“IDUPIED” – An Ethno Pharmacological Study of the Injecting use of performance and image enhancing drugs  Rebekah Brennan , PhD researcher Supervisor Prof. John Wells & Dr. MarieClaire Van Hout Department of Health, Sport and Exercise Science School of Health Sciences

What are PIED? Younger…… Stronger … More Beautiful…

Anabolic Androgenic Steroids (AAS) What are PIED? Anabolic Androgenic Steroids (AAS) synthetic variants of the male sex hormone testosterone. Anabolic= muscle building Androgenic= increased male sex characteristics Can be taken orally but most inject User groups – male and female bodybuilders or strength trainers, athletes, aesthetically driven males Adverse effects include: acne, hair loss, testicular atrophy, development of breasts, mood swings & withdrawal

Human Growth Hormone (hGH) A peptide hormone that stimulates growth, cell reproduction and regeneration in humans and animals Synthetic human growth hormone was developed in 1985 Used as an anabolic agent used to build muscle and improve athletic performance, sometimes alongside AAS Used as an anti-aging agent to reduce wrinkling and other aging signs There is no evidence for hGHs efficacy as an anti-aging treatment

Synthetic Tanning Agents Melanotan I Melanotan II Bremelanotide

Synthetic Tanning Agents Synthetic analogues of the naturally occurring melanocyte-stimulating hormones ( -MSHs) which promote melanogenesis or pigmentation of the hair and skin Melanotan I is currently under phase I and II clinical trials for the treatment of photosensitivity disorder and non-melanoma skin cancer. Melanotan II has emerged in recent years and increases pigmentation at a lower cumulative doses than Melanotan 1, with side effects relating to effects on appetite and sexual stimulation. Third variant is ‘bremelanotide’ which was originally developed to enhance libido User groups include male and female bodybuilders, body dysmorphics and aesthetically driven females

Site Enhancement Oils or Liquids Synthol Synthol typically consists of oil (85%) benzyl alcohol and lidocain is commonly sold as “posing oil” Users inject it into the muscle -“fluffing” Muscles can look deformed & misshapen as a result –”synthol freaks” Side effects of synthol include nerve damage, myocardial infarction, cerebral stroke and infection

Site Enhancement Oils or Liquids Botulinum toxin (Botox) Botox is a drug made from a toxin produced by the bacterium Clostridium botulinum used to treat wrinkles and lines on the face. Potential harms include Flulike symptoms, visual disturbances, chronic fatigue, allergic reaction, pain, bruising and swelling Dermal Fillers Dermal fillers are injectable products made from a range of synthetic, animal and human products. They bulk out the skin & reduce the appearance of lines or plump up lips Potential harms include chronic inflammation, allergic responses, as well as distortion and migration of the filler

Public Health Concern Unregulated and untested products freely available online Risk of contaminated products or misrepresented compounds Users don’t identify with a ‘drug user’ profile May be unaware of the potential harms associated with injecting

The Role of the Internet: Cyberpharmacies

The Role of the Internet: Discussion Forums

Study Outcomes The study will achieve a better understanding of the user profile Examine the cyber sourcing trends Examine the consequences of this form of injecting drug use Inform and measure the effect of current legislative controls Develop recommendations for an early warning system for new emergent PIED drugs, and Ultimately contribute to the design of targeted online prevention and harm reduction brief interventions

Dissemination This study is unique and has not been done before. It will generate new data which will be disseminated as follows: A  IDUPIED project website is under construction targeting lay public and PIED users  A series of concise and clearly written fact-sheets for the general public will be prepared on research findings as they arise, giving information on harm and risks to users. Peer reviewed articles in high indexed health, drug and sporting journals  Oral/poster presentation of study findings at National and International Conferences.

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