volume volume 12 12 edition edition 3 1
Budget hormone holidays taking off Hormone holidays are increasingly popular amongst growing populations of steroid injectors who can travel overseas for cheap cycles of performance and image enhancing drugs (PIEDs). A career harm reduction worker in a busy primary Needle and Syringe Program health service is learning that some clients travel on “steroid and peptide tours to places such as Thailand”. “I had a client yesterday who explained that he and some mates go to Thailand for a course of human growth hormones. He said it cost them about $11 a day for the drugs as well as the syringe,” she said. She said that for many, a 10-week cycle spent in a low-cost environment with ready access to advanced drugs, including peptides, was affordable. Coordinator of Australia’s Needle and Syringe Program (NSP) survey and analysis, Jenny Iversen, has kept a close eye on the rapidly increasing use of NSP by steroid and other image/performance enhancing drugs. Her analysis of NSP data finds that people injecting PIEDS and collecting from NSP outlets are predominantly young men, most of whom are new initiates (less than three years since first injection) to injecting. PIEDs are primarily injected intramuscularly, or subcutaneously. “Services must continue to engage with performance and image-enhancing drug injectors in order to prevent blood-borne viral infections and injection-related injuries and disease,” Ms Iversen told the Bulletin. As reported on page two of this Bulletin, Queensland Health has introduced a new scheme to boost access to sterile equipment, including specific steroid packs, through pharmacies. Melissa Virtue from SHARPS in Frankston told the Bulletin that she and her colleagues had made a conscious effort to learn about the ever-changing human growth hormone field so that they could relate to a generally “shy” population of clients.
“They are a hard group to get to know and get their trust,” said Melissa who has been working with all manner of injecting drug users for many years. An increasing number of girls, often young, were picking up 1ml needle and syringe for injection of the tanning drug melanotan, she said.
know what I mean) that’s when the steroid liquid runs back out the injection hole losing some of the drug.” A formula to help a person unsure of how many needles to ask for, or for a worker to provide sufficient equipment, was to ask the number of injections per week and the number of weeks in a cycle, she said.
“So a two injection per week over 10 week cycle is 20 injections, and we usually include another 10 or so syringes to be on the safe side,” she said.
Most PIEDS injectors do not identify as drug injectors, even though they actually are, and “they don’t even want to be here...it’s mostly in and out quickly.” But over time, and through learning from experts such as steroid peer educator Kay Stanton, she and her colleagues had learned some simple and easy to remember conversation starters. “How long is your cycle?” was probably the most useful way to start chatting to new steroid clients who, she said, were often unsure of what they needed. “Try to be informed and try to use their language and make them feel welcome, because a lot of these clients are really scared (of coming into an NSP),” she said. “It is simple to learn and simple to say, and they feel like we know them and what they are about,” she said. She had gone out of her way to learn about steroid and peptide use so she “wouldn’t sound like a dill” and be able to provide a good service “because assistance is our job”. There was a difference between oil-based and water-based formulations which had implications for syringe types, she said. “When they ask for a 25 gauge needle I ask if it is oil base or water base. I let them know that the 23 gauge is the best for injecting intramuscular as it gets in deeper. The 23 gauge is longer - it’s 1¼ inch and the 25 gauge is only 1 inch in length. Also, the 23 guage has a larger bore which allows for thicker liquids to pass through. “Going in deeper means there is less likelihood of crystalisation (of the steroid) less likely to bruise or abscess and less likely for drip back(that’s what I call it but they seem to
Steroids dealer pushes harm minimisation as business tool: page 3
Finding strength in couples who inject drugs: page 6
Time inside allows hep C clearance: page 8