Drug workers and nurses working in harm reduction will need a “whole new set of skills” to respond to the huge increase in anabolic steroid users attending needle exchanges, experts have reported.
Over the past five years, needle exchanges in Cheshire, Manchester and Merseyside have seen steroid users overtake recreational drug users as their main client group.
Figures are not collected nationally, but Jim McVeigh, deputy director of the Liverpool John Moores University Centre for Public Health, said other parts of the country were also seeing significant increases in steroid user attendances.
Whereas in the 1990s most steroid users at needle exchanges were professional bodybuilders, drug workers are now reporting a higher proportion of younger users – some in their late teens – using higher doses.
Mr McVeigh said a key challenge this posed for drug workers and nurses in harm reduction was to find appropriate ways of engaging with these users. “For people who have spent many years working in needle exchange programmes with opiate users or stimulant users, this is a completely different patient population,” he said.
“Their motivations for using drugs, the health problems they may face, even the way the drugs are administered are very different. It’s a whole new set of skills [for health workers].”
Colin Tyrie, senior public health development advisor at Manchester Mental Health and Social Care Trust, agreed. “If somebody comes to me and says I’m injecting insulin… and I’m injecting growth hormone, and I’m injecting Melanotan [an injectable tanning agent], and I don’t understand why they might be doing that then I’ve lost the opportunity for an intervention.”
About two years ago the trust opened the Pump Clinic, one of a few needle exchanges in the country specifically targeting steroid users.
“The service users we were seeing didn’t feel [traditional] needle exchange worked for them,” he said. “They were getting their equipment but they didn’t want to talk to people in the field.” Alongside needles, the centre offers users tests for testosterone and cholesterol levels, and for liver and thyroid function. “The challenge for nurses and drug workers in the field is to try to respond to these users in a way that shows some credibility,” said Mr Tyrie.