Transcript Providing Services for Performance Enhancing Drug Users

Drugs In Sport Clinic and User Support
DISCUS
Providing Services for
Performance Enhancing
Drug Users
Ralph Heron
Team Manager
Harm Minimisation Service
13 &14/10/05
Providing Services for Performance
Enhancing Drug Users
Aims




Side Effects of PEDS
PEDs and Associated Substances
Overview of DISCUS
The Role of Harm Minimisation
Is it Just Steroids





The issue is not just about using Steroids
But about using a wide range of Performance
Enhancing Drugs
Steroid use gets the headlines
The other substances
(e.g. Insulin, Human Growth Hormone) do not
make the headlines but are used alongside the
steroids
Body Builders
Body Builders
Body Builders
Body Builders
Historical





Egyptian pharaohs boil hind hooves of ass to
give a sporting edge
Roman gladiators use strychnine and wine with
chariot racers feeding horses “mixtures” to make
them run faster
Olympians using magic mushrooms in 300 b.c.
Vikings renowned for fighting in frenzied state,
fuelled by magic mushrooms
Legendary Knights drink magical potions from
Merlins cup
A Win for Stanozolol!!
Whats Used?
Commonly Used Orals





Oxandrolone - Anavar*
Testosterone Undecanoate - Andriol
Methandienone - Dianabol*
Methenolone - Primobolan
Stanozolol - Winstrol*
*Denotes 17 alpha-alkylated
compounds
Commonly Used I.M. A.A.S.








Nandrolone Decanoate - Deca Durabolin
Methandienone – Dianabol*
Boldenone Undecanoate - Equipoise
Formebolone - Esiclene
Trenbolone - Parabolan
Methenolone - Primobolan
Stanozolol - Stromba*
Testosterone Esters - Sustanon (Mix of IV)
Testex
(Mix of II)
Androgens and Anabolics








Boldenone
Calusterone*
Clostebol
Danazol*
Drostanolone
Epitostanol
Ethyloestrenol*
Fluoxymesterone*








Formebolone
Furazabol*
Mepitiostane
Mesterolone
Methandienone*
Methandriol*
Methenolone
Methyltestosterone*
*Denotes 17 alpha-alkylated compounds
Androgens and Anabolics







Mibolerone
Nandrolone
Norclostebol
Norethandrolone*
Oxabolone
Oxandrolone*
Oxymethalone*
* Denotes 17 alpha-alkylated
compounds






Prasterone
Quinbolone
Stanolone
Stanozolol*
Testosterone
Trenbolone
Not just steroids









Insulin
Ephedrine
Dehydrating Agents
Growth hormone
HCG (Human Chorionic Gonadotrophin)
Nubain
Clomid
Tamoxifen
Recreational Drugs
Effects
Main Positive Effects of
P.E.Ds Cited by Service Users
Physical





Increased muscle
mass
Increased strength
Ability to train
longer/harder
Enhanced appearance
Weight gain
Psychological





Increased confidence
Feeling of wellbeing
Increased aggression
Feeling powerful
Increased libido
Main Negative Effects of
P.E.Ds Cited by Service Users
Physical




Tender injection site
Gynaecomastia
Acne
Tissue scarring
Psychological




Increased aggression
Paranoia
Fear of disease
Fear of effects on
cessation of P.E.D use
Problems Associated






Altered Coagulation
Increased Haematocrit (HCT)
Infertility
Testicular shrinkage
Clitoral hypertrophy
Epiphyseal closure in prepubertal children
Psychological









Psychosis
Hypomania
Euphoria
Emotional Lability
Aggression
Irritability
Reckless behaviour
Increased libido
Paranoid reactions
The Role of Harm
Minimisation
The Price Some Will Pay

“If I had a magic drug that was so fantastic that
if you took it once you would win every
competition you would enter, from the Olympic
decathlon to the Mr.Universe, for the next five
years, but it had one minor drawback – it would
kill you five years after you took it – would you
still take the drug?”
Harm Minimisation
SOURSUCK








Start with lowest dose/stack possible
Optimise diet and training regimes
Use low androgenic initially
Regular investigations
Shortest cycle possible with max. time off cycle
Use your own, sterile injecting equipment
Correct injecting technique
Know your source of gear
Creatine Monohydrate







Acts as muscle’s capacitor
Effective in 70% of users
5-7lb of lean muscle
Each dose = 2lb steak
Take in warm drink with 100g of carbohydrate
Loading phase = 10g for 5/7 then 5g for 5/7
Maintenance phase = 2g daily
Drugs In Sport Clinic and User
Support
The DISCUS Team
Clinic Co-ordinator
11 years old
this year
Nurse
DISCUS Client
Women’s Outreach
Sports Dietician
R.M.O.
Why DISCUS?






Need identified locally in 1993
50% of needle exchanges were for PED users
Prevention of blood borne infections
PED users reluctant to approach existing “drugs”
services
Experience within gyms
Gateway service focussing on harm reduction
Services Available







2 Hours per week
700 individuals registered
Informal and confidential
Full range of injecting
equipment services
Safer injecting advice
Responsible Medical
Officer
Nursing assessment
Services Available 2






Dietician
Hepatitis A & B vaccination
Regular blood investigations (LFTs, FBC,
Cholesterol etc)
ECG
Body fat analysis
Referral on to other services if/when necessary
Activity Levels 04-05
DISCUS ACTIVITY 04-05
ECG
Bloods
NX
Diet
GP
New
Attendees
0
50
100
150
200
250
300
350
400
Number 86
Providing Services for Performance
Enhancing Drug Users






What can you provide
What can’t you provide
Why can’t you provide
What is realistic
What are the constraints
What are the benefits to service users
Our Role


“Substance misusers have the same entitlement
as other clients to the services provided by the
National Health Service. It is the responsibility of
all Health Care Workers to provide care for both
the general health needs and drug related
problems, whether or not the patient is ready to
withdraw from drugs.”
Where do services for Performance Enhancing
Drug Users fit into this statement????
Department of Health (1999)
Providing Services for Performance Enhancing
Drug Users
Ralph Heron
Team Manager
Harm Minimisation Service and DISCUS
Contact details
0191 3336032/6031
07747865604 (Mobile and Contact Number for DISCUS)
[email protected]