200 Cost £50Cost £45

30 30 Cost £320Cost £80Cost £160Cost £100Cost £1000Cost £70

31 After the cycle comes the crash The body enters a catabolic state Testes become de-sensitised FSH and LH are not produced/released Estrogen level rise Lethargy and low mood can set in 31

32 32 8 Week Cycle

33 An unproven and unfounded assumption has been made in the medical establishment that the treatment for an individual suffering from ASIH is to do nothing which is coined watchful waiting and in time HPTA functioning will return to normal Doctors appear to be treating the symptoms of low test, not the cause 33

34 Idea is to accelerate and restore the bodys endogenous test production There are many different views on how this can be achieved However, most involve the same drugs……….. 34

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37 One of the most detrimental thing that could happen is the stunting of growth plates Other complications involve extreme bone pain, liver toxicity, vascular damage, kidney damage, and joint problems

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39 Changes in the reproductive system Birth defects (virilisation of female foetus) Development of a more masculine physique, shrinkage of the breast tissue, deepening of the voice, male pattern baldness and coarse skin.

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41 Shrinking of the testicles - temporary Reduced sperm count - infertility Sexual dysfunction Prostate enlargement Baldness Gynaecomastia - development of breasts

42 Acne High Blood Pressure Mood swings Jaundice/liver damage Pain in the joints (esp with Winny or hGH) Urinary problems Increases in LDL (bad cholesterol) and decreases in HDL (good cholesterol) Modification in the left ventricle of the heart, with serious implications Increased risk of developing heart related complications/stroke

43 DSM IV - Drug dependency occurs if: The drug is taken higher doses or for longer than intended Unsuccessful efforts to stop or cut down Excessive time spent obtaining or using the substance Important activities are given up Continued use despite negative health effects Need for higher amounts to be taken for the desired effect Withdrawal symptoms occur 43

44 If people are addicted to using these substances what interventions may help? Do we work with PIEDs users in the same way as we would other drug users? If we need to change our approach how do we do this? 44

45 Talking therapies Continued use due to fear of muscle loss – CBT Dealing with steroid cravings – Relapse Prevention Unwillingness to stop - MI Medical interventions Depression post cycle – antidepressants Loss of sexual function - Viagra Hypogonadism – HCG & Clomid 45

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