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Norman C, Harries RL, Reid R, Nisbet LA, Nic Daéid N. Changing trends in anabolic-androgenic steroid use within Scottish prisons: Detection, prevalence, and quantitation. Drug Test Anal 2024. [PMID: 39162327 DOI: 10.1002/dta.3790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 08/01/2024] [Accepted: 08/02/2024] [Indexed: 08/21/2024]
Abstract
Anabolic-androgenic steroids (AASs) are a subclassification of image performance enhancing drugs (IPEDs). While AAS use is most prevalent among people in athletics, there is also high lifetime prevalence of AAS use among prisoners. This study reports the qualitative detection of AASs in seized samples from the Scottish prisons from 2019-2023. Additionally, methods were developed for the quantitative analysis of AASs using gas chromatography-mass spectrometry (GC-MS) and applied to 61 samples of tablets or powders seized from Scottish prisons between July 2022 and July 2023. Since 2022, there has been an increase in AAS detections in the Scottish prisons. Oxymetholone was the most prevalent AAS, followed by metandienone (methandrostenolone, methandienone), methyltestosterone, oxandrolone, mestanolone (methylandrostanolone), stanozolol, and androstenedione. Multiple AASs were found in 21 samples and 10 samples contained other drugs, including amitriptyline, sertraline, zopiclone, mirtazapine, sildenafil, etizolam, Δ9-tetrahydrocannabinol, and the synthetic cannabinoid MDMB-INACA. Most AAS samples were tablets (77.0%), although they were also detected in powders, herbal material, e-cigarettes, and a fragmented soap bar-type sample. There was a large variation in the concentration of AASs in the tablets and powders seized from the Scottish prisons, demonstrating AASs are another highly variable component of the polydrug use situation in prisons, the effects of which need to be examined further.
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Affiliation(s)
- Caitlyn Norman
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Richard L Harries
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Robert Reid
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Lorna A Nisbet
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
| | - Niamh Nic Daéid
- Leverhulme Research Centre for Forensic Science, School of Science and Engineering, University of Dundee, Dundee, UK
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2
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Zaiser C, Laskowski NM, Müller R, Abdulla K, Sabel L, Ballero Reque C, Brandt G, Paslakis G. The relationship between anabolic androgenic steroid use and body image, eating behavior, and physical activity by gender: A systematic review. Neurosci Biobehav Rev 2024; 163:105772. [PMID: 38879097 DOI: 10.1016/j.neubiorev.2024.105772] [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: 04/06/2024] [Revised: 05/30/2024] [Accepted: 06/12/2024] [Indexed: 06/25/2024]
Abstract
The prevalence of anabolic androgenic steroids (AAS) is rising, especially in recreational sports and the general population. While body image significantly influences AAS use, gender differences remain unclear. We examined gender-related connections between AAS use, body image, eating behavior, and physical activity. Following PRISMA guidelines, we analyzed 22 studies: 14 with male-only samples, 5 mixed-gender, 2 with sexual and gender minorities, and 1 with a female-only sample. FINDINGS: confirm body image as a key predictor of AAS use. Though AAS use correlates with eating disorders, outcomes vary by context; for instance, no discernible difference in eating behavior was observed between AAS users and non-users in bodybuilding. Physical activity findings varied, with some studies showing no significant differences between AAS users and non-users. Due to limited gender-comparison studies, conclusive gender-related differences cannot be drawn. This systematic review underscores the complex interplay between AAS use, body image, eating behavior, and physical activity, emphasizing the necessity for further research to develop targeted interventions for diverse populations, addressing AAS-related concerns and promoting overall well-being.
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Affiliation(s)
- Christopher Zaiser
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia Lippe, Ruhr-University Bochum, Luebbecke, Germany.
| | - Nora M Laskowski
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia Lippe, Ruhr-University Bochum, Luebbecke, Germany
| | - Roland Müller
- Association for Practical Prevention of Eating Disorders, Bern, Switzerland
| | - Kahar Abdulla
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia Lippe, Ruhr-University Bochum, Luebbecke, Germany
| | - Luisa Sabel
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia Lippe, Ruhr-University Bochum, Luebbecke, Germany
| | - Cristina Ballero Reque
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia Lippe, Ruhr-University Bochum, Luebbecke, Germany
| | - Gerrit Brandt
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia Lippe, Ruhr-University Bochum, Luebbecke, Germany
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia Lippe, Ruhr-University Bochum, Luebbecke, Germany
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3
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Zelleroth S, Stam F, Nylander E, Kjellgren E, Gising J, Larhed M, Grönbladh A, Hallberg M. The decanoate esters of nandrolone, testosterone, and trenbolone induce steroid specific memory impairment and somatic effects in the male rat. Horm Behav 2024; 161:105501. [PMID: 38368844 DOI: 10.1016/j.yhbeh.2024.105501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/26/2024] [Accepted: 02/05/2024] [Indexed: 02/20/2024]
Abstract
Long-term use of anabolic androgenic steroids (AAS) in supratherapeutic doses is associated with severe adverse effects, including physical, mental, and behavioral alterations. When used for recreational purposes several AAS are often combined, and in scientific studies of the physiological impact of AAS either a single compound or a cocktail of several steroids is often used. Because of this, steroid-specific effects have been difficult to define and are not fully elucidated. The present study used male Wistar rats to evaluate potential somatic and behavioral effects of three different AAS; the decanoate esters of nandrolone, testosterone, and trenbolone. The rats were exposed to 15 mg/kg of nandrolone decanoate, testosterone decanoate, or trenbolone decanoate every third day for 24 days. Body weight gain and organ weights (thymus, liver, kidney, testis, and heart) were measured together with the corticosterone plasma levels. Behavioral effects were studied in the novel object recognition-test (NOR-test) and the multivariate concentric square field-test (MCSF-test). The results conclude that nandrolone decanoate, but neither testosterone decanoate nor trenbolone decanoate, caused impaired recognition memory in the NOR-test, indicating an altered cognitive function. The behavioral profile and stress hormone level of the rats were not affected by the AAS treatments. Furthermore, the study revealed diverse AAS-induced somatic effects i.e., reduced body weight development and changes in organ weights. Of the three AAS included in the study, nandrolone decanoate was identified to cause the most prominent impact on the male rat, as it affected body weight development, the weights of multiple organs, and caused an impaired memory function.
