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Piatkowski T, Benn S, Ayurzana L, King M, McMillan S, Hattingh L. Exploring the role of community pharmacies as a harm reduction environment for anabolic-androgenic steroid consumers: triangulating the perspectives of consumers and pharmacists. Harm Reduct J 2024; 21:59. [PMID: 38481218 PMCID: PMC10935940 DOI: 10.1186/s12954-024-00972-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/22/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND While community pharmacies have been successful in providing harm reduction support for illicit substance consumers, little research has explored their role in addressing the needs of anabolic-androgenic steroid (AAS) consumers. OBJECTIVE This study aimed to triangulate the attitudes and experiences of AAS consumers and community pharmacist's regarding AAS harm reduction. METHODS Semi-structured interviews were conducted with AAS consumers (n = 8) and community pharmacists (n = 15) between December 2022 and August 2023 in Australia. Interview data were analysed using reflexive thematic analysis. RESULTS While consumers emphasised easy access to pharmacies, particularly in urban areas, challenges were noted in rural regions. AAS consumers expressed a preference for community pharmacies, perceiving them as less confronting and a feasible avenue for accessing professional advice, highlighting the potential role of pharmacists in nurturing therapeutic alliances with AAS consumers. Similarly, pharmacists expressed receptivity to providing harm reduction information but acknowledged knowledge gaps, suggesting a need for tailored education programs to support AAS consumers effectively. CONCLUSIONS Community pharmacies can be an important environment for AAS harm reduction. Strategies include utilising private spaces for open discussions with AAS consumers and enhancing pharmacists' understanding of AAS to foster trust and support. Further research is needed to address knowledge gaps and training needs for pharmacy staff, with the aim of creating a safer environment for AAS consumers.
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Affiliation(s)
- Timothy Piatkowski
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia.
- Griffith Centre for Mental Health, Griffith University, Brisbane, QLD, Australia.
| | - Sarah Benn
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Lkhagvadulam Ayurzana
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Michelle King
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Sara McMillan
- Griffith Centre for Mental Health, Griffith University, Brisbane, QLD, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Laetitia Hattingh
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
- Pharmacy Department, Gold Coast Health, Southport, QLD, 4215, Australia
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Piatkowski T, Puljevic C, Francis C, Ferris J, Dunn M. "They sent it away for testing and it was all bunk": Exploring perspectives on drug checking among steroid consumers in Queensland, Australia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 119:104139. [PMID: 37481876 DOI: 10.1016/j.drugpo.2023.104139] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
INTRODUCTION Research supports the feasibility and acceptance of drug checking among nightlife and festival attendees. Interest in expanding drug checking to other groups of people who use drugs, including those who inject drugs, has grown. However, understanding the acceptability and feasibility of drug checking among specific cohorts, like anabolic-androgenic steroids (AAS) consumers, remains a research gap. This study explores AAS consumers' perspectives on drug checking and service preferences, aiding the preparation for drug checking delivery in Queensland, Australia. METHODS A purposive sampling technique was used to recruit 15 AAS consumers (9 males, 6 females; Mage = 36.80 years, SD = 6.12) from Australia. One-on-one semi-structured qualitative interviews were conducted with questions exploring participants' views on drug checking/testing and their preferences for AAS analysis. Thematic analysis was conducted with final themes established through iterative consensus. RESULTS Consumers expressed frustration with the prevailing stereotypes, social stigma, and the perception of criminality associated with the use of AAS. There was a strong dependence on personal connections and trusted suppliers, with coaches exerting significant influence. Participants expressed concerns about the widespread availability of counterfeit products and underground operations. The act of using unknown AAS was likened to a game of Russian roulette, underscoring the importance of obtaining accurate information and access to reliable drug checking services. Consumers expressed a preference for a web-based platform that enables individuals to access their own test results while contributing to a comprehensive database of brand-specific testing outcomes. DISCUSSION AAS consumers recognise the significance of monitoring their AAS use and seek a service that can not only assist them in making informed decisions regarding AAS usage but also potentially contribute to the knowledge of the wider AAS-consuming community. These findings underscore the importance of tailored education, drug checking services, and harm reduction measures to address the diverse needs of AAS consumers.
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Affiliation(s)
- Timothy Piatkowski
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia; The Loop Australia, Australia.
| | - Cheneal Puljevic
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia; The Loop Australia, Australia
| | | | - Jason Ferris
- The Loop Australia, Australia; Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Matthew Dunn
- The Loop Australia, Australia; School of Health and Social Development/Institute for Health Transformation, Deakin University, Geelong, Australia
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Barkoukis V, Harris PR, Rowe R, Lazuras L. Self-Affirmation and Image/Performance Enhancing Drug Use in Recreational Exercise. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2023; 94:698-706. [PMID: 35452365 DOI: 10.1080/02701367.2022.2046253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 02/18/2022] [Indexed: 06/14/2023]
Abstract
Objectives: The use of image and performance enhancement drugs (IPEDs) in recreational sport represents an emerging public health and societal problem. The present study investigated whether self-affirmation changed exercisers' intentions to use IPEDs, via the effects of mental construal and message acceptance. Method: Sixty-eight exercisers who self-reported IPEDs use participated in the study and were randomly assigned to either a self-affirmation or a control group. All participants read a health-related message about the 10 consequences of IPEDs and subsequently completed a survey measuring message acceptance, mental construal, doping intentions and IPEDs-related social cognitive variables. Results: There were no significant differences between the self-affirmed and the control groups. Hierarchical linear regression analysis further showed that message acceptance, subjective norms, and situational temptation were significantly associated with intentions to use IPEDs. Conclusion: Our findings raise the possibility that for recreational exercisers IPED's use is seen mostly as a health-related matter than a socio-moral transgression.
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Harvey O, van Teijlingen E, Parrish M. Mixed-methods research on androgen abuse - a review. Curr Opin Endocrinol Diabetes Obes 2022; 29:586-593. [PMID: 35943190 DOI: 10.1097/med.0000000000000767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW This paper reviews the mixed-methods studies from the last 2 years (2021-2022) into androgen use to highlight the most relevant developments within the field. RECENT FINDINGS The literature review found seven papers from 2021 to 2022. These seven cover a range of important considerations, including interventions to reduce androgen use, educational tools to increase professionals' knowledge, explorations on the comorbidity of use with other substances, motivations for use, potential risks factors for androgens' initiation, or risks of using androgens. Key findings include a greater understanding of motivations for use, particularly in females and older males; identification of potential risks for starting use/using androgens; benefits of including practical strength exercises in preventive intervention programmes and the efficacy of e-learning tools to increase professionals' knowledge of androgens use, as well as an increase in their confidence to support androgen users. SUMMARY The key implications for clinical practice are that we still need to support healthcare professionals to overcome the barriers for increasing their skills and knowledge around androgen use. A recognition that people who have become dependent on androgen use are potentially at risk of considerable harm, with further research needed into sub-groups of androgen users. VIDEO ABSTRACT , http://links.lww.com/COE/A35.
