Secondary distribution of injecting equipment obtained from needle and syringe programmes by people injecting image and performance enhancing drugs: England and Wales, 2012-15

Glass, Rachel; Hope, Vivian; Njoroge, Jacquelyn; Edmundson, Claire; Smith, Josie; McVeigh, Jim; Parry, John; Desai, Monica

doi:10.1016/j.drugalcdep.2018.11.021

Cited by 13 publications

(20 citation statements)

References 22 publications

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“…Harm reduction programmes, in the form of needle and syringe programmes (NSP), have clearly been successful in engaging AAS users in Australia [42, 43, 77, 78] and, in particular, the United Kingdom [5, 30, 79, 80]. However, even where uptake of service is high, substantial numbers of AAS users do not access these services [26, 68, 80, 81]. Policy guidance regarding the delivery of harm reduction services for AAS users, centred around NSP provision, is in place in the United Kingdom [82, 83], with its importance recognised in National Drug Strategy and Treatment guidelines [84, 85].…”

Section: Introductionmentioning

confidence: 99%

Treatments for people who use anabolic androgenic steroids: a scoping review

et al. 2019

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Background: A growing body of evidence suggests that anabolic androgenic steroids (AAS) are used globally by a diverse population with varying motivations. Evidence has increased greatly in recent years to support understanding of this form of substance use and the associated health harms, but there remains little evidence regarding interventions to support cessation and treat the consequences of use. In this scoping review, we identify and describe what is known about interventions that aim to support and achieve cessation of AAS, and treat and prevent associated health problems.Methods: A comprehensive search strategy was developed in four bibliographic databases, supported by an iterative citation searching process to identify eligible studies. Studies of any psychological or medical treatment interventions delivered in response to non-prescribed use of AAS or an associated harm in any setting were eligible. Results: In total, 109 eligible studies were identified, which included case reports representing a diverse range of disciplines and sources. Studies predominantly focussed on treatments for harms associated with AAS use, with scant evidence on interventions to support cessation of AAS use or responding to dependence. The types of conditions requiring treatment included psychiatric, neuroendocrine, hepatic, kidney, cardiovascular, musculoskeletal and infectious. There was limited evidence of engagement with users or delivery of psychosocial interventions as part of treatment for any condition, and of harm reduction interventions initiated alongside, or following, treatment. Findings were limited throughout by the case report study designs and limited information was provided.Conclusion: This scoping review indicates that while a range of case reports describe treatments provided to AAS users, there is scarce evidence on treating dependence, managing withdrawal, or initiating behaviour change in users in any settings. Evidence is urgently required to support the development of effective services for users and of evidence-based guidance and interventions to respond to users in a range of healthcare settings. More consistent reporting in articles of whether engagement or assessment relating to AAS was initiated, and publication within broader health-or drug-related journals, will support development of the evidence base.

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Section: Introductionmentioning

confidence: 99%

Treatments for people who use anabolic androgenic steroids: a scoping review

et al. 2019

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“…In addition to the expansion of innovative development and activity within NSPs [ 107 , 122 ], other venues and modes of engagement to promote sexual health [ 101 ] and ensure non-stigmatising environments were called for [ 28 , 29 , 123 , 124 ]. There were also calls for the implementation of effective assertive outreach [ 125 ] and the adjustment of health and social care settings to enhance on-site engagement with people who use IPEDs [ 107 ].…”

Section: Resultsmentioning

confidence: 99%

“…Findings also underscore the need for future efforts to develop and evaluate interventions should see the involvement of people who use IPEDs as an essential component during all stages of the research process. For example, many included records emphasised that interventions should encompass peer support groups and educators [ 113 , 125 ], and a client-centred approach [ 79 , 106 ]. Thus, there was a recurring theme within the UK literature of the recognition of the need to effectively engage with the communities of people who use IPEDs.…”