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Affiliation(s)
- Sofia Zelleroth
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Sweden.
| | - Frida Stam
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Sweden.
| | - Erik Nylander
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Sweden.
| | - Ellinor Kjellgren
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Sweden
| | - Johan Gising
- The Beijer Laboratory, Science for Life Laboratory, Department of Medicinal Chemistry, SE-751 23, Uppsala University, Sweden.
| | - Mats Larhed
- The Beijer Laboratory, Science for Life Laboratory, Department of Medicinal Chemistry, SE-751 23, Uppsala University, Sweden.
| | - Alfhild Grönbladh
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Sweden.
| | - Mathias Hallberg
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Sweden.
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4
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Karila D, Kerlan V, Christin-Maitre S. Androgenic steroid excess in women. ANNALES D'ENDOCRINOLOGIE 2024; 85:142-149. [PMID: 38040089 DOI: 10.1016/j.ando.2023.11.001] [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: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
Excessive use of anabolic-androgenic steroids (AAS) in sport occurs among professional athletes but increasingly also in amateurs. Prevalence of steroid use has been on the rise for a number of years. While the practice involves mostly men, it also occurs in women with an estimated prevalence of 1.6%. Since 2014, a 'steroid passport' has operated for sports people in competition that is based on longitudinal urinary and blood steroid levels, measured by liquid chromatography and mass spectrometry. Androgen excess stimulates muscle growth and improves muscle performance. However, their consumption carries numerous side effects, including myocardial hypertrophy; altered lipid metabolism and pro-thrombotic effects. The excess of AAS is associated with increased risk of atherosclerosis and cardiovascular events. Data for their effects in women is lacking. Perturbations of the menstrual cycle are common in female athletes, with spaniomenorrhea and even amenorrhea. This can be a consequence of gonadotropin insufficiency due to negative caloric balance, but may also be due to endogenous or exogenous hyperandrogenism. The use of AAS is probably underestimated as a public health issue, particularly in women, and thus presents a prevention challenge for healthcare professionals.
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Affiliation(s)
- Daphné Karila
- Service d'endocrinologie, diabétologie et médecine de la reproduction, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, 75012 Paris, France; Sorbonne université, 75006 Paris, France.
| | - Véronique Kerlan
- Service d'endocrinologie, hôpital de Brest, université de Bretagne-Occidentale, 29200 Brest, France
| | - Sophie Christin-Maitre
- Service d'endocrinologie, diabétologie et médecine de la reproduction, hôpital Saint-Antoine, Assistance publique-Hôpitaux de Paris, 75012 Paris, France; Sorbonne université, 75006 Paris, France
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5
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Hoseini R, Hoseini Z. Exploring the prevalence of anabolic steroid use among men and women resistance training practitioners after the COVID-19 pandemic. BMC Public Health 2024; 24:798. [PMID: 38481173 PMCID: PMC10938795 DOI: 10.1186/s12889-024-18292-5] [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: 07/28/2023] [Accepted: 03/05/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a significant impact on individual health and fitness routines globally. Resistance training, in particular, has become increasingly popular among men and women looking to maintain or improve their physical fitness during the pandemic. However, using Anabolic Steroids (AS) for performance enhancement in resistance training has known adverse effects. Thus, this study aimed to explore the prevalence of AS use among men and women resistance training practitioners after the COVID-19 pandemic. METHODS A cross-sectional survey was conducted among 3,603 resistance training practitioners (1,855 men and 1,748 women) in various geographical locations impacted by COVID-19. The participants were asked to complete self-administered questionnaires, which included questions regarding demographic information, training habits, and current or prior usage of AS. The data were analyzed using SPSS statistical software and the chi-square method, with a significance level of (P < 0.05). RESULTS A total of 3603 men and women resistance training practitioners completed the survey. In the study, 53.05% of men and 41.99% of women used anabolic and androgenic steroids. Of those men who used steroids, 29.47% used Testosterone, while 31.20% of women used Winstrol. Additionally, 50.30% of men used steroids via injection, while 49.05% of women used them orally. According to the study, 49.99% of the participants had 6 to 12 months of experience with resistance training, and 64.25% of them underwent three training sessions per week. The analysis using the χ2 test did not reveal any significant difference between men and women in terms of duration of bodybuilding, frequency per week, and engagement in other activities. CONCLUSION This study shows that a significant proportion of men and women resistance training practitioners used AS, particularly among young adults with limited training experience. Thus, there is a need for targeted education and awareness campaigns to address the hazards of AS use and promote healthy training habits during the COVID-19 pandemic.
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Affiliation(s)
- Rastegar Hoseini
- Department of Exercise Physiology, Faculty of Sport Sciences, Razi University, Kermanshah, P.O. Box. 6714414971, Iran.
