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Adding life to years and years to life Delivering Effective Needle and Syringe Programmes Working With and Providing Services for Performance and Image.

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Presentation on theme: "Adding life to years and years to life Delivering Effective Needle and Syringe Programmes Working With and Providing Services for Performance and Image."— Presentation transcript:

1 Adding life to years and years to life Delivering Effective Needle and Syringe Programmes Working With and Providing Services for Performance and Image Enhancing Drug Users (PIEDs) Mark Harrison. Ralph Heron. County Durham Drug and Alcohol Action Team

2 Adding life to years and years to life DISCUS D RUGS I N S PORT C LINIC and U SERS S UPPORT The use of images in this presentation does not imply an individuals use of performance and image enhancing drugs, rather that they are used to depict the attainment of a desired physique and appearance of the individuals.

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6 Why DISCUS Need identified locally in % of needle exchanges were for PIED users April-Sept 07 43% all new registrations Prevention of blood borne viruses PIED users reluctant to approach existing drugs services Experience within gyms Gateway service focussing on harm reduction Some users collecting for up to 250 users

7 Adding life to years and years to life The DISCUS Team DISCUS Service User Clinic Co-ordinator R.M.O. 15 years old this year Nurse Sports DietitianSports Massage Onward Referral

8 Adding life to years and years to life Services Available 1 2 Hours per week Over 1000 individuals registered Informal and confidential Full range of needle exchange services Safer injecting advice Responsible Medical Officer Nursing assessment

9 Adding life to years and years to life Services Available 2 Specialist Dietician Hepatitis A and B vaccination Regular blood investigations ECG Body fat analysis BBV testing Referral on to other services if / when necessary

10 Adding life to years and years to life Services Available 3 Regular blood investigations FBC LFTs Cholesterol HDL/LDL Testosterone levels Thyroid Stimulating Hormone (TSH) Hepatitis Titre

11 Adding life to years and years to life DISCUS Activity Number of attendances 750 Number of Individuals 198 New Registrations 53 Needle Exchanges 225 Bloods Taken 154 Durham Harm Minimisation Services (April-September 07) 43% of all new registrations to all Harm Minimisation services were for PIEDs users.

12 Adding life to years and years to life DISCUS Gender Ratio Male 97% Female 3% Male Female DISCUS Gender Split Female 3% Male 97%

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14 Harm Minimisation S tart with lowest dose/stack possible O ptimise diet and training regimes U se low androgenic initially R egular investigations S hortest cycle possible with max. time clean U se your own, sterile injecting equipment C orrect injecting technique K now your source of gear

15 Adding life to years and years to life Creatine Monohydrate Acts as muscles capacitor Effective in 70% of users 5-7lb of lean muscle Each dose = 2lb steak Take in warm drink with 100g of carbohydrate Loading phase = 10g for 5/7 then 5g for 5/7 Maintenance phase = 2g daily

16 Adding life to years and years to life Style of PIED Use Style of usage – stacking style of cycle duration of cycle time off cycle Oral or I.M. ? 17 Alpha-Alkylation

17 Adding life to years and years to life Indications of Public Health in the English Regions IndicatorEnglandNorth East North West Yorkshire & Humber East midlands West Midlands East England LondonSouth East South West Rate per 1000 population who have used anabolic steroids ( ) Better than averageConsistent with averageWorse than average Rates of Performance and Image Enhancing Drugs Association of Public Health Observatories (2009) (from British Crime Survey)

18 Adding life to years and years to life Our Role (1) Drug misusers have the same entitlement as other patients to the services provided by the NHS. The General Medical Council has stated: The investigations or treatment you provide or arrange must be based on the assessment you and the patient make of their needs and priorities, and on your clinical judgement about the likely effectiveness of the treatment options. You must not refuse or delay treatment because you believe that a patients actions have contributed to their condition. Drug Misuse and Dependence: UK Guidelines on Clinical Management (2007)

19 Adding life to years and years to life Our Role (2) The General Medical Council has stated: You must treat your patients with respect whatever their life choices and beliefs. You must not unfairly discriminate against them by allowing your personal views (including your views about a patients lifestyle) to adversely affect your professional relationship with them or the treatment you provide or arrange. Where do PIED users fit into this guidance????

20 Adding life to years and years to life Recognition British Medical Association identified DISCUS as an example of good practice. (Pressure to Perform BMA 2001) October 2008 DISCUS presented to Advisory Council on the Misuse of Drugs (ACMD) and contributing to national review of PIEDs. Previous presentations at national injecting and PIED conferences.

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22 Contact Details Mark Harrison Joint Commissioning Manager Office: Mobile: Ralph Heron Development Manager Office: Mobile:


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