Tracking internet interest in anabolic-androgenic steroids using Google Trends

Internet search patterns for psychoactive substance use prevention and treatment in Mexico: A cross-sectional study

Objectives

This study was aimed at describing the patterns of searches for information on the prevention and treatment of psychoactive drug use in Mexico, among both the general population and the personnel dedicated to the prevention and treatment of this type of substance use in Mexico.

Methods

An exploratory cross-sectional quantitative study was performed with a validated online questionnaire to collect sociodemographic information, background information and self-reported internet search patterns on psychoactive substance use prevention. A chi-square test was used to identify differences between groups, and a classification tree was used to analyze the search patterns. The combinations of the search criteria with the search topics were entered into Google Trends to validate the information.

Results

The participants (n = 544 adults) were mostly women (65%), 18-30 years of age and bachelor's degree holders (57%). A total of 32% were students, 59% searched the Internet for drug use prevention or treatment, and 12% professionally engaged in drug use prevention or treatment.

Conclusions

Statistically significant differences were found between the general population and professionals dedicated to drug dependency services. We identified six search patterns used in the decision-making process by people seeking information on drug prevention and treatment on the Internet. These patterns were graphically visualized with a classification tree, although, this method did not allow clear differentiation of patterns between groups. The search patterns were successfully validated with Google trends.

Advances in the Determination of Anabolic-Androgenic Steroids: From Standard Practices to Tailor-Designed Multidisciplinary Approaches

Anabolic-androgenic steroids (AASs), a group of compounds frequently misused by athletes and, unfortunately, also by the general population, have lately attracted global attention; thus, significant demands for more precise, facile, and rapid AAS detection have arisen. The standard methods ordinarily used for AAS determination include liquid and gas chromatography coupled with mass spectrometry. However, good knowledge of steroid metabolism, pretreatment of samples (such as derivatization), and well-trained operators of the instruments are required, making this procedure expensive, complicated, and not routinely applicable. In the drive to meet current AAS detection demands, the scientific focus has shifted to developing novel, tailor-made approaches leading to time- and cost-effective, routine, and field-portable methods for AAS determination in various matrices, such as biological fluids, food supplements, meat, water, or other environmental components. Therefore, herein, we present a comprehensive review article covering recent advances in AAS determination, with a strong emphasis on the increasingly important role of chemically designed artificial sensors, biosensors, and antibody- and fluorescence-based methods.

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

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.

Androgen Misuse and Abuse

Androgens are potent drugs requiring prescription for valid medical indications but are misused for invalid, unproven, or off-label reasons as well as being abused without prescription for illicit nonmedical application for performance or image enhancement. Following discovery and first clinical application of testosterone in the 1930s, commercialization of testosterone and synthetic androgens proliferated in the decades after World War II. It remains among the oldest marketed drugs in therapeutic use, yet after 8 decades of clinical use, the sole unequivocal indication for testosterone remains in replacement therapy for pathological hypogonadism, organic disorders of the male reproductive system. Nevertheless, wider claims assert unproven, unsafe, or implausible benefits for testosterone, mostly representing wishful thinking about rejuvenation. Over recent decades, this created an epidemic of testosterone misuse involving prescription as a revitalizing tonic for anti-aging, sexual dysfunction and/or obesity, where efficacy and safety remains unproven and doubtful. Androgen abuse originated during the Cold War as an epidemic of androgen doping among elite athletes for performance enhancement before the 1980s when it crossed over into the general community to become an endemic variant of drug abuse in sufficiently affluent communities that support an illicit drug industry geared to bodybuilding and aiming to create a hypermasculine body physique and image. This review focuses on the misuse of testosterone, defined as prescribing without valid clinical indications, and abuse of testosterone or synthetic androgens (androgen abuse), defined as the illicit use of androgens without prescription or valid indications, typically by athletes, bodybuilders and others for image-oriented, cosmetic, or occupational reasons.

ASSESSING INTEREST IN ARTISTIC GYMNASTICS

Despite information from world media, worldwide interest in artistic gymnastics has neverbeen assessed. Memberships, equipment and apparel purchases, subscriptions, and other datahave been used as indirect substitutes for gauging interest and participation in gymnastics. Areadily available tool for assessing gymnastics interest could be of use in uncovering myriadtrends. Aim of Study: This study sought to use a relatively new internet search tool calledGoogle TrendsTM (GT) to assess gymnastics interest by records of search terms used inGoogleTM. Methods: GoogleTM searches involve the use of search terms that are recorded andthen accessible by GT. As GoogleTM searches provide access to topics of interest nearlyanywhere in the world, by anyone with internet access, then using Google TrendsTM, then GTcould be used to harvest the number and types of searches involving the search-terms “men’sgymnastics” and “women’s gymnastics.” The tally of the search terms was obtained usingfilters such as country, region, and others. GT reports the search-term trends by calculating arelative percentage based on a sample of the largest number of specific search-term useduring a particular time. Although the relative percentage approach is somewhat awkward,processing large amounts of data may be considered valuable and otherwise unattainable.Results and Conclusions: Results should be interpreted cautiously. However, the analysisrevealed a litany of important trends in the worldwide interest in gymnastics.

