CENTRE FOR PUBLIC HEALTHFACULTY OF EDUCATION, HEALTH & COMMUNITY

LIVERPOOL JOHN MOORES UNIVERSITY

3rd National Intelligence Network meeting on the health harms associated with drug use

29th January

Image & Performance Enhancing Drugs Emerging Trends

Prevalence

Characteristics of users

Reasons for use

Efficacy

Methods regimes & risks

Harms

Effective drug prevention

Effective harm reduction

Very little

Some

A bit

Limited

Mostly flawed

Patchy

Nothing at all

Intuitive

What do we actually know about anabolic steroid use in the UK?

Approx 25% first use in teensUsers more likely to use orals before injecting (??)More likely to have been to prison (17%) Small numbers injected drugs other than IPEDsCycles longer & approx 25% ‘blast & cruise’Nobody knows what they are taking!

In the last 12 months47% snorted cocaine12% used amphetamine

Anabolic steroid use facts

Proportion n

Anabolic Steroids 57% 226

Anti-oestrogens 23% 92

Clenbuterol 15% 60

Ephedrine 20% 78

Thyroid Hormones 9% 37

PDE5i (Viagra / Cialis) 6.6% 26

Oral use in previous year

Hope, McVeigh et al

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

Injected in previous year

Hope, McVeigh et al

Prevalence of growth hormone use amongst anabolic steroid users

Pegylated Mecano Growth Factor A long acting MGF similar to IGF-1

Growth Differentiation Factor 8 a myostatin inhibitor.

FSTPossibly Follistatin –myostatin inhibitor.

Sermorelin Stimulates growth hormone release

The new stuff…

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%

Melanotan

Kimergård, McVeigh et al

.

The strange case of GHRP-6…

Kimergård, McVeigh et al.

“We aim for a high standard….”

EU PEPTIDES

We Are Sorry For The InconvenienceCurrently Our Site Is Under Construction

‘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

Metabolic poisonAdvert for Dilux-Redusols containing dinitrophenol, 1936.

The old stuff…Dinitrophenol - It’s back

“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)

Motivation to use steroids

“You can’t get anything pharmaceutical grade, everything is ‘underground’”(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)

The market

Kimergård & McVeigh

“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)

“...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)

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)

“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)

Kimergård & McVeigh

“Working as a doorman I get provoked every night”Steroid user and doorman aged 35)

“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)

Blood borne viruses

Kimergård & McVeigh

“...the drug service is just a handy place to get your needles, literally that is all” (Steroid user, NSP,)

Kimergård & McVeigh

Service expectation

Enhancement Drugs & Public Health9th April 2014

Liverpool

CONTACT DETAILS

Jim McVeigh Acting Director

Centre for Public Health

0151 231 4512j.mcveigh@ljmu.ac.uk

www.cph.org.ukTwitter @mcveigh_jim