Section: Discussionmentioning

confidence: 99%

Generating evidence on the use of Image and performance enhancing drugs in the UK: results from a scoping review and expert consultation by the Anabolic Steroid UK network

et al. 2021

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Background The use of anabolic androgenic steroids (AAS) and associated image and performance enhancing drugs (IPEDs) is now a global phenomenon. There is a need to develop evidence to support the development of interventions to prevent the commencement of use, to minimise the potential harms or to support those in their cessation of use. While the United Kingdom (UK) is no exception to this issue, its public health and legislative response to the phenomenon differs to other countries and requires the examination of research specific to the UK. Therefore, a scoping review has been conducted to examine the recent relevant literature to help inform the development and evaluation of effective interventions to reduce the harmful use of IPEDs. Methods A comprehensive search strategy was developed for multiple bibliographic databases, supported by and iterative citation searching process and complimented by expert input from the Anabolic Steroid UK Network. Research conducted by or UK academics or within the UK were eligible, if published in the previous five years. Results In total 87 eligible outputs were identified, including 26 review articles, 25 qualitative papers and 24 quantitative papers. together with small numbers of clinical studies/case reports (6) and commentaries/correspondence (6). The most common topics of research were public health, treatment and harm reduction (41), followed by studies focusing on epidemiology, sub-groups of people using IPEDs and motivations for use (34). The studies illustrated the diverse populations of people who use a range of enhancement drugs including concomitant psychoactive drug use. A number of papers focused on blood borne viruses and associated issues, while others reported on the uptake of needle and syringe programmes. No effectiveness evaluations related to any aspect of treatment, harm reduction or other intervention were published during study period. Conclusion There is a need for the development of effectiveness evaluations of current interventions and any future service provision for people using image and performance enhancing drugs. While there have been no studies of this nature to date, this review illustrates the rich data that has been gathered through diverse methodologies, that will assist in the development of future effectiveness evaluations.

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“…There is great diversity among people who use AAS that limits the effectiveness of any one intervention approach alone and over focus on BBVs may deter engagement with health services for AAS injectors (Underwood, 2019), while overlooking the needs of those who only use oral AAS (van de Ven et al, 2020). Additionally, many people who use AAS may acquire their injecting equipment online or via secondary distribution of equipment provided in NSPs by peers (Begley et al, 2017; Glass et al, 2019) and seek advice and support from peers rather than engaging with NSPs. The emphasis on BBVs and injection equipment provision in services targeting people who use AAS may therefore limit the opportunity for engagement with health professionals on other important issues and many prefer to seek advice and information from their peers rather than health professionals (Harvey et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Looking Beyond the Provision of Injecting Equipment to People Who Use Anabolic Androgenic Steroids: Harm Reduction and Behavior Change Goals for UK Policy

Bates

McVeigh

Leavey

2021

Contemporary Drug Problems

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Understanding of the choices and motivations of people who use anabolic androgenic steroids (AAS) for muscular enhancement has increased greatly in the past thirty years, along with understanding of a wide range of health harms associated with this form of drug use in the community. During this period the predominant public health intervention for this population in the UK has consistently remained the provision of injecting equipment to prevent blood borne virus (BBV) transmission. The study explored the health professionals’ and other stakeholders’ perceptions on: whether the current UK public health response is sufficient to address the needs of people who use AAS, and if not, what other needs they might have. This included an exploration of whether there were gaps in harm reduction strategies or other behavioral outcomes and interventions that were needed. Interviews with 27 stakeholders who provide support to people who use AAS in a variety of roles established consensus on the need for a range of interventions to reduce harm and risk in those that choose to use AAS, to prevent initiation, to motivate and support cessation, and to prevent relapse. Study findings indicate that while providing sterile injecting equipment remains essential, it should be considered a bare minimum. The challenge is to develop and deliver a range of harm reduction interventions that look beyond BBV prevention to provide appropriate support to who choose to use AAS at all points in their cycles of use and ultimately for those choosing the temporary or permanent cessation of use.

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Secondary distribution of injecting equipment obtained from needle and syringe programmes by people injecting image and performance enhancing drugs: England and Wales, 2012-15

Cited by 13 publications

References 22 publications

Treatments for people who use anabolic androgenic steroids: a scoping review

Treatments for people who use anabolic androgenic steroids: a scoping review

Generating evidence on the use of Image and performance enhancing drugs in the UK: results from a scoping review and expert consultation by the Anabolic Steroid UK network

Looking Beyond the Provision of Injecting Equipment to People Who Use Anabolic Androgenic Steroids: Harm Reduction and Behavior Change Goals for UK Policy

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