| | - Zahra Hoseini
- Department of Exercise Physiology, Faculty of Sport Sciences, Razi University, Kermanshah, P.O. Box. 6714414971, Iran
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6
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McGuirt AF, Brezing CA. Opioid-induced hypogonadism in opioid use disorder, its role in negative reinforcement, and implications for treatment and retention. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:132-138. [PMID: 38320237 DOI: 10.1080/00952990.2023.2292012] [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: 09/14/2023] [Accepted: 12/03/2023] [Indexed: 02/08/2024]
Abstract
Hypogonadism is a highly prevalent complication of chronic opioid use associated with a constellation of affective, algesic, and cognitive symptoms as well as decreased quality of life. Given that the mainstays of pharmacologic opioid use disorder (OUD) treatment - methadone and buprenorphine - are themselves agonists or partial agonists at the mu opioid receptor, opioid-induced hypogonadism (OIH) remains an underappreciated clinical concern throughout the course of OUD treatment. Prominent theoretical frameworks for OUD emphasize the importance of negative reinforcement and hyperkatifeia, defined as the heightened salience of negative emotional and motivational states brought on by chronic opioid use. In this perspective article, we highlight the striking parallels between the symptom domains of hyperfakifeia and hypogonadism in males, who comprise the vast majority of existing clinical research on OIH. By extension we propose that future research and ultimately clinical care should focus on the identification and treatment of OIH in OUD patients to help address the longstanding paradox of poor treatment retention despite efficacious therapies, particularly in the setting of the current opioid overdose epidemic driven by high potency synthetic opioids such as fentanyl. We then review evidence from chronic pain patients that testosterone replacement provides clinically significant benefits to men with OIH. Finally, using this framework, we compare extant OUD therapeutics and discuss critical gaps in the clinical literature-including the relative dearth of data regarding hypothalamic-pituitary-gonadal function in females who use opioids-where future study should be focused.
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Affiliation(s)
- Avery F McGuirt
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Christina A Brezing
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
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7
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Barcelos MN, Gonçalves-Santos E, Souza MA, Santos EC, Gonçalves RV, Castro-Gamero AM, Novaes RD. Prolonged testosterone 17β-cyclopentylpropionate exposition induces behavioral, ovarian, oviductal, uterine and reproductive disturbances in female mice. Life Sci 2024; 338:122408. [PMID: 38181852 DOI: 10.1016/j.lfs.2023.122408] [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: 10/27/2023] [Revised: 12/16/2023] [Accepted: 12/29/2023] [Indexed: 01/07/2024]
Abstract
Anabolic-androgenic steroids (AAS) abuse is often associated with metabolic disorders and infertility. However, the current evidence on AAS-induced reproductive toxicity is mainly based on male studies. Thus, AAS repercussions on female reproductive capacity remain poorly understood, despite scarce evidence that fertility determinants may be more severely impaired in females than males exposed to these drugs. Accordingly, this study used an integrated framework to investigate the impact of different testosterone 17β-cyclopentylpropionate (TC) doses on pain sensitivity, aggressiveness, anxiety, sexual behavior, ovarian, oviductal, uterine and reproductive morphofunctional and molecular outcomes. These parameters were used to explore the reproductive capacity in female mice exposed to this synthetic testosterone ester. The animals were untreated or intraperitoneally treated with 5, 10 and 20 mg/kg TC every 48 h for 12 weeks. Our findings indicated that testosterone was upregulated while the hormones luteinizing, follicle-stimulating, estrogen and progesterone were down-regulated by TC. This AAS also exerted deleterious effects on anxiety, aggressivity, nociception, exploratory and sexual behavior in female mice. Concurrently, TC attenuated ovarian follicle maturation, interrupted the estrous cycle, induced oviductal and uterine hypotrophy. Estrous cyclicity was reestablished 60 days after AAS treatment. However, TC-treated mice still exhibited impaired reproductive capacity, a disturbance potentially related to deficiency in folliculogenesis, sex hormones production, and endometrial receptivity mediate by ER-α, PR, HOXA-10 and LIF down-regulation. Taken together, our findings indicated that in addition to female behavior, reproductive organs microstructure and function are markedly impaired by TC in a dose-dependent manner, whose time-dependent reversibility remains to be clarified.
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Affiliation(s)
- Mônica N Barcelos
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil
| | - Elda Gonçalves-Santos
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil
| | - Matheus A Souza
- Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil
| | - Eliziária C Santos
- Faculdade de Medicina, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina 39100-000, Minas Gerais, Brazil
| | - Reggiani V Gonçalves
- Programa de Pós-Graduação em Biologia Animal, Departamento de Biologia Animal, Universidade Federal de Viçosa, Viçosa 36570-900, Minas Gerais, Brazil
| | - Angel Mauricio Castro-Gamero
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil; Instituto de Ciências da Natureza, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil
| | - Rômulo D Novaes
- Programa de Pós-Graduação em Biociências Aplicadas à Saúde, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil; Programa de Pós-Graduação em Ciências Biológicas, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil; Programa de Pós-Graduação em Biologia Animal, Departamento de Biologia Animal, Universidade Federal de Viçosa, Viçosa 36570-900, Minas Gerais, Brazil; Instituto de Ciências Biomédicas, Universidade Federal de Alfenas, Alfenas 37130-001, Minas Gerais, Brazil.
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8
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Bulut Y, Brandt-Jacobsen N, Buhl L, Schou M, Frystyk J, Kistorp C, Rasmussen JJ. Persistently Decreased Quality of Life and its Determinants in Previous Illicit Androgen Users. J Clin Endocrinol Metab 2024; 109:e689-e697. [PMID: 37708363 DOI: 10.1210/clinem/dgad551] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Quality of life (QoL) has never been assessed in previous illicit users of androgens years following androgen cessation. Therefore, the objective of this study was to assess QoL in previous illicit androgen users compared with current illicit androgen users and controls who had never used androgens. METHODS Cross-sectional study including men involved in recreational strength training grouped according to their history of androgen use. We used the RAND Short-Form-36 questionnaire to assess physical and mental health-related QoL. RESULTS We included 77 previous and 118 current androgen users and 39 healthy nonusers. The mean (SD) age of all participants was 33 (8) years. The elapsed duration since androgen cessation, geometric mean (95% CI), was 2.0 (1.5-2.6) years in former users. Median (25th-75th percentiles) serum total testosterone was lower in former users than controls, 14 (11-17) vs 19 (16-21) nmol/L, P < .001. Previous users displayed lower mean (SD) across both mental and physical (PCS) component summary scores, 48 (10) vs 54 (4) (P = .004) and 48 (9) vs 53 (3) (P = .002) compared with controls.Using multivariate linear regressions, evaluating physical and mental component scores as dependent variables, lower serum total testosterone, longer duration since androgen cessation, study recruitment from an endocrine outpatient clinic, and established chronic diseases were all independently associated with reduced QoL in previous users, P < .05. CONCLUSIONS Previous illicit androgen users exhibited reduced QoL 2 years after androgen discontinuation, which may be a persistent condition.
