Study aims / objectives:
To report on performance and image enhancing drug (PIED) usage in Western Sydney, including the type and pattern of substance use and associated biochemical and haematological abnormalities.
Population / setting:
A retrospective cohort of young adult male PIED users who have attended a public hospital needle & syringe program (NSP) for the purpose of harm minimisation.
Sixty-eight adult males who visited the NSP on one or more occasions between October 2008 and February 2016 were included in this audit. Drugs used, patterns and duration of usage were highly varied. Self-reported adverse events were relatively infrequent and there were no reported hospitalisations or serious events.
Current PIED use was associated with a significant change in sixteen biochemical and haematological tests when compared with current non-users. The mean testosterone level was abnormally high and significantly greater in active users compared with non-users (42.4 nmol/L vs. 16.0 nmol/L, p<0.001), with a range of 1.7 nmol/L to >120.0 nmol/L in current users. Mean oestradiol was also elevated in current users (323.4 pmol/L vs. 130.5 pmol/L, p 0.01), with a range of <100 pmol/L to 3199 pmol/L in current users. Active PIED use was associated with abnormal lipid levels, with a low mean HDL cholesterol (0.78 mmol/L vs. 1.02 mmol/L, p 0.002) the most significant finding. Other potential cardiovascular risk factors evaluated including blood pressure, haematocrit, LDL cholesterol, total cholesterol, and C-reactive protein were not significantly different between study groups.
This study suggests that decreased HDL may be a significant factor in the reported increased risk of cardiovascular disease in PIED users. PIED users are engaged in their health care and actively seek information from reliable sources regarding potential adverse effects of PIEDs use. This study will raise awareness and inform the medical and wider community of potential harms.