Substance misuse 3 - anabolic steroids Flashcards
(12 cards)
Anabolic steroids
What do ppl use them for
Used for Aesthetic purposes
Athletic performance
Non-competitive body-building
People using steroids may not perceive themselves as a ‘drug user’ as they are not using psychoactive drugs such as heroin, Also that they are not at risk of getting a blood borne virus because they are sharing equipment with friends
Image and performance enhancing drugs (IPEPs)\
Schedule 4 CD’s
Class C – supply can be up to 14 years in prison plus a fine
Used to increase skeletal muscle mass and physical strength, reduce body fat
Anabolic steroids - how can it be taken, when is it not an offence
Can be taken orally, IM or SC
Not an offence to possess for personal use
Majority are male users
Increase stamina and decrease fatigue
People can undertake longer and more difficult training sessions
Side effects of anabolic steroids
Acne, depression, changes in sex drive
Long term: hypertension, ischaemic heart disease, liver damage, renal problems
Young people: stunted growth, interruption of puberty, emotional difficulties
Dependence/tolerance does not occur instead users fear the decrease of physical effects
Normally used on a cycle for up to 12 weeks following very intense training (which is called on cycle).
Then stopped for the same length of time (off cycle). Then restarted.
During the cycle, several other drugs are used to:
Enhance the steroids and
Counteract the steroids negative effects
What is stacking
where anabolic steroids taken together. This allows a decreased dose of individual drugs to reduce SEs of each drug but maximise effects – can be Problems with drug interactions which can be compounded by using counterfeit drugs
What is pyramiding
Doses gradually increased to a maximum. This amount is then gradually decreased – tapering towards the end of the cycle
What is Plateauing
where a drug gradually becomes ineffective, a different drug is then used
Blast and cruise what is it
User has no off cycle. Blast is a high dose followed by a cruise (lower maintenance dose) – Patients who have a psychological fear of coming off steroids may use this method
Drugs used in conjunction with anabolic steroids
Insulin – this promote muscle growth (risk of hypos- low blood sugar )
Hypnotics – counteract insomnia caused by steroids
Human growth hormone – somatropin – promote muscle growth, fat loss and strengthens tendons
Oestrogen antagonists – tamoxifen – decreases chance of developing gynaecomastia
Captopril – decreases body fat and become more sensitive to insulin in addition to its diuretic effects
Diuretics – decrease fluid retention caused by steroids and enhance muscle definition
Antibiotics and retinoids – decrease acne inducing SEs of steroids
Human chorionic gonadotrophin – males use this to increase
spermatogenesis – suppressed by testosterone
Erythropoietin – increases the capacity of the blood to carry oxygen – enhances performance
Nalbuphine – Decreases training pain due to injuries and over exertion
Stimulants (amphetamines and ephedrine) – taken prior to a work out to allow longer training. Users also believe that they help to burn fat
Paraphernalia
People injecting steroids will need a wider needle (smaller gauge):
Steroids are oil-based drugs, more viscous, injected in larger volumes in IM injections. Also risk of a thin needle breaking if going into a large muscle
Must not be injected IV but IM which requires a longer needle
Size and length or needle will be a personal choice dependent on the drug and site of injection. Clients should be offered a choice of sizes (exchange programme)
Generally, use a 21G, 1.5-inch needle due to IM use for adding oil diluent to a powdered steroid followed by a blue 23G, 1 inch needle for injection
Users might need a variety of needles due to injecting a number of different drugs
Safer injecting
Advice on the preparation of drugs for injection:
Encouraging good hygiene
Explain the risks of sharing equipment
Always use sterile equipment
Never share even when just drawing up needles
Use appropriately sized needles
Length needed dependent on the site you are injecting
Body mass of the user
Use smallest dose of steroids – do not use other people’s regimens
Advice on injection site:
Large muscles are most preferable e.g. buttocks, outer thigh, upper arm is the next best choice
Rotate sites and do not use on an area where there is a lump
Advice on injecting technique:
Wash hands prior to injection
Injection with steroids must be IM not IV
Site thoroughly cleaned with soap and water
Relax and loosely hold the muscle then insert the needle with the jab motion at 90⁰
Insert the needle slowly – it is more painful and causes tissue damage if done quickly
Insert the needle ¾ of the way into the muscle, if it doesn’t go far enough it could cause an abscess. If it goes too far it may not be easy to remove if it snaps
Pull back the plunger if there is blood then slowly inject. Remove needle slowly. Massage site to disperse the drug
Other advice:
Spend adequate time on training, nutrition and sleep
Limit the length on cycles
Know the dangers of recreational drugs e.g. cocaine
Be aware of SE’s and discontinue use if they occur and seek medical advice
If other drugs are needed to treat SE’s it means that their dose of steroids is too high
Encourage users to tell other HCP’s that they are anabolic steroid users so that appropriate health monitoring can take place (such as bp and blood sugar checks)