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Affiliation(s)
- Yeliz Bulut
- Department of Endocrinology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK-2200, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Denmark, Copenhagen, DK-2200, Denmark
| | - Niels Brandt-Jacobsen
- Department of Endocrinology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK-2200, Denmark
| | - Laust Buhl
- Department of Endocrinology, Odense University Hospital, Odense, DK-5000, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, DK-5230, Denmark
| | - Morten Schou
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Denmark, Copenhagen, DK-2200, Denmark
- Department of Cardiology, Herlev/Gentofte University Hospital, Herlev, DK-2730, Denmark
| | - Jan Frystyk
- Department of Endocrinology, Odense University Hospital, Odense, DK-5000, Denmark
- Faculty of Health Sciences, University of Southern Denmark, Odense, DK-5230, Denmark
| | - Caroline Kistorp
- Department of Endocrinology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK-2200, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Denmark, Copenhagen, DK-2200, Denmark
| | - Jon Jarløv Rasmussen
- Department of Endocrinology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DK-2200, Denmark
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9
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Skauen JE, Pallesen S, Bjørnebekk A, Chegeni R, Syvertsen A, Petróczi A, Sagoe D. Prevalence and correlates of androgen dependence: a meta-analysis, meta-regression analysis and qualitative synthesis. Curr Opin Endocrinol Diabetes Obes 2023; 30:309-323. [PMID: 37410490 DOI: 10.1097/med.0000000000000822] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
PURPOSE OF REVIEW To investigate the prevalence and correlates of androgen dependence among users. A meta-analysis, meta-regression analysis, and qualitative synthesis were conducted based on a systematic literature search in Google Scholar, ISO Web of Science, PsycNET, and PubMed. RECENT FINDINGS Twenty-six studies were included in the review and 18 studies ( N = 1782) in the statistical analysis. The overall lifetime androgen dependence prevalence was 34.4% [95% confidence interval (CI): 27.8-41.7, Q = 113.1, I2 = 85.0, P < 0.001]. Although males (36.1%, P < 0.001) and females (37.0%, P = 0.188) did not differ ( Q = 0.0, P = 0.930) in dependence prevalence, controlling for other study characteristics, higher study male sample proportion was related to higher dependence prevalence. Combined interview and questionnaire assessments showed higher prevalence compared to interviews only. Publications from 1990-1999 generated higher prevalence compared to 2000-2009 and 2010-2023 publications. Dependents were associated with a wide array of demographic inequalities, and biophysical, cognitive, emotional, and psychosocial problems. SUMMARY One of three persons who initiate androgen use experiences dependence along with various serious disorders. Androgen use and dependence should be considered an important public health issue requiring targeted health interventions.
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Affiliation(s)
- Jenny Eriksrød Skauen
- Department of Psychosocial Science
- Human Enhancement and Body Image Lab (HEBI Lab), Addiction Research Group, University of Bergen, Bergen
| | - Ståle Pallesen
- Department of Psychosocial Science
- Human Enhancement and Body Image Lab (HEBI Lab), Addiction Research Group, University of Bergen, Bergen
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital
| | - Razieh Chegeni
- Human Enhancement and Body Image Lab (HEBI Lab), Addiction Research Group, University of Bergen, Bergen
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - André Syvertsen
- Department of Psychosocial Science
- Human Enhancement and Body Image Lab (HEBI Lab), Addiction Research Group, University of Bergen, Bergen
| | - Andrea Petróczi
- School of Life Sciences, Pharmacy and Chemistry, Faculty of Health, Science, Social Care and Education, Kingston University, London, UK
- Institute of Health Promotion and Sport Sciences, Eötvös Loránd University (ELTE), Budapest, Hungary
| | - Dominic Sagoe
- Department of Psychosocial Science
- Human Enhancement and Body Image Lab (HEBI Lab), Addiction Research Group, University of Bergen, Bergen
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10
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Nyssanbayeva K, Abdulla V, Semenova Y, Bakasheva M, Sagoe D, Glushkova N. Characteristics of the Online Market for Anabolic-Androgenic Steroids in Central Asia: A Netnographic Analysis. Subst Use Misuse 2023; 59:10-19. [PMID: 37724019 DOI: 10.1080/10826084.2023.2257317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Background: With the online proliferation of illegal substances, the Internet offers a wide variety of information on the acquisition and intake of anabolic-androgenic steroids (AAS) and other performance and image enhancing drugs. This study focuses on investigating the characteristics of the online AAS market in Central Asia. OBJECTIVES The primary objectives of this study were to investigate the accessibility and features of the online market for AAS in Central Asia. To achieve this, we employed a netnographic approach for a systematic exploration of websites advertising and selling AAS. The study aimed to conduct a comprehensive analysis of several key aspects, including the variety of AAS products offered, the quality of health advice provided the level of product availability, the procedures involved in making purchases, and the pricing structures within this market. RESULTS Twenty-one websites supplying AAS in Central Asia met our inclusion criteria. Using content analysis, data were gathered on AAS offerings, quality of health advice provided, availability, purchase process, and prices. Data were synthesized using descriptive statistics. Results indicate that AAS are easily accessible for purchase without valid medical prescription in the Central Asia online market. Most websites advertised the aesthetic and ergogenic benefits of AAS use without indicating the potential complications and adverse effects. CONCLUSIONS Public health efforts to mitigate AAS use in Central Asia should consider both the online accessibility of AAS and the lack of accompanying information on potential complications as well as adverse effects associated with their use. Efforts must be intensified to curtail the proliferation of AAS and related misleading information on the Central Asian online market.