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Hearne E, Atkinson A, Boardley I, McVeigh J, Van Hout MC. ‘Sustaining masculinity’: a scoping review of anabolic androgenic steroid use by older males. DRUGS: EDUCATION, PREVENTION AND POLICY 2022. [DOI: 10.1080/09687637.2022.2132135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Evelyn Hearne
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Amanda Atkinson
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Ian Boardley
- Department of Sociology, Manchester Metropolitan University, Manchester, UK
| | - Jim McVeigh
- School of Sport Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Marie Claire Van Hout
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK
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James E, Wynn L. Testosterone vs. steroids: Comparing the disciplined bodywork projects of performance and image enhancing drug users in Australia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 107:103776. [DOI: 10.1016/j.drugpo.2022.103776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/14/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022]
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Nácul AP, Rezende GP, Gomes DAY, Maranhão T, Costa LOBF, Dos Reis FM, Maciel GAR, Damásio LCVDC, de Sá Rosa E Silva ACJ, Lopes VM, Baracat MC, Soares GM, Soares JM, Benetti-Pinto CL. Use of androgens at different stages of life: reproductive period. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:988-994. [PMID: 34933394 PMCID: PMC10183883 DOI: 10.1055/s-0041-1740610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Andrea Prestes Nácul
- Unidade de Reprodução Humana, Hospital Fúmina, Grupo Hospitalar Conceição, Porto Alegre,RS, Brazil
| | | | | | - Técia Maranhão
- Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | | | | | | | | | | | | | | | | | - José Maria Soares
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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McVeigh J, Hearne E, Boardley I, Bates G, Hope V, Ralphs R, Van Hout MC. Generating evidence on the use of Image and performance enhancing drugs in the UK: results from a scoping review and expert consultation by the Anabolic Steroid UK network. Harm Reduct J 2021; 18:107. [PMID: 34657627 PMCID: PMC8522223 DOI: 10.1186/s12954-021-00550-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/23/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The use of anabolic androgenic steroids (AAS) and associated image and performance enhancing drugs (IPEDs) is now a global phenomenon. There is a need to develop evidence to support the development of interventions to prevent the commencement of use, to minimise the potential harms or to support those in their cessation of use. While the United Kingdom (UK) is no exception to this issue, its public health and legislative response to the phenomenon differs to other countries and requires the examination of research specific to the UK. Therefore, a scoping review has been conducted to examine the recent relevant literature to help inform the development and evaluation of effective interventions to reduce the harmful use of IPEDs. METHODS A comprehensive search strategy was developed for multiple bibliographic databases, supported by and iterative citation searching process and complimented by expert input from the Anabolic Steroid UK Network. Research conducted by or UK academics or within the UK were eligible, if published in the previous five years. RESULTS In total 87 eligible outputs were identified, including 26 review articles, 25 qualitative papers and 24 quantitative papers. together with small numbers of clinical studies/case reports (6) and commentaries/correspondence (6). The most common topics of research were public health, treatment and harm reduction (41), followed by studies focusing on epidemiology, sub-groups of people using IPEDs and motivations for use (34). The studies illustrated the diverse populations of people who use a range of enhancement drugs including concomitant psychoactive drug use. A number of papers focused on blood borne viruses and associated issues, while others reported on the uptake of needle and syringe programmes. No effectiveness evaluations related to any aspect of treatment, harm reduction or other intervention were published during study period. CONCLUSION There is a need for the development of effectiveness evaluations of current interventions and any future service provision for people using image and performance enhancing drugs. While there have been no studies of this nature to date, this review illustrates the rich data that has been gathered through diverse methodologies, that will assist in the development of future effectiveness evaluations.
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Affiliation(s)
- Jim McVeigh
- Substance Use & Associated Behaviours, Department of Sociology, Manchester Metropolitan University, Manchester, UK.
| | - Evelyn Hearne
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Ian Boardley
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Geoff Bates
- Institute for Policy Research, University of Bath, Bath, UK
| | - Vivian Hope
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Rob Ralphs
- Substance Use & Associated Behaviours, Department of Sociology, Manchester Metropolitan University, Manchester, UK
| | - Marie Claire Van Hout
- Faculty of Health, Public Health Institute, Liverpool John Moores University, Liverpool, UK
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Campbell A, Carins J, Rundle-Thiele S, Deshpande S, Baker B. Motivators of Indiscriminate and Unsafe Supplement Use among Young Australians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199974. [PMID: 34639275 PMCID: PMC8507933 DOI: 10.3390/ijerph18199974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is growing concern about the self-administration of supplements, which can often be indiscriminate, counterproductive to health, and serve as a gateway to more harmful drugs and substances. Research suggests that high uptake of performance- and image-enhancing drugs (PIEDs) is correlated with body image to accentuate masculinity. This study provides insights into limiting unhealthy supplement usage. This research identifies reasons for casual unhealthy supplement use among young adult Australians through the Theory of Planned Behavior (TPB) lens, providing practitioners with insights into developing interventions to deter their use. METHOD Semi-structured in-depth interviews were conducted with ten participants aged between 18 and 40, using a convenience sample. Leximancer analysis was used to assess word co-occurrence and map to TPB constructs. RESULTS Leximancer identified positive attitudes, social norms, and perceived behavioral control towards supplement usage. Key themes that influenced supplement use were weight loss, body image, nutrition, training, education, challenges, need, and time. Furthermore, using TPB constructs, affective and instrumental attitudes and prevailing norms were observed when investigating what would cause an individual to use supplements in an unhealthy manner. CONCLUSION Through understanding the motivations of indiscriminate supplement use across the Australian population, the study has uncovered several social factors that may reduce or limit the practice of unsafe supplement usage.
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Affiliation(s)
- Alexander Campbell
- Social Marketing at Griffith, Griffith Business School, Griffith University, Nathan, QLD 4111, Australia; (J.C.); (S.R.-T.); (S.D.)
