title: Variability and dilemmas in harm reduction for anabolic steroid users in the UK: a multi-area interview study.
abstract: BACKGROUND
  The UK continues to experience a rise in the number of anabolic steroid-using clients attending harm reduction services such as needle and syringe programmes.
  
  
  METHODS
  The present study uses interviews conducted with harm reduction service providers as well as illicit users of anabolic steroids from different areas of England and Wales to explore harm reduction for this group of drug users, focussing on needle distribution policies and harm reduction interventions developed specifically for this population of drug users.
  
  
  RESULTS
  The article addresses the complexity of harm reduction service delivery, highlighting different models of needle distribution, such as peer-led distribution networks, as well as interventions available in steroid clinics, including liver function testing of anabolic steroid users. Aside from providing insights into the function of interventions available to steroid users, along with principles adopted by service providers, the study found significant tensions and dilemmas in policy implementation due to differing perspectives between service providers and service users relating to practices, risks and effective interventions.
  
  
  CONCLUSIONS
  The overarching finding of the study was the tremendous variability across harm reduction delivery sites in terms of available measures and mode of operation. Further research into the effectiveness of different policies directed towards people who use anabolic steroids is critical to the development of harm reduction.
authors.affiliation: Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, 4 Windsor Walk, London SE5 8BB, UK. Andreas.Kimergard@kcl.ac.uk.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kimergård
authors.forename: Jim
authors.initials: J
authors.lastname: McVeigh
mesh_terms: D045930:Anabolic Agents / Q000009:adverse effects*; D055030:Drug Users; D040261:Harm Reduction; D006801:Humans; D007273:Injections, Intramuscular; D008111:Liver Function Tests; D018671:Needle-Exchange Programs; D013256:Steroids / Q000009:adverse effects*; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D045930:Anabolic Agents; D013256:Steroids