A new project is helping steroid users to recalibrate their lives while providing evidence for better treatment, says Jody Leach.
At 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 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.’
There 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.
IPED users rarely view their behaviour as being similar to users of other substances. This mindset results in many users being reluctant to access any formal treatment services outside of generic needle exchange programmes. Consequently, IPED users are less likely to recognise and acknowledge, let alone address, the potential risks and behavioural issues associated with this group of substances.
Jody Leach is SWEAT project manager and quality coordinator at Open Road
‘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 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 mind-set. 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 with the low moments and he stuck with the programme. A new healthy diet and workout regime meant, to Justin’s surprise, that his testosterone levels began to return to normal after a few months – he even kept most of his ‘pumped-up’ physique.
He also conquered all the self-doubt and re-built his self confidence. His relationship with his wife is now more honest and fulfilled, his children are even prouder of their father, and he spends more time with them now because he is no longer obsessed with weight training. And he’s no longer feeding dodgy suppliers with cash that should be spent on his family.
‘SWEAT is the first service that actually listened to my needs and understood the difficulties behind my steroid misuse,’ he said. ‘Most other services just give you your needles and don’t ask how you are.
‘The team gave me hope and helped me help myself into a sensible diet and fitness routine, and I would probably still be using now with no way out, if I hadn’t found them.’
Open Road’s conference, ‘A Shot in the Dark: Steroids, IPEDS – the hidden harm’ is on 26 April in Colchester, Essex. Details and booking here