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Affiliation(s)
- Kulman Nyssanbayeva
- Department of Public Health and Social Sciences, Kazakhstan Medical University (KSPH), Almaty, Kazakhstan
| | - Venera Abdulla
- Department of Public Health and Social Sciences, Kazakhstan Medical University (KSPH), Almaty, Kazakhstan
| | - Yuliya Semenova
- School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Maira Bakasheva
- Kazakhstan National Anti-Doping Organization, Almaty, Kazakhstan
| | - Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Natalya Glushkova
- Department of Epidemiology, Biostatistics and Evidence, Al-Farabi Kazakh National University Based Medicine, Almaty, Kazakhstan
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11
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Kvillemo P, Gripenberg J, Strandberg AK, Elgán TH. Police officers' perspective on doping and prevention among recreational athletes: a cross-sectional study. Front Sports Act Living 2023; 5:1251531. [PMID: 37936878 PMCID: PMC10626526 DOI: 10.3389/fspor.2023.1251531] [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: 07/12/2023] [Accepted: 10/09/2023] [Indexed: 11/09/2023] Open
Abstract
Introduction The use of anabolic androgenic steroids among recreational athletes has received growing attention in recent decades. Several countries have implemented bans on doping; however, recreational athletes and other subpopulations continue to use doping substances. Recognizing that the police play a crucial role in preventing the use and dealing of doping substances in Sweden, efforts have been made to intensify police interventions and enhance collaboration with other key actors. This study examined police officers' perceptions of doping as defined in Swedish law, related problems, and suggestions for effective prevention of doping in the society. Methods A cross-sectional survey study was conducted using a web survey of police officers (N = 597). Data were analyzed using descriptive statistics and free-form text responses were analyzed using content analysis. Results Participant responses to the survey (73.7% response rate) indicated that approximately 62.6% thought that doping is a societal problem, and approximately 26% perceived that the availability of doping substances has increased over the past three years. A total of 95.6% of respondents believed that doping occurred in connection with other crimes such as intimate partner violence (88.2%) and drug-related crimes (88.0%). Further, 96.3% of respondents perceived that it was their duty to prevent doping, but 63.8% indicated that doping-related work was not prioritized within their local police district. Discussion Police officers perceived doping as a societal problem and expressed motivation to counteract it, highlighting increased knowledge, legislative changes, intensified doping prevention in gyms, and commitment from other societal actors to increase the effectiveness of doping prevention. Suggestions for increasing the efficiency of doping prevention included education and increased knowledge at all levels in the police organization, intensified prevention efforts at gyms, legislative changes to permit simplified doping test procedures, and breach of secrecy for postal items. There was also a suggestion for further engagement from other actors, such as healthcare workers, school officials, and non-governmental organizations.
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Affiliation(s)
- Pia Kvillemo
- Department of Clinical Neuroscience, STAD, Centre for Psychiatry Research, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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12
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Izzat N, Abu-Farha R, Harahsheh MM, Thiab S. A qualitative assessment of anabolic-androgenic steroid use among gym users in Jordan: motives, perception, and safety. Int J Legal Med 2023; 137:1421-1430. [PMID: 37355480 DOI: 10.1007/s00414-023-03046-6] [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: 05/26/2023] [Accepted: 06/14/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND Over the years, the use of anabolic-androgenic steroids (AAS) has become widespread among athletes and bodybuilders. The prevalence of their use has been estimated at around 20 to 50% globally. Unfortunately, many athletes do not have the proper knowledge about the effects of these banned substances Thus, this study aims to qualitatively assess Jordanian gym users' AAS intentions, perceptions, and safety. METHODS Twenty male Jordanian anabolic steroid users were interviewed using in-depth interviews as part of a qualitative study evaluating the motivations, perceptions, and safety of AAS among gym users. RESULTS The findings of this study indicate that the desire to compete in bodybuilding contests was the primary motivation for participants to use AAS. The study participants mentioned using a combination of oral and injectable medications. Gym coaches and trainers were also identified as an essential source of information for AAS use. A very limited number of AAS users were getting their information from healthcare providers, and most of them have experienced some of these medications side effects but are still willing to continue the use of AAS to get what they need in terms of their physical appearance or for winning competitions. CONCLUSION There is an urgent need for structured awareness campaigns targeting gyms and fitness clubs' members to increase their knowledge about the side effects and health risks associated with the use of AAS. In addition, sports governing bodies should have stricter measures to tackle this problem and discourage athletes from using such products.
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Affiliation(s)
- Nawal Izzat
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, P.O. Box 11937, Amman, Jordan
| | - Rana Abu-Farha
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, P.O. Box 11937, Amman, Jordan.
| | - Mea'ad M Harahsheh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Samar Thiab
- Department of Pharmaceutical Chemistry and Pharmacognosy, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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13
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Jørstad ML, Scarth M, Torgersen S, Pope HG, Bjørnebekk A. Clustering psychopathology in male anabolic-androgenic steroid users and nonusing weightlifters. Brain Behav 2023:e3040. [PMID: 37150843 DOI: 10.1002/brb3.3040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/14/2023] [Accepted: 04/20/2023] [Indexed: 05/09/2023] Open
Abstract
INTRODUCTION Prior research has demonstrated that personality disorders and clinical psychiatric syndromes are common among users of anabolic-androgenic steroids (AAS). However, the prevalence, expression, and severity of psychopathology differ among AAS users and remain poorly understood. In this study, we examine the existence of potential clinically coherent psychopathology subgroups, using cluster procedures. METHODS A sample of 118 male AAS users and 97 weightlifting nonusers was assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III), measuring personality disorders and clinical syndromes. Group differences in MCMI-III scales were assessed using Wilcoxon-Mann-Whitney tests and Fisher's exact test. Agglomerative hierarchical clustering was used to identify clusters based on MCMI-III scale scores from the whole sample. RESULTS AAS users displayed significantly higher scores on all personality disorder (except narcissistic) and clinical syndrome scales compared to nonusing weightlifters. The clustering analysis found four separate clusters with different levels and patterns of psychopathology. The "no psychopathology" cluster was most common among nonusing weightlifters, while the three other clusters were more common among AAS users: "severe multipathology," "low multipathology," and "mild externalizing." The "severe multipathology" cluster was found almost exclusively among AAS users. AAS users also displayed the highest scores on drug and alcohol dependence syndromes. CONCLUSIONS AAS users in our sample demonstrated greater psychopathology than the nonusing weightlifters, with many exhibiting multipathology. This may pose a significant challenge to clinical care for AAS users, particularly as there appears to be significant variation in psychopathology in this population. Individual psychiatric profiles should be taken into consideration when providing treatment to this group. SIGNIFICANT OUTCOMES As a group, AAS users displayed markedly greater psychopathology than nonusing weightlifters. Multipathology was common among AAS users. Four different subgroups of personality profiles were identified with distinct patterns of pathology and severity. LIMITATIONS The cross-sectional nature of the study precludes inferences about causality. The study is limited by possible selection bias, as participants choosing to be involved in research may not be entirely representative for the group as a whole. The study is vulnerable to information bias, as the results are based on self-report measures and interviews.
