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Although evidence is somewhat scattered, the use of performance and image enhancing drugs (PIEDs) is long said to be on the rise in the recreational sport scene. It concerns substances that help people lose weight and/or build stronger muscles. Mainline is part of a new European project that aims to test two online interventions around PIED use.
The new project makes efficient use of the experience and knowledge that is available in the projects' partner countries: Finland, Greece, Lithuania, the United Kingdom and the Netherlands. It is up to Mainline to see whether the existing interventions from other countries fit the Dutch context and whether they can contribute to the health of those who use PIEDs.
Doping education
The project runs from January 2018 to December 2019. The formal title of the project is: ‘Towards doping education in recreational sports’. However, informally, the group named the project the DELTS-project after the muscle that is often used to inject steroids.
The project seeks to fill a gap in the public health field that was already identified by the European Commission in 2007 (EU White Paper on Sport) and reaffirmed in 2013 via a European expert group. European experts found that:
Goals
The project has two core objectives:
Mainline’s responsibility is to test one of the interventions in the Dutch context. Our main target group is people who work in the health sector and who might come across PIED users. Naturally, Mainline will, over the course of the project, try to find out whether we could play a role to offer harm reduction services to people who use PIEDs in a recreational setting.
Partners
The project brings together a group of people with extensive expertise in complementing areas. The lead partner is Dopinglinkki- a department of the Finnish A-Clinic Foundation. A-Clinic is, like Mainline, a harm reduction organisation in Finland. They established a multifunctional project that focuses on low-threshold health advice and education: Dopinglinkki. In their country, Dopinglinkki focuses on the recreational sport scene, where the national doping authority focuses on professional athletes.
The partnership further consists of two research institutes renowned for their research on PIED use- the Aristotle University of Thessaloniki in Greece and for their systematic and evaluative drug research Liverpool John Moores University in the United Kingdom. Mainline is the second NGO in the project and brings its expertise on harm reduction. The partnership is completed with the anti-doping Agency of Lithuania.
The online interventions
One intervention is an e-learning tool that was developed by Dopinglinkki in Finland. Mainline will set out to evaluate the acceptability of this tool in the Dutch setting and among health care workers. This could include doctors, nurses and medical staff with a specialisation in PIEDs, general practitioners and people who work at traditional drug services. The online modules will be translated to English and Dutch and tested for its acceptability in Finland, the Netherlands and the United Kingdom. The Finnish module originally targeted those who work in the fitness industry. This original module is translated to Lithuanian and tested by the Lithuanian Anti-doping Agency.
The Aristotle University of Thessaloniki has been the lead partner in an earlier European project, the SAFE YOU project. The second intervention that will be tested was designed under this project. It focuses on coaches and trainers in the recreational sports scene and on (potential) users of PIEDs. The SAFE YOU project was extended due to its success. The application that results from the project will be evaluated under the DELTS project. It will be tested in Lithuania and Greece.
Contact
Are you interested in learning more about this project? Or would you like to see the options for collaboration? Please contact Machteld Busz (m.busz@mainline.nl).
Nepal
Mainline was asked to review the current harm reduction programmes in Nepal from the perspective of women who inject drugs. Based on interviews with women we formulated recommendations to improve service delivery.
Netherlands, Belgium, Spain, Greece, Germany, France
Several risk factors increase the vulnerability of (new) groups of migrants to engage in problematic drug use. These risk factors include traumatic experiences, disengagement with society, unemployment and poverty. Services and municipalities throughout the European Union are faced with the urgent challenge to address these migrants’ needs.
Burkina Faso, Burundi, Egypt, Kenya, Marocco, Mozambique, Nigeria, South Africa, Uganda, Zimbabwe
Mainline is a partner in the Love Alliance programme. The Love Alliance brings together organisations led by communities most affected by HIV and AIDS.
Vietnam
In 2021 and 2022, SCDI in Vietnam and Mainline can continue to strengthen and expand the available harm reduction offer for people who use meth-amphetamines. After establishing the regional field lab in 2019 and 2020 we now have the opportunity to push this innovative initiative to the next level. One important element: to improve and expand the community mental health response. Moreover, the skills that were built in Hanoi's field lab are ready to be further disseminated across the South East Asian Region.
United Kingdom, Finland, Greece, Estonia, Serbia, Portugal, the Netherlands
Harm reduction approaches are rarely applied in a recreational sports setting. And why would we - sport equals health, right? Not always. Research shows that the use of performance and image-enhancing drugs (PIEDs) is quite common in various recreational sport scenes. And for those people who use frequently and in high doses, harm reduction can make a big difference.
Brazil
Mainline is starting a two-year project in Recife, Brazil, together with LANPUD, and the Free School for Harm Reduction (ELRD). The project aims to expand harm reduction and HIV care and support for young people who use crack cocaine.
Global
The use of drugs during sex is a growing worldwide phenomenon among men who have sex with men (MSM). Mainline has built a unique track record while working in the frontline of the Dutch 'chemsex' scene. Now, we also apply this expertise in an international context.
Zimbabwe
Mainline have been asked to assess the drug scene in five provinces in Zimbabwe. A team of three researchers worked in close collaboration with the Zimbabwe Civil Liberties Drug Network throughout 2022. The goal: to gain an insight into which drugs are commonly used and to recommend health interventions.
Kenya
Women who use drugs in Kenya face violence every day: At home. On the streets. By the police. In their communities. A unique study - conducted in Mombasa, Kenya - sheds light on the tough realities these women encounter. Urgent action is needed.
Zambia
Harm reduction is new in Zambia. Mainline was asked to estimate how many people inject drugs in the country and to map the already existing harm reduction and HIV services for people who use drugs. Based on this information, we drafted practical service guidelines. In doing so, Mainline hopes to have contributed to the introduction of harm reduction in Zambia.
Indonesia
Prisons in Indonesia are overcrowded and health services are limited. Is quality prison health too expensive? Not according to findings from Atma Jaya University, who applied the method of 'economic modelling' to prison health services, including drug dependency programmes. The findings fed important advocacy messages to improve the prison system in 2021. Moreover, Atma Jaya - via a 2021 implementation study - succesfully introduced motivational interviewing into the prison setting: an evidence-based method to assist people who are dependent on drugs and would like to reduce or quit their drug use.
Iran
Iran is renowned for its harm reduction programme. It was one of the first countries in this geographical region to adopt a harm reduction approach. Government supports and funds the programme. But the drug scene in Iran has changed over the past 20 years. More people are using stimulant drugs and, due to economic circumstances, more people who use drugs have become homeless. Mainline sets out to see whether the current programme in Tehran still fits the needs of the local people who use drugs.
South Africa
Women Who Use Drugs face additional problems compared to their male counterparts. The harm reduction field far too often neglects the needs of women. To some extent, the same is true for peer workers: incredibly valuable staff in any impactful service. How can local services make sure that peer workers are valued, supported and living up to their full potential? And how can access for women who use drugs be improved?
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