- Correspondence: ; Tel.: +61-7-37358449
| | - Julia Carins
- Social Marketing at Griffith, Griffith Business School, Griffith University, Nathan, QLD 4111, Australia; (J.C.); (S.R.-T.); (S.D.)
| | - Sharyn Rundle-Thiele
- Social Marketing at Griffith, Griffith Business School, Griffith University, Nathan, QLD 4111, Australia; (J.C.); (S.R.-T.); (S.D.)
| | - Sameer Deshpande
- Social Marketing at Griffith, Griffith Business School, Griffith University, Nathan, QLD 4111, Australia; (J.C.); (S.R.-T.); (S.D.)
| | - Bradley Baker
- Defence Science & Technology Group, Land Division, Scottsdale, TAS 7260, Australia;
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Whyte I, Pattinson E, Leyland S, Soos I, Ling J. Performance and image enhancing drugs use in active military personnel and veterans: A contemporary review. TRANSLATIONAL SPORTS MEDICINE 2021. [DOI: 10.1002/tsm2.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ian Whyte
- Faculty of Health Sciences and Wellbeing University of Sunderland Sunderland UK
| | | | - Sandra Leyland
- Faculty of Health Sciences and Wellbeing University of Sunderland Sunderland UK
| | - Istvan Soos
- Pedagogy and Methodology Department University of Physical Education Budapest UK
| | - Jonathan Ling
- Faculty of Health Sciences and Wellbeing University of Sunderland Sunderland UK
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Henning A, Andreasson J. Preventing, producing, or reducing harm? Fitness doping risk and enabling environments. DRUGS-EDUCATION PREVENTION AND POLICY 2020. [DOI: 10.1080/09687637.2020.1865273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- April Henning
- Faculty of Health Sciences and Sport, Sports Studies, University of Stirling, Stirling, UK
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Askew R, Williams L. Rethinking enhancement substance use: A critical discourse studies approach. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 95:102994. [PMID: 33272772 DOI: 10.1016/j.drugpo.2020.102994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/25/2020] [Accepted: 09/30/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND We draw on both interdisciplinary enhancement substance use research and critical drug studies scholarship to reconceptualise enhancement substance use. Our critical discourse approach illuminates how a variety of substances are positioned as tools for self-improvement. In reconceptualising enhancement substance use, we ask what different substances can be positioned as providing enhancement? How are they positioned as tools for achieving enhancement or self-improvement goals? What discursive repertoires are employed to achieve these aims? METHODS Forty interviews were conducted with people who use substances, such as ayahuasca, psilocybin, cocaine, alcohol, nootropics and non-prescription pharmaceuticals, including Adderall and modafinil. To explore the meanings of and motivations for substance consumption, we apply the sociocognitive approach (SCA) pioneered by Teun van Dijk (2014; 2015) and examine language through the triangulation of cognition, discourse and society. We analyse how different substances are positioned as tools for achieving enhancement or self-improvement goals. RESULTS We identify three distinct discursive repertoires that frame substance use as enhancement: the discourse of transformation, the discourse of healing and the discourse of productivity. When accounting for enhancement substance use, our participants employ a number of discursive strategies, including ideological polarisation or 'othering', analogies, examples, maxims, metaphors and figurative speech. We also find evidence of interdiscursivity with most participants drawing on more than one discourse when speaking about how substances are positioned as providing enhancement. CONCLUSION We conclude that the concept of enhancement has wider applicability than current understandings allow. We argue that if we reframe all substance use as providing enhancement or achieving a self-improvement goal, we have the potential to destigmatise substance use and eliminate the over-simplistic binaries that surround it.
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Affiliation(s)
- Rebecca Askew
- Manchester Metropolitan University, Department of Sociology, All Saints Campus, Geoffrey Manton Building, Rosamond Street West, M15 6LL.
| | - Lisa Williams
- University of Manchester, Department of Criminology, School of Social Sciences, Williamson Building, Oxford Road, Manchester, M13 9PL
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Havnes IA, Bukten A, Rognli EB, Muller AE. Use of anabolic-androgenic steroids and other substances prior to and during imprisonment - Results from the Norwegian Offender Mental Health and Addiction (NorMA) study. Drug Alcohol Depend 2020; 217:108255. [PMID: 32949884 DOI: 10.1016/j.drugalcdep.2020.108255] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/10/2020] [Accepted: 08/20/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Anabolic-androgenic steroid (AAS) use is associated with health problems and substance use. Substance use is common among inmates. This study aims to estimate lifetime and prison use of AAS and other substances, compare characteristics of groups of inmates, and describe factors associated with AAS use in a national prison population. METHODS Data from the Norwegian Offender Mental Health and Addiction (NorMA) Study, a cross-sectional survey of people in prisons, included sociodemographic variables and lifetime and prison use of AAS and other substances. Altogether 1,499 inmates, including 96 (6.4%) women, were divided into three mutually exclusive groups according to lifetime AAS use, non-AAS substance use and no substance use. RESULTS Lifetime AAS use was reported by 427 (28.5%) inmates; 6 women and 421 men. Non-AAS substance use was reported by 593 (39.6%) and 479 (31.9%) had never used AAS or non-AAS substances. Compared to the non-AAS substance group, the AAS group reported younger debut ages for nearly all non-AAS substances, higher mean number of non-AAS substances used in their lifetime (8.9, 6.6, p < 0.001), during the six months prior to incarceration (5.2, 3.1, p < 0.001), and during (2.3, 1.3, p < 0.001) imprisonment. Although 120 (8.0%) inmates used AAS during the six months prior to incarceration, only ten continued during imprisonment. CONCLUSIONS Lifetime AAS use is common among inmates and may be an indicator of more severe substance use problems. Screening for previous and present AAS use at incarceration and increased staff awareness are needed to tailor treatment approaches appropriately.
