Transcript Document

CENTRE FOR PUBLIC HEALTH
FA C U LT Y O F E D U C AT I O N , H E A LT H & C O M M U N I TY
L I V E R P O O L J O H N M O O R E S U N I V E R S I TY
3rd National Intelligence Network meeting on the
health harms associated with drug use
29th January
Image & Performance Enhancing Drugs
Emerging Trends
What do we actually know about anabolic
steroid use in the UK?
Prevalence
Characteristics of users
Very little
Reasons for use
Efficacy
Methods regimes & risks
Some
A bit
Limited
Mostly flawed
Harms
Effective drug prevention
Patchy
Nothing at all
Effective harm reduction
Intuitive
Anabolic steroid use facts
Approx 25% first use in teens
Users more likely to use orals before injecting (??)
More likely to have been to prison (17%)
Small numbers injected drugs other than IPEDs
Cycles longer & approx 25% ‘blast & cruise’
Nobody knows what they are taking!
In the last 12 months
47% snorted cocaine
12% used amphetamine
Oral use in previous year
Proportion
n
Anabolic Steroids
57%
226
Anti-oestrogens
23%
92
Clenbuterol
15%
60
Ephedrine
20%
78
Thyroid Hormones
9%
37
6.6%
26
PDE5i (Viagra / Cialis)
Hope, McVeigh et al
Injected in previous year
Proportion
n
Anabolic Steroids
86%
340
Growth Hormone
32%
128
HCG
16%
62
Insulin injected
5.6%
22
Melanotan
8.6%
34
Other PIED (inc. EPO, IGF-1 and Nubain)
5.1%
20
Hope, McVeigh et al
Prevalence of growth hormone use amongst
anabolic steroid users
The new stuff…
Pegylated Mecano Growth Factor
A long acting MGF similar to IGF-1
Growth Differentiation Factor 8
a myostatin inhibitor.
FST
Possibly Follistatin –myostatin inhibitor.
Sermorelin
Stimulates growth hormone release
Melanotan
.
The three most ‘popular’ internet shops
identified
A total of 73 vials of melanotan II 10mg
were purchased
Melanotan II in vials ranged between 4.32
to 8.84 mg
Contained impurities ranged from 4.1 to
5.9%
Kimergård, McVeigh et al
The strange case of GHRP-6…
“We aim for a high standard….”
EU PEPTIDES
We Are Sorry For The Inconvenience
Currently Our Site Is Under Construction
Kimergård, McVeigh et al.
The old stuff…Dinitrophenol
- It’s back
‘No dieting… No self-denial… No strenuous
exercises… You can have the slender figure of
Youth’.
‘Literally burns the fat away’.
‘Sounds too good to be true? Yet it is true’
Unpredictable responses & narrow therapeutic
window
In just 2 years, 160 reported cases of cataracts
and at least 10 deaths
Advert for Dilux-Redusols
containing dinitrophenol, 1936.
Metabolic poison
Motivation to use steroids
“People who hadn’t seen me since school would come up to me and go,
‘Oh my God, you look massive, you look fantastic’ “
(Steroid and growth hormone user aged 36)
“I like to increase my strength, and now it’s more for conditioning”
(Steroid user and doorman aged 35)
“I think I started weight training more seriously as I was losing my hair
because I think I started to suffer a loss of confidence”
(Steroid user aged 35)
The market
“You can’t get anything pharmaceutical grade, everything is ‘underground’”
(Steroid user, competing bodybuilder and gym owner aged 45)
“I’ve heard horror stories about dealers that I talk to...there’ll be a tray of vials
and they’ll ask, ‘what are you after?’ [specific types of steroids] And they say,
‘well there’s the bottles, there’s the labels, take whatever labels you need and
just stick them on the bottles’”
(Steroid user, competing bodybuilder and gym owner aged 45)
“You wouldn’t know, but you do find out the difference after you’ve finished your
course and your are not getting the results you should be getting. I think that’s a
risk you take, it comes in life, it comes everywhere”
(Steroid user aged 27)
Kimergård & McVeigh
Obtaining information on anabolic steroids
“My mate was on them, so I started to learn from him. He got on the internet
and researched, so that he made sure that he knew what he was doing”
(Steroid user aged 21)
“...certain steroids on the [illicit] market are called different names to what they are
called in the ‘book’ (Llewellyn, 2009)], and some aren’t in the book. So, I go on the
Internet for that information, but each site says different things about it”
(Steroid user aged 22)
“I’ve never had any information off drug services, all my information
has been from the guy I bought the steroids from”
(Steroid user, NSP)
“If I get problems with cholesterol, I’ll take statins, which is a drug that can
lower cholesterol. That helps control that”
(Steroid user aged 35)
Kimergård & McVeigh
Aggression
“I got bigger, I got stronger, but I also got nasty and more aggressive,
and the two put together was dangerous. I kept fighting all the time and
used to get myself locked up, and in the end it wasn’t working. I could
be really nasty. I was a horrible person to talk to”
(Steroid user aged 23)
“Working as a doorman I get provoked every night”
Steroid user and doorman aged 35)
Kimergård & McVeigh
Blood borne viruses
“No bodybuilders that I know share. I
mean you hear of what are called
druggies, people who use other stuff. I
don’t mix in those circles to be
honest”
(Steroid user, NSP)
Kimergård & McVeigh
Service expectation
“...the drug service is just a handy
place to get your needles, literally
that is all”
(Steroid user, NSP,)
Kimergård & McVeigh
Enhancement Drugs & Public Health
9th April 2014
Liverpool
CONTACT DETAILS
Jim McVeigh
Acting Director
Centre for Public Health
0151 231 4512
[email protected]
www.cph.org.uk
Twitter @mcveigh_jim