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NICE: Guidelines to slash infections for steroid users

Services for people who inject image and performance enhancing drugs could benefit from updated guidelines to limit the spread of blood-borne viruses. 

Almost 60,000 people aged between 16 and 59 in England and Wales have injected anabolic steroids in the last year, and needle and syringe programmes have reported increasing number of steroid users attending their services. 

The programmes were introduced in the 1980s and 1990s in the face of the UK's AIDS epidemic. However the National Institute for Health and Care Excellence (NICE) has acknowledged they face a challenge in the changing type of person who injects substances. 

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.

New or updated recommendations in this updated guideline include:

 - Commissioners and providers of needle and syringe programmes should 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 (e.g. by offering outreach services in gyms or outside normal working hours), and by properly trained staff.

 - Organisations should 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. This should include thinking about how to achieve the right balance between protecting the young person and providing them with advice on harm reduction and other services.

 - Services should be co-ordinated so that people who need injecting equipment can get it when they need it.

Professor Mike Kelly, director of the NICE centre for public health, said: "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. These services must continue to be configured in the most effective way to reach and support the people who need them the most, wherever they live, and protect their health as much as possible.”