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Affiliation(s)
- Ingrid Amalia Havnes
- National Advisory Unit on Substance Use Disorder Treatment, Oslo University Hospital, Pb 4959, Nydalen, 0424, Oslo, Norway.
| | - Anne Bukten
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, 0318, Oslo, Norway; Section for Clinical Addiction Research (RusForsk), Oslo University Hospital, Pb 4956, Nydalen, 0424, Oslo, Norway
| | - Eline Borger Rognli
- Section for Clinical Addiction Research (RusForsk), Oslo University Hospital, Pb 4956, Nydalen, 0424, Oslo, Norway
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Henning A, McLean K, Andreasson J, Dimeo P. Risk and enabling environments in sport: Systematic doping as harm reduction. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 91:102897. [PMID: 32768155 PMCID: PMC7402240 DOI: 10.1016/j.drugpo.2020.102897] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/20/2020] [Accepted: 07/29/2020] [Indexed: 01/21/2023]
Abstract
Doping and the use of performance enhancing drugs (PEDs) are often considered and discussed as a separate issue from other types of substance use, by sporting bodies, politicians, the media, and athletes who use drugs themselves. However, perceptions and understandings of substance use in the sport and fitness world are directly related to those of substance use in the non-sport world. One way the gap between sport and non-sport substance use research can be bridged is to consider sport risk and enabling environments. Similar to non-sport contexts and drug use, it is important to analyse the environments in which doping occurs. This approach allows us to examine the dynamic interplay between risk and enabling factors, as the enabling environment shifts in response to changes produced in the risk environment, and vice versa. There are models of sport environments that have proven effective at both enabling doping by athletes and reducing harms to athletes: systematic doping. This article will use secondary literature in order to review and analyse known cases of systematic doping through the risk and enabling environment frameworks. We argue that these systems responded to anti-doping in ways that protected athletes from the risk factors established by anti-doping policy and that athletes suffered most when these systems were revealed, exposing athletes to the full range of doping harms. Further, we argue that risks within these systems (i.e. extortion, bullying) resulted from the broader prohibitive sport environment that forces doping underground and allows such abuses to occur.
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Affiliation(s)
- April Henning
- Faculty of Health Sciences and Sport, University of Stirling, UK.
| | | | | | - Paul Dimeo
- Faculty of Health Sciences and Sport, University of Stirling, UK
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Reynolds CA, Davison KL, Andrews N, Brailsford SR. What are blood donors telling us about injecting drug use? Vox Sang 2020; 115:637-646. [PMID: 32702174 DOI: 10.1111/vox.12976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 06/04/2020] [Accepted: 06/20/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Injecting drug use (IDU), a permanent deferral for blood donors, was included in a review of donor selection criteria completed in 2017. Here, we describe what is known about IDU in blood donors in the United Kingdom (UK). MATERIALS AND METHODS Data were obtained from routine surveillance of donation testing and confirmed positive donors and a 2013/2014 UK survey of behaviour and compliance in screen-negative donors. RESULTS Between 2009 and 2018, of 22 UK million donations screened, IDU was self-reported at the post-test discussion in 5% (86/1777) of donors with confirmed positive donations. Recent injecting within 12 months was reported in 8 HCV-positive donors, but only in 1/14 donors where it was clear HCV infection had been acquired in the previous 12 months. Of 65 439 survey responders, 25 reported IDU, which when weighted to the donor population gave 99·95% compliance. Most of the 111 donors reporting IDU felt it was not important to their donation, mainly because their injecting was in the past, while three HCV-positive recent injectors reported not sharing needles so presumably felt safe to donate. CONCLUSION Compliance with the permanent deferral appeared extremely high with low levels of injecting reported by donors, mainly in the past. This agreed with the low-incident HCV infection observed in UK donors. These data contributed to a recommendation to reduce the deferral to 1 year. Ways of improving compliance in those few donors at current increased risk of infection need to be investigated.
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Affiliation(s)
- Claire A Reynolds
- NHS Blood and Transplant/Public Health England Epidemiology Unit, NHS Blood and Transplant, London, UK
| | - Katy L Davison
- NHS Blood and Transplant/Public Health England Epidemiology Unit, Public Health England, London, UK
| | - Nick Andrews
- Statistics, Modelling and Economics Department, Public Health England, London, UK
| | - Susan R Brailsford
- NHS Blood and Transplant/Public Health England Epidemiology Unit, NHS Blood and Transplant, London, UK
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Mullen C, Whalley BJ, Schifano F, Baker JS. Anabolic androgenic steroid abuse in the United Kingdom: An update. Br J Pharmacol 2020; 177:2180-2198. [PMID: 31989581 PMCID: PMC7174889 DOI: 10.1111/bph.14995] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/03/2019] [Accepted: 01/07/2020] [Indexed: 12/11/2022] Open
Abstract
Anabolic androgenic steroids (AASs) are prescribed for medical conditions related to low testosterone. Abuse of AASs has surged as they become recognised as potent image enhancement drugs. The primary goal of most abusers is to obtain a more attractive outward appearance. Abuse is complex. There are a vast range of AAS substances illegally available, the nature of their true composition is difficult to evaluate. Users follow dosing patterns which incorporate a number of different AASs, in addition to other pharmaceutical substances believed to complement the desired physical effects or manage unwanted effects. Animal work and medical case reports suggest potential to cause serious hepatotoxicity, plus possible neurotoxicity, nephrotoxicity and damage to the cardiovascular and reproductive systems. As the long-term AASs users reach maturity, further controlled experimentation, with larger sample sizes, is required. Data gathering should be directed towards the most vulnerable group of AAS users, females and adolescent boys.
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Affiliation(s)
- Carrie Mullen
- School of Computing, Engineering and Physical SciencesUniversity of the West of ScotlandPaisleyUK
| | - Benjamin J. Whalley
- School of Chemistry, Food and Nutritional Sciences, and PharmacyThe University of ReadingReadingUK
| | - Fabrizio Schifano
- School of Life and Medical SciencesUniversity of HertfordshireHatfieldUK
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and HealthHong Kong Baptist UniversityKowloon TongHong Kong
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Anabolic-Androgenic Steroid Use in the Eastern Mediterranean Region: a Scoping Review of Extant Empirical Literature. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00217-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AbstractThe use of image- and performance-enhancing drugs particularly anabolic-androgenic steroids (AAS) is not a new phenomenon. AAS use is not limited to athletes, with mainstream populations using these drugs for aesthetic purposes. Prevalence has been predominantly in Western countries, with some recent studies indicating a rise in popularity in the Eastern Mediterranean region. A scoping review of extant empirical literature from the Eastern Mediterranean region described and mapped what is known about the extent of AAS in the region. Four themes emerged from the review: (1) profile of AAS users; (2) AAS within gymnasium practice; (3) AAS regimes of use; and (4) knowledge and understanding of the AAS concept and related adverse effects. The review highlights a relatively new phenomenon of AAS use in the Eastern Mediterranean. The review underscores the need to carry out further research, particularly qualitative and quantitative studies with both genders, and cognisant of the complexities of culture and religiosity.
