Limit spread of blood-borne viruses among steroid users
9 Apr 2014 02:40 PM
Needle and syringe
programmes should support the growing number of image and performance enhancing
drug users so they can be offered sterile equipment to reduce the spread of
blood-borne viruses and infections from contaminated needles, says
NICE.
This has long been considered a
“grey area” for needle and syringe services around England that are
traditionally geared up to help hard drug users, such as those who use heroin
or crack.
Conservative estimates suggest
almost 60,000 people aged between 16 and 59 in England and Wales have used
anabolic steroids in the last year.
But many needle and syringe
programmes have reported an increase in the number of steroid users,
particularly among men aged 18-25, presenting in the last few years, fuelled by
the increasing pressures to look good.
Research shows that people who
inject image and performance enhancing drugs are at an increased risk of
blood-borne viruses and bacterial infections - 1.5% have tested positive for
HIV. Public Health England has warned that men who inject anabolic steroids are
also at greater risk of developing viral hepatitis.
Needle and syringe programmes
aim to stop people sharing potentially contaminated injecting equipment by
providing them with sterile needles, syringes and other equipment. They have
successfully helped to limit the spread of infectious blood-borne diseases such
as HIV and Hepatitis B and C.
In updated guidance, NICE recommends that
commissioners and providers of needle and syringe programmes ensure services
provide users of image or performance enhancing drugs with the equipment they
need.
Services should be provided at
times and in places that meet their needs, such as in gyms or outside normal
working hours, and by properly trained staff.
The guidance also recommends
that organisations develop local, area-wide policies to provide services that
meet the needs of young people aged under 18, including young people under 16,
who inject drugs.
David Rourke, Harm Reduction
Lead for CRI's Arundel Street Project - a needle and syringe programme in
Sheffield, said: “We run a weekly clinic for steroid users but we have
people coming through the door on a daily basis, with at least seven new
clients a week.
“We know there are many
more people out there who are not using needle and syringe programmes because
this group of users do not see themselves as drug users. Traditionally they are
more sexually active than users of heroin or crack, so there is more potential
for the spread of infections through sex.
“This guideline gives
front-line workers clear recommendations on how to support image and
performance enhancing drug users. Up to now this has been a grey area; services
around the country have been patchy to say the least.”
Professor Mike Kelly, Director
of the NICE Centre for Public Health, said: “Needle and syringe
programmes have been a huge success story in the UK, they are credited with
helping stem the AIDS epidemic in the ‘80s and ‘90s. However, we
are now seeing a completely different group of people injecting drugs. They do
not see themselves as ‘drug addicts'; quite the contrary, they
consider themselves to be fit and healthy people who take pride in their
appearance.
“Since we last published
our guideline on needle and syringe programmes in 2009, we've seen an
increase in the use of image and performance enhancing drugs such as anabolic
steroids.
“We've also heard
anecdotal evidence that more teenagers are injecting these image and
performance enhancing drugs too. We're updating our guideline to make sure
all of these groups of people are considered in the planning and delivery of
needle and syringe programmes.”
Dr Fortune Ncube, Consultant
Epidemiologist and Head of Blood-borne Virus Section HIV & STI Department,
at the Public Health England National Centre for Infectious Disease
Surveillance and Control (CIDSC), said: “Anyone who injects drugs is at
risk of HIV and other blood-borne viruses, regardless of the substance they
inject.
“Our recent research
suggests that levels of HIV and hepatitis infection among men using image and
performance enhancing drugs have increased since the 1990s.
“We must maintain and
strengthen public health interventions focused on reducing injection-related
risk behaviours to prevent HIV and hepatitis infections in this group. This
includes ensuring easy access for those who inject image and performance
enhancing drugs to voluntary confidential testing services for HIV and
hepatitis and vaccination against hepatitis B, as well as to appropriate
sterile injecting equipment through needle and syringe
programmes.”