Turning health policy into Benefits Street

Thursday, April 10th, 2014

Blood borne viruses have hit the mainstream news this week. This is rare, given the magnitude of the public health crisis awaiting us, but has been reported in an unsurprisingly trashy manner.

Steroid users are sharing needles. This is not a new phenomenon – last year I told you about a needle exchange I worked in twelve years ago, where steroid users would attend like cocky peacocks, using excessive machoism to ensure you knew they ‘weren’t drug users’. Their bulk and their glowing fake tans were a contrast to the usual grey-faced, skinny clientele, but their knowledge of what they perceived as a health intervention, injecting, was significantly inferior to their skeletal counterparts.

Before buying substances over the internet was commonplace, all the local gym owners were selling steroids – but only one of them attended the exchange to provide clean works along with them. He told stories of four or five men cramming themselves into toilet cubicles, passing round a single needle. This was twelve years ago – so one can only imagine the extent of the veinous damage and cross-contamination that has taken place in that time. Couple this with increased, aggressive sex drives, the other likely routes of Hep B and HIV infection. Then consider the additional cardiac strain, potential pulmonary problems, potential for bacterial infections.. Under all that fake tan and muscle, health may just be a mirage.

Which makes it only more irritating that next to news articles shouting the dangers of IV use, on the same page in some cases, are inflammatory pieces about heroin users getting paid to quit. This cheap attention-grabbing seems to miss the point that the clinical trial which paid injectors to receive a course of Hep B immunisations is in fact attempting to avoid the very same public health crisis. And if it only costs £30 to stop someone getting hepatitis, given that it costs £50,000 for a liver transplant, I’d say crack on.

And whilst I really cannot see a £10 shopping voucher acting as a deterrent to serious substance use, in light of current figures showing that over half of our IV drug users already have Hepatitis C and each course of treatment costs up to £14,000 – again, it doesn’t take a maths genius to substantiate the equation. If it reduces injecting rates, it’s worth a go.

It makes us all uncomfortable, of course, the idea that a mother should be paid to breastfeed, or a drug user could get money for accessing basic healthcare. But who, exactly, do we think we are to stand in judgement if these interventions actually work? We Guardian and Independent readers might have the education and social inclusion to make positive decisions about our health without taking bribes – well done us, let’s give ourselves a pat on the back. To presume that everyone operates in the same manner is naive and unempathetic. I wouldn’t inject into a necrotic, stinking hole in my groin, yet thousands do. Should our health policy exclusively fit those who need it the least?

5 comments on “Turning health policy into Benefits Street

  1. Jamie says:

    Maybe in part it’s about responding but not in the traditional sense of opiate based services …. I believe stigma still exists for all IV users in someway – so whilst I don’t think we need to be providing free IV. Equipment to relatively socially mobile young men and women who may , though overly image concious , have a better sense of well being and self respect … I do believe we should enable straight forward pathways to IV equipment …purchased discreetly and from reputable sanctioned outlets or even dispensarys In gyms so as not to push this stuff further underground- again the legality and the stigma with steroid use as is with most illegal substances , seems to pose a greater problem than the risk off use. In most cases

    • Yes it’s a fair point – should they be getting their equipment for free when they have enough money to be members of a gym and buy steroids? I guess, for me, it’s worth the money reducing hepatitis infection in the long run, so I would support gyms being provided with free needles and sharp boxes, if only at first while an education package was undertaken – after that, I don’t think many steroid users would be stupid or desperate enough to share anyway.

      But I agree that different pathways are required, and most steroid users will not present at a drug service.

  2. jefna says:


    My name’s Jefna, I co-edit an arts and culture magazine called Heartwork, relaunching in June. Would it be possible to do a short interview with you?


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