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Bates G, Van Hout MC, Teck JTW, McVeigh J. Treatments for people who use anabolic androgenic steroids: a scoping review. Harm Reduct J 2019; 16:75. [PMID: 31888665 PMCID: PMC6937954 DOI: 10.1186/s12954-019-0343-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 11/21/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND A growing body of evidence suggests that anabolic androgenic steroids (AAS) are used globally by a diverse population with varying motivations. Evidence has increased greatly in recent years to support understanding of this form of substance use and the associated health harms, but there remains little evidence regarding interventions to support cessation and treat the consequences of use. In this scoping review, we identify and describe what is known about interventions that aim to support and achieve cessation of AAS, and treat and prevent associated health problems. METHODS A comprehensive search strategy was developed in four bibliographic databases, supported by an iterative citation searching process to identify eligible studies. Studies of any psychological or medical treatment interventions delivered in response to non-prescribed use of AAS or an associated harm in any setting were eligible. RESULTS In total, 109 eligible studies were identified, which included case reports representing a diverse range of disciplines and sources. Studies predominantly focussed on treatments for harms associated with AAS use, with scant evidence on interventions to support cessation of AAS use or responding to dependence. The types of conditions requiring treatment included psychiatric, neuroendocrine, hepatic, kidney, cardiovascular, musculoskeletal and infectious. There was limited evidence of engagement with users or delivery of psychosocial interventions as part of treatment for any condition, and of harm reduction interventions initiated alongside, or following, treatment. Findings were limited throughout by the case report study designs and limited information was provided. CONCLUSION This scoping review indicates that while a range of case reports describe treatments provided to AAS users, there is scarce evidence on treating dependence, managing withdrawal, or initiating behaviour change in users in any settings. Evidence is urgently required to support the development of effective services for users and of evidence-based guidance and interventions to respond to users in a range of healthcare settings. More consistent reporting in articles of whether engagement or assessment relating to AAS was initiated, and publication within broader health- or drug-related journals, will support development of the evidence base.
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Affiliation(s)
- Geoff Bates
- Public Health Institute, Liverpool John Moores University, Liverpool, England
| | | | | | - Jim McVeigh
- Department of Sociology, Manchester Metropolitan University, Manchester, England
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Fomiatti R, Lenton E, Latham JR, Fraser S, Moore D, Seear K, Aitken C. Maintaining the healthy body: Blood management and hepatitis C prevention among men who inject performance and image-enhancing drugs. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 75:102592. [PMID: 31855731 DOI: 10.1016/j.drugpo.2019.10.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 10/21/2019] [Accepted: 10/27/2019] [Indexed: 12/11/2022]
Abstract
Australia's ambitious aim to 'eliminate' hepatitis C as a public health concern by 2030 requires researchers, policy makers and health practitioners to engage with populations rarely identified as a priority. Men who inject performance and image-enhancing drugs (PIEDs) are one such population, yet research suggests they have low rates of knowledge about hepatitis C. Although rates of needle-sharing in this group are thought to be low, other risks of blood-to-blood contact exist due to the use of large-gauge needles, intramuscular injecting, hard-to-reach injection sites, repeated injecting and peer-to-peer injecting. How should health initiatives engage people who might not customarily consider themselves vulnerable to hepatitis C? Drawing on the work of body theorist Margrit Shildrick, this article considers how men who inject PIEDs understand their bodies, with a particular focus on injecting practices, blood awareness and infection control, in order to inform hepatitis C prevention efforts. In our analysis, we draw on qualitative interviews with 60 men who inject PIEDs, which we conducted for an Australian Research Council-funded project focused on better understanding PIED injecting to improve health and minimise hepatitis C transmission. The interviews suggest that men who inject PIEDs closely monitor potential external infection risks, such as dirt and bacteria that might intrude upon the 'purity and security' of the body. However, less attention appears to be paid to what might be transferred out of the body and potentially to others, such as blood. Notions of trust and cleanliness, and normative perceptions of intravenous drug use, also shaped injecting practices and cursory attention to blood management. While environmental transmission poses a smaller transmission risk than needle-sharing, educating PIED consumers about it is nevertheless warranted. Focusing targeted health promotion materials on environmental blood as a potential route of hepatitis C transmission may help engage this population in prevention, and encourage more frequent hepatitis C testing.
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Affiliation(s)
- Renae Fomiatti
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia.
| | - Emily Lenton
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia
| | - J R Latham
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, Australia; School of Culture and Communication, University of Melbourne, Parkville, Australia
| | - Suzanne Fraser
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia
| | - David Moore
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia; National Drug Research Institute, Curtin University, Perth, Australia
| | - Kate Seear
- National Drug Research Institute, Curtin University, Perth, Australia; Faculty of Law, Monash University, Clayton, Australia
| | - Campbell Aitken
- Burnet Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Australia
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Latham JR, Fraser S, Fomiatti R, Moore D, Seear K, Aitken C. Men’s Performance and Image-Enhancing Drug Use as Self-Transformation: Working Out in Makeover Culture. AUSTRALIAN FEMINIST STUDIES 2019. [DOI: 10.1080/08164649.2019.1644952] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- J. R. Latham
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, Australia
- School of Culture and Communication, University of Melbourne, Parkville, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Suzanne Fraser
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia
| | - Renae Fomiatti
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia
| | - David Moore
- National Drug Research Institute, Curtin University, Perth, Australia
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia
| | - Kate Seear
- National Drug Research Institute, Curtin University, Perth, Australia
- Faculty of Law, Monash University, Clayton, Australia
- Springvale Monash Legal Service, Springvale, Australia
| | - Campbell Aitken
- Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Australia
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Harvey O, Keen S, Parrish M, van Teijlingen E. Support for people who use Anabolic Androgenic Steroids: A Systematic Scoping Review into what they want and what they access. BMC Public Health 2019; 19:1024. [PMID: 31366349 PMCID: PMC6670144 DOI: 10.1186/s12889-019-7288-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/09/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Since there is a paucity of research on support for people using Anabolic Androgenic Steroids (AAS), we aimed to identify and synthesise the available evidence in this field. Gaining an understanding of the support both accessed and wanted by recreational AAS users will be of use to professionals who provide services to intravenous substance users and also to those working in the fields of public health and social care, with the aim to increase engagement of those using AAS. METHODS A systematic scoping review of the literature to explore and identify the nature and scope of information and support both accessed and wanted by non-prescribed AAS users. Any support services or information designed to help people who use AAS were considered. RESULTS We identified 23 papers and one report for review, which indicated that AAS users access a range of sources of information on: how to inject, substance effectiveness, dosages and side effects, suggesting this is the type of information users want. AAS users sought support from a range of sources including medical professionals, needle and syringe programmes, friends, dealers, and via the internet, suggesting that, different sources were used dependent on the information or support sought. DISCUSSION AAS users tended to prefer peer advice and support over that of professionals, and access information online via specialist forums, reflecting the stigma that is experienced by AAS users. These tendencies can act as barriers to accessing services provided by professionals. CONCLUSIONS Support needs to be specific and targeted towards AAS users. Sensitivity to their perceptions of their drug-use and the associated stigma of being classified in the same sub-set as other illicit drug users is relevant to facilitating successful engagement.
