A new project is helping steroid users to recalibrate their lives while
providing evidence for better treatment, says Jody Leach
t Open Road we launched a project – Steroids, Weights, Education And
Therapy (SWEAT) – in 2017 in direct response to the growing number of
steroid users accessing our needle exchange programmes across Essex.
SWEAT is funded by The Big Lottery and tackles the increasingly
complex needs of those using image and performance enhancing drugs (IPEDs).
The service is based in needle exchanges, where steroid users are first identified,
and offers support to those who are using, thinking about using, or have
previously used IPEDs.
We work alongside local gyms and pharmacies to promote our SWEAT contact
points, but the project goes way beyond generic needle exchange provision. We
ensure access to specialised psychosocial interventions, harm minimisation
programmes and educational resources to dispel myths and promote
understanding of the potential side effects and long-term harm of IPED use.
Our project guides clients through post-cycle therapy (PCT), good diet and
nutrition, training regimes and sleep, to support them in making informed decisions
about steroid use. A combination of one-to-one sessions with specialist workers and
formal in-house counselling allows them to explore their motivators for using and
the impact this lifestyle could be having on their mental health and relationships.
SWEAT is a three-year project and will be formally evaluated in collaboration
with the University of Essex, with the intention of informing IPED-specific service
‘IT HELPED ME HELP MYSELF’
Most other services just give you your needles,
but SWEAT actually listened, says Justin
JUSTIN WAS A LONG TERM STEROID USER . During 20 years of use, he
recognised that steroids were having serious negative effects on his life but he
was afraid of letting go of the habit and he didn’t know how to stop. In
particular he feared damaging his relationship with his wife and young family,
if his image changed.
Justin constantly feared losing respect from his children – they were proud
of his hulk like figure, often asking him to ‘show off his muscles’ to their
22 | drinkanddrugsnews | February 2018
provision at both local and national level. In April we will be running a conference,
‘A Shot in the Dark’, to bring together experts, practitioners and support services to
learn, inform and share their expertise in IPEDs and to hear about the impact of our
project in its first year of operation. Among the speakers will be Prof Jim McVeigh,
director of the Public Health Institute at Liverpool John Moores University.
‘The use of anabolic steroids and other IPEDs amongst the general population is
now a recognised public health issue,’ he says. ‘However, there are few services
providing and evaluating interventions for this population. While some of those
beacons of good practice remain, others have fallen victim to the current funding
crisis. The SWEAT Project is an exception and an important development, not just
for the population it serves, but in generating evidence of effectiveness.’
here are many health implications associated with IPED use, with physical
risks ranging from superficial harms such as acne and balding, through to
sexual dysfunction, cardiovascular disease and impaired liver function.
Injecting-related harms are a potential feature of steroid use, with site
swelling, abscesses and exposure to blood-borne virus infection being possible.
Users’ mental health can be impacted in varying degrees, with changes in mood,
levels of aggression and an impact on general psychological wellbeing relating to
existing body image and/or self esteem conditions.
friends – and he was afraid of how they would feel about him if he stopped
using steroids became just an ‘ordinary dad’.
He also felt that his steroid abuse was affecting his libido but did not know
how to tell his wife for fear that she would feel it was her fault. He had been
using steroids for so long he feared that, even if he stopped now, it was too
late for his testosterone levels to return to normal and he worried about any
withdrawal effects on his mental health. Justin knew he got the short term
boost from steroids he needed, but he also realised it was time to stop.
Justin discussed his options with the SWEAT worker and we looked into
ways to boost testosterone naturally through diet, workout regimes and
We then looked at how to reduce his dependency and eventually cease his
current cycle of behaviour. We discussed what his side effects or ‘come down’
may be, to prepare him.
As Justin’s testosterone levels started re-balancing, he was ready to cope