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Affiliation(s)
- Marie Lindvik Jørstad
- Anabolic Androgenic Steroid Research Group, National Advisory Unit on SUD Treatment, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Morgan Scarth
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Harrison Graham Pope
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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14
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Henriksen HCB, Havnes IA, Jørstad ML, Bjørnebekk A. Health service engagement, side effects and concerns among men with anabolic-androgenic steroid use: a cross-sectional Norwegian study. Subst Abuse Treat Prev Policy 2023; 18:19. [PMID: 37013635 PMCID: PMC10071723 DOI: 10.1186/s13011-023-00528-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/14/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Recreational use of anabolic-androgenic steroids (AAS) is a public health concern world-wide associated with a range of physical and psychological side effects. Still, people who use AAS tend to be reluctant to seek treatment. This study aims to explore use characteristics, treatment-seeking behaviour, side effects and associated health concerns among men with AAS use. METHODS The study includes cross-sectional self-report data from 90 men with a current or previous use of AAS exceeding 12 months, where 41 (45.6%) had sought treatment at least once during their lifetime, and 49 (54.4%) had not. Health service engagement was examined with descriptive statistics on reasons for contacting health services, transparency about AAS use, satisfaction with health services and reasons for not seeking treatment. Furthermore, experienced side effects and health concerns were compared between the treatment seeking and the non-treatment seeking group, using two-sample t-tests and Chi2 or Fisher exact tests for numerical and categorical variables, respectively. RESULTS All 90 AAS-using men reported side effects from AAS use. Treatment seekers were significantly younger, experienced more side effects including gynecomastia, excessive sweating, fatigue, depression and anxiety, and expressed more concern for testosterone deficiency. Preventive health check-up was the most common reason for seeking treatment (n = 22, 53.7%), and 38 men (93%) were transparent about AAS use during consultations with health professionals. The main reported reasons for not seeking healthcare services were that the experienced side effects were not considered to be of treatment demanding nature (n = 39, 79.6%) and the belief that healthcare providers had scarce knowledge about AAS use and its health impacts (n = 12, 24.5%). CONCLUSIONS Reluctance to seek treatment among people who use AAS, despite having associated side effects and health concerns, may contribute to continued health risks. It is important to fill the knowledge gap on how to reach and treat this new patient group, and policy makers and treatment providers need to be educated on how to meet their treatment needs.
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Affiliation(s)
- Hans Christian Bordado Henriksen
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Ingrid Amalia Havnes
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Marie Lindvik Jørstad
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- National Advisory Unit on Substance Use Treatment, Oslo University Hospital, Oslo, Norway
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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15
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Adenosine receptors participate in anabolic-androgenic steroid-induced changes on risk assessment/anxiety-like behaviors in male and female rats. Physiol Behav 2023; 261:114071. [PMID: 36584765 DOI: 10.1016/j.physbeh.2022.114071] [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: 09/20/2022] [Revised: 12/24/2022] [Accepted: 12/26/2022] [Indexed: 12/29/2022]
Abstract
Anabolic-androgenic steroids (AAS) and caffeine can induce several behavioral alterations in humans and rodents. Administration of nandrolone decanoate is known to affect defensive responses to aversive stimuli, generally decreasing inhibitory control and increasing aggressivity but whether caffeine intake influences behavioral changes induced by AAS is unknown. The present study aimed to investigate behavioral effects of caffeine (a non-selective antagonist of adenosine receptors) alone or combined with nandrolone decanoate (one of the most commonly AAS abused) in female and male Lister Hooded rats. Our results indicated that chronic administration of nandrolone decanoate (10 mg/kg, i.m., once a week for 8 weeks) decreased risk assessment/anxiety-like behaviors (in the elevated plus maze test), regardless of sex. These effects were prevented by combined caffeine intake (0.1 g/L, p.o., ad libitum). Overall, the present study heralds a key role for caffeine intake in the modulation of nandrolone decanoate-induced behavioral changes in rats, suggesting adenosine receptors as candidate targets to manage impact of AAS on brain function and behavior.
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16
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Ganson KT, Hallward L, Cunningham ML, Murray SB, Nagata JM. Anabolic-Androgenic Steroid Use: Patterns of Use among a National Sample of Canadian Adolescents and Young Adults. PERFORMANCE ENHANCEMENT & HEALTH 2023; 11:100241. [PMID: 37841070 PMCID: PMC10571510 DOI: 10.1016/j.peh.2022.100241] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background Androgenic-anabolic steroid (AAS) use is relatively common among international recreational and community samples and is associated with several deleterious side effects and health consequences that have not been studied recently among a large Canadian sample. Therefore, the purpose of this study was to assess and describe characteristics of AAS users compared to non-AAS users among a national sample of Canadian adolescents and young adults. Methods Data from 2,774 adolescents and young adults from the Canadian Study of Adolescent Health Behaviors were analyzed. Participants were recruited via social media advertisements and completed the survey online. Survey items measured sociodemographics, AAS use, AAS side effects, motives for AAS use, AAS administration, body satisfaction, other illicit substance use, mental health, and violence involvement. Results Among the overall sample, 1.6% of participants reported lifetime AAS use, with the majority of users being White, heterosexual males. Most users strived to gain weight, with main motives for AAS use including increased muscularity and strength, and improved appearance. Most AAS users were satisfied with their body compared to non-users. Approximately one in five users had AAS dependence and experienced multiple adverse side effects. Few differences between users and non-users in self-reported mental health were found. Conclusion Findings indicate that AAS use among a community sample of Canadian adolescents and young adults is an important health issue, particularly given the relatively high occurrence of AAS dependence and adverse side effects reported by users. Findings support the need for education and intervention efforts from healthcare professionals. Further investigations among Canadian AAS users may provide more insight regarding the unique supports these individuals require.