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Affiliation(s)
- Orlanda Harvey
- Bournemouth University, Lansdowne Campus, Royal London House, 109 Christchurch Road, Bournemouth, BH1 3LT UK
| | - Steve Keen
- Bournemouth University, Lansdowne Campus, Royal London House, 109 Christchurch Road, Bournemouth, BH1 3LT UK
| | - Margarete Parrish
- Bournemouth University, Lansdowne Campus, Royal London House, 109 Christchurch Road, Bournemouth, BH1 3LT UK
| | - Edwin van Teijlingen
- Bournemouth University, CMMPH, Bournemouth House, 19 Christchurch Road, Bournemouth, BH1 3LH UK
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Lykhonosov MP, Babenko AY. [The medical aspect of using anabolic androgenic steroids in males attending gyms of Saint-Petersburg]. ACTA ACUST UNITED AC 2019; 65:19-30. [PMID: 31091047 DOI: 10.14341/probl9832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 09/06/2018] [Accepted: 11/12/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Anabolic androgenic steroids (AASs) are often used by individuals engaged in physical recreational activity. AASs inhibit the hypothalamus-pituitary-gonad axis and can cause erectile dysfunction and reduced fertility. There is no data on the use of AASs in this category of people in the Russian Federation; therefore, a study exploring the rate and patterns of using steroids for non-medical purposes is topical. Aim - of this study was to investigate the rate and patterns of using AASs in males attending gyms in Saint Petersburg. MATERIAL AND METHODS We used individual anonymous postal survey of males attending gyms. We analyzed demographic and anthropometric data, information on the use of AASs, awareness of their side effects, used agents, patterns and duration of their use, and rehabilitation therapy. RESULTS Out of 1,815 sent questionnaires, we received back 762 ones. The criteria were met by 550 questionnaires. The mean age was 29.3±7.4 years. The use of AASs was reported by 30.4% of respondents. The main AAS (74.3%) consumers were males aged 22 to 35 years. The most popular drug was Testosterone Propionate (51.5%); the drug was often combined with Oxandrolone (19.7%). In 70.6% of cases, drugs were administered by injection or injection combined with tablet intake. The injectable testosterone dose ranged from 500 to 2,000 mg/week and above. The most common dose was 1,000 mg/week (23.9%). AAS administration for more than 1 year was reported in 16.1% of males. Anastrozole (55%), hCG (51.3%), Clomiphene (41.3%), and Tamoxifen (30.5%) were used during the recovery period. The main source of information on AASs, doses, and dosage patterns was the Internet (48.7%). A negative attitude towards AASs was found in 17.3% of respondents. The desire to receive qualified information about AASs and their impact on health was reported by 54.8% of the surveyed respondents. CONCLUSION Almost every fourth gym visitor has experience in using AASs. These are males of an optimal reproductive age. The common pattern of using AASs is an aggressive steroid course followed by a recovery period. The list of used drugs and their doses indicate a significant pharmacological intervention and a high risk to health.
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Salinas M, Floodgate W, Ralphs R. Polydrug use and polydrug markets amongst image and performance enhancing drug users: Implications for harm reduction interventions and drug policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 67:43-51. [DOI: 10.1016/j.drugpo.2019.01.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/26/2018] [Accepted: 01/16/2019] [Indexed: 11/30/2022]
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24
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Bodybuilding and Fitness Doping in Transition. Historical Transformations and Contemporary Challenges. SOCIAL SCIENCES 2019. [DOI: 10.3390/socsci8030080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This article describes and analyses the historical development of gym and fitness culture in general and doping use in this context in particular. Theoretically, the paper utilises the concept of subculture and explores how a subcultural response can be used analytically in relation to processes of cultural normalisation as well as marginalisation. The focus is on historical and symbolic negotiations that have occurred over time, between perceived expressions of extreme body cultures and sociocultural transformations in society—with a perspective on fitness doping in public discourse. Several distinct phases in the history of fitness doping are identified. First, there is an introductory phase in the mid-1950s, in which there is an optimism connected to modernity and thoughts about scientifically-engineered bodies. Secondly, in the 1960s and 70s, a distinct bodybuilding subculture is developed, cultivating previously unseen muscular male bodies. Thirdly, there is a critical phase in the 1980s and 90s, where drugs gradually become morally objectionable. The fourth phase, the fitness revolution, can be seen as a transformational phase in gym culture. The massive bodybuilding body is replaced with the well-defined and moderately muscular fitness body, but at the same time there are strong commercialised values which contribute to the development of a new doping market. Finally, it is possible to speculate on the development of a fifth phase, in which fitness doping is increasingly being filtered into mainstream gym and fitness culture, influencing the fitness doping demography.
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The unintended consequences of emphasising blood-borne virus in research on, and services for, people who inject image and performance enhancing drugs: A commentary based on enhanced bodybuilder perspectives. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 67:19-23. [PMID: 30844641 DOI: 10.1016/j.drugpo.2018.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/07/2018] [Accepted: 11/19/2018] [Indexed: 11/22/2022]
Abstract
Blood-borne viruses (BBVs) are an established focus of drug research and harm reduction. While a focus on BBVs has been applied to people who inject image and performance enhancing drugs (IPEDs), research has demonstrated that there are significant differences between this group and people who inject other drugs. Furthermore, the literature on BBVs and IPED use has been misrepresented by the media and harm reduction programs, with significant consequences for how some people who inject IPEDs view academic research and health services. It seems time to ask, is our current approach to the issue of BBV among people who inject IPEDs the most appropriate, and are there ways that it could be improved to ensure that there are no unintended consequences? In this commentary I suggest ways research and harm reduction efforts could tackle the issue of BBV without exacerbating existing divides between people who inject IPEDs and the health and academic communities. These suggestions are based on the views of the enhanced bodybuilders with whom I am privileged to work.
