Technical report

Understanding and responding to the rise of steroid injecting in Australia: recommendations from a national consultation

26 Jun 2015

Executive summary

This report details findings from a national consultation on illicit steroid use in Australia undertaken between late 2014 and early 2015. The report presents findings from interviews conducted with a range of stakeholders, including academics, policymakers, service providers, user group representatives and other advocates. These interviews explored the phenomenon of steroid injecting along with the contemporary landscape of research, policy and practice in the Australian context. Interview questions were concerned with future directions for research on illicit steroid use, the relationship between research and policy, the relationship between drug services and policy implementation, and the most appropriate public health responses. This report presents participants’ perceptions of steroid injecting, key risks and responses, and needs for future research. The report also details participants’ perceptions of the landscape of steroids-related research, policy and practice in Australia, including the extent to which these three fields are sufficiently integrated, and where appropriate, strategies for improving the interface between these spheres of practice.

The main findings of this report are that:

▶ There is presently a lack of fit between research, policymaking and service provision in relation to steroid use in Australia;

▶ The current prevalence of steroid use in Australia is unclear but appears to be increasing;

▶ There is an appreciable risk of blood-borne virus (BBV) transmission among people who inject steroids;

▶ More research is required in relation to:

> Prevalence of use;

> Motivations for use;

> Issues around sourcing and supply;

> The relationship (if any) between steroid use and other forms of illicit and injecting drug use;

> The harms associated with steroid use, including but not limited to the risk of BBV transmission;

> The minutiae of injecting practices among people who inject steroids; and

> Knowledge of harms, including risks associated with particular injecting practices;

▶ A more targeted harm reduction strategy is needed for people who use steroids, including those who inject them;

▶ Targeted harm reduction strategies must take into account the changing demographics of use, with younger men and culturally and linguistically diverse groups, among others, using illicit steroids;

▶ Some recent policy, legal and regulatory responses to steroid use in Australia have been implemented too hastily, without a sufficient evidence base and in ways that may be counter-productive to harm reduction; and

▶ There are barriers and enablers to engaging with people who use illicit steroids, both for the purposes of improving our knowledge base and for harm reduction and safer injecting strategies.

This report is intended to inform researchers in the field of alcohol and other drugs, policymakers and service providers, advocates and user groups and relevant industries (such as the gym/fitness industry).

The report documents areas of agreement and disagreement between stakeholders on the nature, and extent of steroid use in Australia; areas requiring further investigation; and perceptions about the barriers and enablers to integration between research, policy and practice and translation of research findings. As such the report aims to act as a guiding resource for future work in this area.

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