ASSESSING INTEREST IN ARTISTIC GYMNASTICS

Despite information from world media, worldwide interest in artistic gymnastics has never been assessed. Memberships, equipment and apparel purchases, subscriptions, and other data have been used as indirect substitutes for gauging interest and participation in gymnastics. A readily available tool for assessing gymnastics interest could be of use in uncovering myriad trends. Aim of Study: This study sought to use a relatively new internet search tool called Google TrendsTM (GT) to assess gymnastics interest by records of search terms used in GoogleTM. Methods: GoogleTM searches involve the use of search terms that are recorded and then accessible by GT. As GoogleTM searches provide access to topics of interest nearly anywhere in the world, by anyone with internet access, then using Google TrendsTM, then GT could be used to harvest the number and types of searches involving the search-terms “men’s gymnastics” and “women’s gymnastics.” The tally of the search terms was obtained using filters such as country, region, and others. GT reports the search-term trends by calculating a relative percentage based on a sample of the largest number of specific search-term use during a particular time. Although the relative percentage approach is somewhat awkward, processing large amounts of data may be considered valuable and otherwise unattainable. Results and Conclusions: Results should be interpreted cautiously. However, the analysis revealed a litany of important trends in the worldwide interest in gymnastics.

Treatments for people who use anabolic androgenic steroids: a scoping review

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.

Anabolic-androgenic steroids: procurement and administration practices of doping athletes

Performance enhancing substances are becoming increasingly popular amongst bodybuilders and people who want to enhance their physiques. However, due to the rise of the Internet and laws prohibiting sales of these substances without prescription, the route of procurement and administration practices have become more and more dangerous. Prior to the mid-1970's, anabolic steroids were not regulated and easily available from physicians and pharmacies in several countries. In 1990, the United States enacted the Anabolic Steroid Control Act, leading to the proliferation of black markets and underground laboratories. The shift from pharmacy to underground online sites for the procurement of anabolic steroids led to an increase of fake products with low purity and the ability to potentially endanger the health of anabolic steroid users. Underground laboratories emerged both locally and in countries with lax legal regulations. 'Anabolic steroid tourism' and large networks of online resellers emerged, leading to the banalisation of the illegal procurement of anabolic steroids. Furthermore, the increase of anecdotal information spreading on the internet among anabolic steroid user forums nourishes the rampant misinformation and dangerous practices that currently exist. The dosages and ways of administration recommended on these forums can be false and misleading to those who lack a medical background and cannot go to their physician to seek advice because of the fear of repercussions. This review aims to elucidate and describe current practices of the anabolic-androgenic steroids black market and draw attention to potential dangers for users.

Androgen abuse epidemiology

PURPOSE OF REVIEW

To systematically review current epidemiological literature on androgen abuse. Estimates from 32 empirical epidemiological articles were reviewed.

RECENT FINDINGS

Generally, androgen abuse epidemiology and prevalence is higher in Europe, the Middle East, North America (the USA), Oceania (Australia and New Zealand), and South America (Brazil) and lower in Africa and Asia. In contrast to the general population, androgen abuse epidemiology and prevalence is higher among athletes, injection drug users, recreational sportspeople, and sexual and gender minorities.

SUMMARY

From the 1970s, androgen abuse spread from athletes into the general population. Consistent with previous evidence, reviewed studies suggest that androgen abuse epidemiology and prevalence is higher in Western cultural contexts, the Middle East, and South America (Brazil) and lower in Africa and Asia. Evidence also corroborates indications that androgen abuse is less prevalent among women (vs. men), and in the general population in contrast to particular subpopulations consisting of athletes, injection drug users, recreational sportspeople, and sexual and gender minorities. Adolescents' androgen abuse should be of special concern. Androgen abuse in some nonsports occupations (e.g. security workers) requires further exploration. Polypharmacy and the Internet proliferation of androgens and other PIEDs require surveillance for prevention and harm reduction.