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Glass R, Hope VD, Njoroge J, Edmundson C, Smith J, McVeigh J, Parry J, Desai M. Secondary distribution of injecting equipment obtained from needle and syringe programmes by people injecting image and performance enhancing drugs: England and Wales, 2012-15. Drug Alcohol Depend 2019; 195:40-44. [PMID: 30580202 DOI: 10.1016/j.drugalcdep.2018.11.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/19/2018] [Accepted: 11/19/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND People who inject image and performance enhancing drugs (IPEDs) are often the largest group using needle and syringe programmes (NSPs) in the UK. NSP providers report these clients repeatedly collecting large amounts of equipment for others. The extent of secondary distribution of injecting equipment is unknown. METHODS Data from national surveillance of people injecting IPEDs were used. Participants completed a questionnaire and provided a dried-blood spot sample. Data from two biennial surveys was combined; repeat participants were excluded. Self-reported data was used to explore the extent of secondary distribution. RESULTS Of the participants, 87% (467) reported NSP use; median age was 31 years; 98% were male. A third (34%, 157) reported collecting equipment for others. Of those collecting for others, 154 reported how many people they had collected for: 55% had collected for one person, 27% for 2-9 people, 5% for 10-19 and 13% for 20 or more (no difference by psychoactive drug use). Those vaccinated for hepatitis B were more likely (22% [15/68] vs 6% [5/86], p = 0.003), and those reporting redness/swelling at an injection site were less likely to collect equipment for at least 20 others (8% [8/106] vs 25% [12/48], p = 0.003). Overall, 154 people collected equipment for 639-1569 people injecting IPEDs. CONCLUSIONS Secondary distribution of injecting equipment is common among those injecting IPEDs and using NSPs. Whilst not allowing for rotational collection within groups, our analysis suggests that many of those injecting IPEDs are not in direct contact with NSPs. Innovation approaches for harm reduction interventions are needed.
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Affiliation(s)
- Rachel Glass
- National Infection Service, Public Health England, London, UK.
| | - Vivian D Hope
- National Infection Service, Public Health England, London, UK; Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | | | | | - Josie Smith
- Health Protection, Public Health Wales, Cardiff, UK
| | - James McVeigh
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - John Parry
- National Infection Service, Public Health England, London, UK
| | - Monica Desai
- National Infection Service, Public Health England, London, UK
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Garcia-Argibay M. The Relationship Between the Big Five Personality Traits, Impulsivity, and Anabolic Steroid Use. Subst Use Misuse 2019; 54:236-246. [PMID: 30375916 DOI: 10.1080/10826084.2018.1512630] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND The increase in the prevalence of anabolic-androgenic steroids (AAS) use has been the subject of study in the last decades. Several studies indicated a strong association between the use of AAS and the performance of risky behaviors mediated by factors such as aggression, impulsivity, depression, and anxiety. OBJECTIVE This study aimed to identify differences in personality trait, impulsivity, and the ability to delay gratification between AAS users and non-users that predispose or serve as a buffering mechanism against its usage and whether it is related to an increased likelihood of engaging in infidelity. METHODS Two hundred and twelve male volunteers (88 AAS users), aged between 21 and 36 years (M = 28.22), completed self-report measures of personality, impulsivity, delayed gratification, and attitudes toward infidelity. Multivariate analysis of variance and logistic regression were conducted to establish differences between AAS users and non-users. RESULTS The results showed that AAS users displayed an inability to delay gratification, a greater impulsivity, and a more benevolent attitude toward infidelity. AAS users obtained higher scores on openness and neuroticism, which was larger "off-cycle," although they presented lower scores on extraversion compared to the non-users group. Regression analysis revealed that neuroticism, impulsivity, and delaying gratification scores were significant predictors of AAS usage. In addition, impulsivity functioned as a partial mediator in the relationship between neuroticism and AAS use. CONCLUSION The results of this research highlight a pivotal implication of impulsivity in AAS use in conjunction with neuroticism, openness, and extraversion traits.
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Affiliation(s)
- Miguel Garcia-Argibay
- a Department of Behavioral Science, Faculty of Psychology , National University of Distance Education (UNED) , Madrid , Spain
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Tircova B, Bosakova Z, Kozlik P. Development of an ultra-high performance liquid chromatography-tandem mass spectrometry method for the determination of anabolic steroids currently available on the black market in the Czech Republic and Slovakia. Drug Test Anal 2018; 11:355-360. [DOI: 10.1002/dta.2541] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 11/05/2018] [Accepted: 11/06/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Barbora Tircova
- Department of Chemistry, Faculty of Natural Science; Matej Bel University in Banska Bystrica; Banska Bystrica Slovakia
| | - Zuzana Bosakova
- Department of Analytical Chemistry, Faculty of Science; Charles University; Prague Czech Republic
| | - Petr Kozlik
- Department of Analytical Chemistry, Faculty of Science; Charles University; Prague Czech Republic
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Making a difference? Applying Vitellone’s Social Science of the Syringe to performance and image enhancing drug injecting. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018. [DOI: 10.1016/j.drugpo.2018.03.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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30
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Alexandrova-Karamanova A. Мотиви за свързани с външния вид поведения при млади мъже с различен статус на телесното тегло: Качествено изследване. PSYCHOLOGICAL THOUGHT 2018. [DOI: 10.5964/psyct.v11i2.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Изследването проучва мотивите за свързаните с външния вид поведения при млади мъже във възникваща зрелост (18-29 г.) с различен статус на телесното тегло. Проведени са 15 дълбинни полу-структурирани интервюта с мъже и 15 с жени, анализирани чрез тематичен анализ и интерпретативен феноменологичен анализ. Седем от петнадесетте млади мъже са с наднормено тегло или затлъстяване, като този статус на телесното тегло оказва значимо влияние върху съдържанието на мотивите за свързаните с външния вид поведения. Идентифицирани са девет мотива: да бъдеш с нормално тегло (по-слаб или по-едър, в зависимост от актуалния статус на телесното тегло); да не ти се подиграват другите; да имаш красиво/мускулесто тяло (стегнато, спортно тяло, или добре развито, мускулесто тяло); за здраве; за да се чувстваш добре; за висока самооценка; за да те харесват момичетата; за да можеш да победиш във физически сблъсък (включва да бъдеш физически силен и да предизвикваш уважение/респект у другите мъже); за (професионално) развитие в спорта. Първите пет мотива са свързани с поведенията на хранене (специален хранителен режим/диета) и с поведенията на физическа активност (спорт, физически упражнения, фитнес), а мотивът да имаш красиво/мускулесто тяло – и с прекомерни физически тренировки, прием на хранителни добавки и анаболни стероиди. Останалите мотиви са свързани с поведенията спорт, фитнес, прекомерни физически тренировки, прием на хранителни добавки и анаболни стероиди. Първите два мотива се отнасят до лицата със свръхтегло, третият – почти изцяло до мъжете с нормално тегло. Мотивите за здраве и да се чувстваш добре са сред най-универсалните (значими при всички статуси на телесното тегло). Последните 4 мотива могат да бъдат отнесени най-вече към нормалното тегло и добре развитата мускулатура.
