Nice has reiterated its recommendation that pharmacists be commissioned to support the growing number of young people injecting image- and performance-enhancing drugs.

Community pharmacies should train staff to provide drug users with sterile injecting equipment and the means to safely dispose of used needles and syringes, Nice said in updated guidelines published yesterday (April 9).

The guidance, which echoes suggestions it made last year, calls on commissioners to develop specific services to suit the needs of people injecting steroids, Botox and tanning agents. These include setting up programmes in or near gyms and making them available to under-16s, Nice said.

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	Pharmacists offering this service should be able to provide advice on safer injecting practices, preventing overdoses and helping to stop injecting. The advice could also be linked to other services, such as hepatitis and HIV testing, vaccinations, opioid substitution therapy and specialist substance misuse services, Nice said.

Nice suggested that pharmacies with longer opening hours be encouraged to provide needles and other injecting equipment. Out-of-hours vending machines for this equipment should also be considered in certain locations, Nice added.

Professor Mike Kelly, director of the Nice Centre for Public Health Excellence, said he is hopeful the new guidelines will be more relevant to drug users today than the guidance published in 2009.

"We've heard anecdotal evidence that more teenagers are injecting these drugs. These services must be configured to reach and support the people who need them most," he said on Tuesday.

David Rourke, harm reduction lead for charity CRI's needle programme in Sheffield, said services for these drug users have been "patchy to say the least", despite the need for such users to have "[the] same support as anyone else who injects drugs".

While the use of opiates and crack cocaine is believed to be in decline, the Home Office estimated that as many as 60,000 people in England and Wales between the ages of 16 and 59 injected anabolic steroids in 2012.

Of those, 1.5 per cent were diagnosed with HIV. Users were also at a greater risk of developing viral hepatitis, Nice said.

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