In some needle and syringe programmes,
particularly in the north of England, steroid users
represent the biggest client group. So are workers up
to speed in terms of meeting their needs now? ‘I think
so, particularly in the last few years, where there’s
been a groundswell of people working within those
environments joining up, contacting each other,
exchanging experience,’ he says.
Recent years have seen the treatment sector having
to adapt to new patterns of drug use – the dramatic
rise of new psychoactive substances, as well growing
problems with people injecting drugs such as
mephedrone and crystal meth. Is there any sense that
the focus on these new issues has meant services
taking their eye off the ball when it comes to steroids?
‘I don’t think so,’ he states. ‘I think the movement
away from just opiates and crack cocaine to this
much wider area encompassing both enhancement
drugs and the novel psychoactives isn’t to the
detriment of either. Injectors are injectors, and HIV
doesn’t really care what drug you’re using. What
we’ve found repeatedly has been a comparable level
of HIV in anabolic steroid injectors to heroin
injectors, and I don’t think that population of steroid
users are aware of that.’
So is there anything that commissioners or
services can be doing to better tackle the problem?
‘There’s a couple of important things. One is ensuring
that services really do engage with this population of
injectors. It’s not sufficient just to have clean injecting
equipment for people to pick up – you have to engage
with them and see exactly what they want. It’s
important that we translate the lessons we’ve learned
from injecting heroin users to this group.
‘Those users were the best source of intelligence
and information about the public health issues. It
really is important that it’s not seen just as “we’re
also letting steroid users come to the service”. You
really do need engagement.’
Liverpool John Moores has a range of educational
programmes, including an MSc in addictions. For more
information visit
14 |
drinkanddrugsnews
| June 2015
Profile
Read the full interview online
’HIV doesn’t really
care what drug
you’re using... I
don’t think that
population of
steroid users are
aware of that.’
Users of anabolic
steroids are now the
biggest client group in
many needle and syringe
programmes.
David Gilliver
talks to
Jim McVeigh of Liverpool
John Moores University’s
Centre for Public Health
about how services can
meet their needs
A growing problem
I
f you’re in any way connected to the substance
sector then chances are you’ll be familiar with
the wide-ranging research of Liverpool John
Moores University’s Centre for Public Health. And
if that research is about image and performance-
enhancing drugs, it’s likely to have had the input of
the centre’s acting director, Jim McVeigh, one of the
foremost authorities on the subject.
He’s been at John Moores since 1998, but had
‘always had an interest in the drugs side of things’, he
says. ‘My original background is in general nursing in
Liverpool, when we had increasing numbers of people
coming in who’d been injecting temazepam, and they
had horrendous injuries from poor injecting techniques.
That’s how I got into working in drug services, through
that desire to get involved in harm reduction.’
There’s a great deal of harm to be prevented when
it comes to users of anabolic steroids and associated
drugs. As well as putting themselves at risk of a
lengthy list of possible physical side effects including
liver, heart and blood pressure problems, there are
potential mental health issues such as depression or
even psychosis. The number of users, however,
continues to grow – why aren’t they being put off
using these substances?
‘Well, one of the key reasons is that they work,’ he
says. ‘People taking large dosages of anabolic steroids
and a range of other enhancement drugs – when
combined with appropriate exercise and nutrition –
will get substantial gains. That’s the first thing to bear
in mind.’
While most steroid users will experience some
adverse effects, they tend to be things seen as ‘coming
with the territory’, he points out, particularly cosmetic
side effects such as acne, premature balding or even
gynaecomastia – the growth of breast tissue. ‘People
will either accept it or they’ll take other drugs to try
and counter it. And while there are many different
adverse effects, in terms of things like psychosis
they’re very, very rare. I could introduce you to
hundreds, if not thousands, of steroid users who will
never have come across anyone who’s had a life-
threatening condition that they’re aware of, or a life-
changing set of psychological adverse effects.’
There is, however, evidence from the US that ‘large
dosages for prolonged periods do have detrimental
effects on your cardiovascular system’, he points out.
‘That sounds like an absolute no-brainer, but we’ve
actually got that hard and fast evidence now.’
The current problem is also on a far bigger scale
than it was when he first became involved, he
stresses. ‘I knew a small number of people who were
using anabolic steroids in the 1980s, but it was only
really when I was working in the needle and syringe
programmes in the early ’90s that we saw that
explosion of use. All of a sudden you had this
different group of people presenting with different
attitudes, different needs, but the staff there – who
were very, very experienced – weren’t experienced in
this particular area.’