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New drugs, new directions? Research priorities for new psychoactive substances and human enhancement drugs. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 40:1-5. [PMID: 28164859 DOI: 10.1016/j.drugpo.2017.01.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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32
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Bates G, Tod D, Leavey C, McVeigh J. An evidence-based socioecological framework to understand men’s use of anabolic androgenic steroids and inform interventions in this area. DRUGS: EDUCATION, PREVENTION AND POLICY 2018. [DOI: 10.1080/09687637.2018.1488947] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Geoff Bates
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - David Tod
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Conan Leavey
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Jim McVeigh
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
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Van de Ven K, Maher L, Wand H, Memedovic S, Jackson E, Iversen J. Health risk and health seeking behaviours among people who inject performance and image enhancing drugs who access needle syringe programs in Australia. Drug Alcohol Rev 2018; 37:837-846. [DOI: 10.1111/dar.12831] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 06/03/2018] [Accepted: 06/06/2018] [Indexed: 02/02/2023]
Affiliation(s)
- Katinka Van de Ven
- Drug Policy Modelling Program; National Drug and Alcohol Research Centre, UNSW Sydney; Sydney Australia
| | - Lisa Maher
- The Kirby Institute for Infection and Immunity, UNSW Sydney; Sydney Australia
| | - Handan Wand
- The Kirby Institute for Infection and Immunity, UNSW Sydney; Sydney Australia
| | - Sonja Memedovic
- Drug Policy Modelling Program; National Drug and Alcohol Research Centre, UNSW Sydney; Sydney Australia
- The Kirby Institute for Infection and Immunity, UNSW Sydney; Sydney Australia
| | - Eva Jackson
- Nepean Blue Mountains Local Health District, NSW Ministry of Health; Sydney Australia
| | - Jenny Iversen
- The Kirby Institute for Infection and Immunity, UNSW Sydney; Sydney Australia
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Zahnow R, McVeigh J, Bates G, Hope V, Kean J, Campbell J, Smith J. Identifying a typology of men who use anabolic androgenic steroids (AAS). THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018. [PMID: 29525360 DOI: 10.1016/j.drugpo.2018.02.022] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Despite recognition that the Anabolic Androgenic Steroid (AAS) using population is diverse, empirical studies to develop theories to conceptualise this variance in use have been limited. METHODS In this study, using cluster analysis and multinomial logistic regression, we identify typologies of people who use AAS and examine variations in motivations for AAS use across types in a sample of 611 men who use AAS. RESULTS The cluster analysis identified four groups in the data with different risk profiles. These groups largely reflect the ideal types of people who use AAS proposed by Christiansen et al. (2016): Cluster 1 (You Only Live Once (YOLO) type, n = 68, 11.1%) were younger and motivated by fat loss; Cluster 2 (Well-being type, n = 236, 38.6%) were concerned with getting fit; Cluster 3 (Athlete type, n = 155, 25.4%) were motivated by muscle and strength gains; Cluster 4 (Expert type, n = 152, 24.9%) were focused on specific goals (i.e. not 'getting fit'). CONCLUSION The results of this study demonstrate the need to make information about AAS accessible to the general population and to inform health service providers about variations in motivations and associated risk behaviours. Attention should also be given to ensuring existing harm minimisation services are equipped to disseminate information about safe intra-muscular injecting and ensuring needle disposal sites are accessible to the different types.
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Affiliation(s)
- Renee Zahnow
- School of Social Science, The University of Queensland, St Lucia, Brisbane, Queensland, 4072, Australia.
| | - Jim McVeigh
- Public Health Institute, Liverpool John Moore's University, Henry Cotton Campus, 15-21 Webster Street, Liverpool, L3 2ET, United Kingdom.
| | - Geoff Bates
- Public Health Institute, Liverpool John Moore's University, Henry Cotton Campus, 15-21 Webster Street, Liverpool, L3 2ET, United Kingdom.
| | - Vivian Hope
- Public Health Institute, Liverpool John Moore's University, Henry Cotton Campus, 15-21 Webster Street, Liverpool, L3 2ET, United Kingdom.
| | - Joseph Kean
- Public Health Institute, Liverpool John Moore's University, Henry Cotton Campus, 15-21 Webster Street, Liverpool, L3 2ET, United Kingdom.
| | - John Campbell
- Research, Development and Innovation at Scottish National Blood Transfusion Service, Edinburgh, United Kingdom.
| | - Josie Smith
- Public Health Wales, Health Promotion, Cardiff, United Kingdom.
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Greenway CW, Price C. A qualitative study of the motivations for anabolic-androgenic steroid use: The role of muscle dysmorphia and self-esteem in long-term users. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.peh.2018.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Griffiths S, Jacka B, Degenhardt L, Murray SB, Larance B. Physical appearance concerns are uniquely associated with the severity of steroid dependence and depression in anabolic-androgenic steroid users. Drug Alcohol Rev 2018; 37:664-670. [DOI: 10.1111/dar.12688] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 01/09/2018] [Accepted: 02/07/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Scott Griffiths
- Melbourne School of Psychological Sciences; University of Melbourne; Melbourne Australia
| | - Brendan Jacka
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Stuart B. Murray
- Department of Psychiatry; University of California; San Francisco USA
| | - Briony Larance
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
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