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Affiliation(s)
- Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Laura Hallward
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- School of Kinesiology, Western University, London, Ontario, Canada
| | | | - Stuart B. Murray
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Jason M. Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
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17
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Abo-El Fetoh ME, Abdel-Fattah MM, Mohamed WR, Ramadan LAA, Afify H. Cyclooxygenase-2 activates EGFR-ERK1/2 pathway via PGE2-mediated ADAM-17 signaling in testosterone-induced benign prostatic hyperplasia. Inflammopharmacology 2023; 31:499-516. [PMID: 36586043 PMCID: PMC9958186 DOI: 10.1007/s10787-022-01123-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/25/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE AND DESIGN Prostatic inflammation is the driving force in benign prostatic hyperplasia (BPH). This work investigated the potential modulatory effect of COX-2 inhibition on ADAM-17/EGFR/ERK1/2 axis. MATERIALS OR SUBJECTS Adult male Wistar rats were used. TREATMENT Celecoxib (10 and 20 mg/kg; i.p.) was injected i.p. daily for three weeks. Testosterone (TST) (3 mg/kg; s.c.) was used to induce BPH. METHODS Prostatic inflammation and hyperplasia were assessed by organ weight and histopathology. Inflammatory mediators were measured using ELISA technique. Protein analysis was performed using western blotting and immunohistochemistry. Gene expression analysis was performed using qRT-PCR. Statistical analyses included one-way ANOVA and Tukey's multiple comparison test. RESULTS Testosterone-treated rats had a marked increase in COX-2, prostate weight, and index. Moreover, TST-induced COX-2 was inferred from cytoskeletal changes and was attributable to the overexpression of PGE2, NF-κB (p65), and IL-6. COX-2-derived PGE2 increased the activity of ADAM-17, TGF-α, and TNF-α. Consequently, EGFR-ERK1/2 pathway was over-activated, disrupting anti-apoptotic Bcl-2, cyclin D1, and pro-apoptotic Bax. Celecoxib reversed these effects. CONCLUSION COX-2 stimulates the ERK1/2 pathway via PGE2-ADAM-17-catalyzed shedding of TGF-α in testosterone-induced BPH. The results indicate a functional correlation between inflammation and hyperplasia in BPH.
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Affiliation(s)
- Mohammed E. Abo-El Fetoh
- grid.442695.80000 0004 6073 9704Department of Pharmacology and Toxicology, Faculty of Pharmacy, Egyptian Russian University, Cairo, Egypt
| | - Maha M. Abdel-Fattah
- grid.411662.60000 0004 0412 4932Department of Pharmacology and Toxicology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, 62514 Egypt
| | - Wafaa R. Mohamed
- grid.411662.60000 0004 0412 4932Department of Pharmacology and Toxicology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, 62514 Egypt
| | - Laila A. A. Ramadan
- grid.442695.80000 0004 6073 9704Department of Pharmacology and Toxicology, Faculty of Pharmacy, Egyptian Russian University, Cairo, Egypt
| | - Hassan Afify
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Egyptian Russian University, Cairo, Egypt.
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18
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Pinazo-Bandera JM, García-Cortés M, Segovia-Zafra A, Lucena MI, Andrade RJ. Recreational Drugs and the Risk of Hepatocellular Carcinoma. Cancers (Basel) 2022; 14:5395. [PMID: 36358813 PMCID: PMC9657889 DOI: 10.3390/cancers14215395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/03/2023] Open
Abstract
Recreational or aesthetic drug use is a distinctive behavior of humans, principally attested in the last century. It is known that recreational and illegal drugs are major contributors to the universal morbidity rate worldwide. Many of these substances have a well-established hepatotoxic potential, causing acute or chronic liver injury, liver fibrosis and cirrhosis, but their implications for hepatocellular carcinoma or other varieties of liver tumors are little known. In this article, we perform an extensive literature review, aiming to provide updated information about recreational drug use and the risk of developing liver tumors. Khat use and pyrrolizidine alkaloid consumption (present in some natural plants) have been linked to liver cirrhosis. Kava intake is associated with different liver tumors in animal models but not in humans. Cannabis' potential to accelerate liver fibrosis in chronic hepatitis is controversial according to the existing data. Cigarette smoking is an important contributor to hepatocellular carcinoma, and anabolic androgen steroids are well-defined causes of a variety of liver cancers and other hepatic tumors. Long-term follow-up studies of subjects who have developed injuries in association with the use of recreational drugs are warranted so as to better define the risk of developing hepatocellular carcinoma in association with these substances and, thus, to implement health care policies to combat this preventable cause of cancer.
