Over the last year or so I've come across a lot of people talking about developing tools for monitoring 'Outcomes' in needle programmes, but I've yet to see one that actually manages to work in real life.

Over the last month I've been developing a tool for NSPs that may be a solution.

Steroid use and the use of other performance & image enhancing drugs (PIEDs) have been on the rise in the UK for a number of years now. We even have services reporting that over 50% of new injectors visiting their needle programmes come from these groups.

But in most services workers are being given very little guidance on the types of advice they should give, and most paperwork used is the standard paperwork that is used for opiate injectors. This has resulted in both steroid users and workers having very little confidence in the quality of the harm reduction advice being given.

To help try and address this I've developed a new PIED assessment tool.