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NETWORK A national newsletter on substance misuse management in primary care
Anabolic steroids
Harm reduction advice for steroid users
� Always use sterile injecting equipment. Never
� Use the smallest dose of steroids (do not adopt
other users’ regimes).
� Limit the length of “on cycles”.
� Be aware of counterfeit drugs.
� Know how to inject safely.
� Spend adequate time on training, nutrition and
� Know the dangers of recreational drug use.
Key points for practitioners
� Be aware of side effects. At the first sign of them,

discontinue use and seek medical advice.
Recognise the potential for steroid use in patients —
particularly those who present with mesomorphic or � If you need to take drugs to treat the side effects
hypermesomorphic body types. of your steroid use, it means your dose of steroids
is too high.
� Always approach the issue in a non-judgemental way
and listen to the patient’s concerns.
� Inform your GP (and any other health practitioner)
of your anabolic steroid use and take advantage
� Recognise that there are diverse drivers of steroid use of any health monitoring that is available.
and look at motivations for use — can their goal be
� Just because you have read something about
achieved without steroids?
steroid use on the internet or from a magazine (or
� If an individual is intent on using steroids, then basic
heard it from another user) doesn’t necessarily
harm reduction advice should be given.
mean it’s true!
…continued on page 12
In this issue
Siobhan Fahey’s article highlights the potential benefits of dried blood spot April Wareham highlights the concerning issue of the withholding of essential
testing for blood borne viruses, and the way in which the practice has been rolled medications, including HIV medications, for drug users in custody. Page 10.
out in Greater Manchester across drug services. Page 2.
NICE have issued a press release on their new guidance on needle and syringe
Clare Gerada and Jane Haywood outline an important new London-based programmes. Page 13.
service for doctors and dentists experiencing mental and/or physical health
Tim Horsburgh and Kate Beale argue that employment can be an important
problems, and substance misuse problems. Page 4.
stage in drug users’ recovery and they discuss the approach Dudley has taken
Gordon Morse discusses the power of the doctor-patient relationship and how to support service users into training, education and employment. Page 16.
it can be influenced as much by personal prejudice and culture as it can be by
Vanessa Crawford is Dr Fixit to a GP seeking advice on polydrug use.
evidence and guidelines. Page 5.
Page 18.
Richie Moore takes us through the history of advocacy in the drug treatment
Jim McVeigh and Michael Evans-Brown are Dr Fixit to a GP seeking
field and explains why it is important that this service is available to people
advice on steroid use. Page 19.
receiving treatment in all drug services, including primary care. Page 6.
Catch up with the latest events on the Bulletin Board. Page 20.
Paul Hayes gives a view of drug treatment that explores the history of the
development of treatment services and also examines the challenges that We hope you enjoy this edition.
services face today. Page 7.
Jenny Keen discusses the adverse affect of care plans, NDTMS and TOP on
her work with drug users. Page 8.
Linda Harris outlines the response the RCGP Substance Misuse Unit has
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