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Affiliation(s)
- José M. Pinazo-Bandera
- Service of Gastroenterology and Hepatology, University Hospital Virgen de la Victoria, Universidad de Málaga, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma Bionand, 29010 Málaga, Spain
| | - Miren García-Cortés
- Service of Gastroenterology and Hepatology, University Hospital Virgen de la Victoria, Universidad de Málaga, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma Bionand, 29010 Málaga, Spain
- Centro de Investigación Biomédico en Red Enfermedades Hepáticas y Digestivas (CIBERehd), 29010 Madrid, Spain
| | - Antonio Segovia-Zafra
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma Bionand, 29010 Málaga, Spain
- Centro de Investigación Biomédico en Red Enfermedades Hepáticas y Digestivas (CIBERehd), 29010 Madrid, Spain
- Service of Clinical Pharmacology, University Hospital Virgen de la Victoria, Universidad de Málaga, 29010 Málaga, Spain
| | - María Isabel Lucena
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma Bionand, 29010 Málaga, Spain
- Centro de Investigación Biomédico en Red Enfermedades Hepáticas y Digestivas (CIBERehd), 29010 Madrid, Spain
- Service of Clinical Pharmacology, University Hospital Virgen de la Victoria, Universidad de Málaga, 29010 Málaga, Spain
| | - Raúl J. Andrade
- Service of Gastroenterology and Hepatology, University Hospital Virgen de la Victoria, Universidad de Málaga, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma Bionand, 29010 Málaga, Spain
- Centro de Investigación Biomédico en Red Enfermedades Hepáticas y Digestivas (CIBERehd), 29010 Madrid, Spain
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Rostom M, Ramasamy R, Kohn TP. History of testosterone therapy through the ages. Int J Impot Res 2022; 34:623-625. [PMID: 35075296 DOI: 10.1038/s41443-021-00493-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/17/2021] [Accepted: 10/28/2021] [Indexed: 11/08/2022]
Abstract
The symptoms of testosterone deficiency have been known throughout history with evidence dating back to the twenty-first century BCE when men were castrated to be docile and obedient servants. Experimentation ingesting mammalian testicles began during the reign of the Roman empire and continued through the nineteenth century with claims that the substance found within these testicles could improve energy, erectile function, and urination. In the twentieth century, studies transplanting animal testes onto other castrated animals suggested that a substance produced in the testicle was responsible for systemic effects. Then in 1929, Adolf Butendant was the first to isolate testosterone and shortly after synthetic formulations of testosterone were created. While testosterone therapy is an important treatment for testosterone deficiency, the history of testosterone therapy has not been without abuse from doping scandals in the twentieth century and the use of testosterone therapy for conversion therapy and treatment of psychiatric disease. Today, there are clear and appropriate clinical uses of testosterone set by the American Urological Association to treat clinically significant testosterone deficiency. Still, even with such guidelines, the potential for misuse and abuse remains high in physicians and athletes. There is a long history that has led to the development of testosterone therapy and when used appropriately can significantly improve the quality of life for men with testosterone deficiency.
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Affiliation(s)
- Mary Rostom
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Taylor P Kohn
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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20
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Current Management and Controversies Surrounding Andropause. Urol Clin North Am 2022; 49:583-592. [DOI: 10.1016/j.ucl.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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21
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Kvillemo P, Strandberg AK, Elgán TH, Gripenberg J. Facilitators and barriers in preventing doping among recreational athletes: A qualitative interview study among police officers. Front Public Health 2022; 10:1017801. [PMID: 36276382 PMCID: PMC9580715 DOI: 10.3389/fpubh.2022.1017801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/12/2022] [Indexed: 01/28/2023] Open
Abstract
Background Doping is a societal problem associated with health problems, violence, and other crimes, especially when combined with alcohol and drugs. Elite, as well as recreational athletes who exercise in gyms may use doping to enhance their performance and/or improve their appearance. According to Swedish law, manufacturing, selling, supplying, possessing, and using anabolic androgenic steroids and growth hormones is forbidden. Exceptions apply if these substances are used for medical purposes and prescribed by doctors. As doping is illegal, the police authority is vital in counteracting doping. Aim We aimed to identify facilitators and barriers to effective doping prevention at gyms by examining police officers' views on doping as a societal problem, their experiences of doping prevention efforts, and their perceptions on what enables or hinders doping prevention. Methods Interviews with police officers (n = 15) were conducted from December 2021 to May 2022. The interviews were recorded and transcribed verbatim. A targeted content analysis of the material was performed. Results Facilitators for effective doping prevention involving the police included the recognition of doping as a societal problem; mobilization of key actors; motivated police management and officers; adequate resource allocation; collaboration between the police, gyms, and other relevant authorities; and skills development for police and other professions. Barriers to effective doping prevention included a lack of knowledge about doping, time-consuming processes around the detection and collection of evidence in doping offenses, and competing tasks for police officers. Conclusion Doping prevention should become more efficient by taking advantage of existing facilitators and removing remaining barriers. This study could guide recommendations linked to the police organization and the surrounding society regarding doping prevention.
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Affiliation(s)
- Pia Kvillemo
- Department of Clinical Neuroscience, Stockholm Prevents Alcohol and Drug Problems (STAD), Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden,Stockholm Health Care Services, Stockholm, Sweden,*Correspondence: Pia Kvillemo
| | - Anna K. Strandberg
- Department of Clinical Neuroscience, Stockholm Prevents Alcohol and Drug Problems (STAD), Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden,Stockholm Health Care Services, Stockholm, Sweden
| | - Tobias H. Elgán
- Department of Clinical Neuroscience, Stockholm Prevents Alcohol and Drug Problems (STAD), Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden,Stockholm Health Care Services, Stockholm, Sweden
| | - Johanna Gripenberg
- Department of Clinical Neuroscience, Stockholm Prevents Alcohol and Drug Problems (STAD), Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden,Stockholm Health Care Services, Stockholm, Sweden
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22
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Khadem Amiri T, Salehidoost R. Anabolic-androgenic steroid use among Iranian male gym-goers. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2110952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Tohid Khadem Amiri
- Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rezvan Salehidoost
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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23
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Qasim Agha O, Al Hennawi H, Alani M, Aslam S, Reynolds J. Anabolic Steroid-Induced Cholestatic Liver Injury: A Case Report. Cureus 2022; 14:e27514. [PMID: 36060356 PMCID: PMC9426951 DOI: 10.7759/cureus.27514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2022] [Indexed: 11/05/2022] Open
Abstract
Owing to performance-enhancing and cosmetic effects, illicit use of anabolic-androgenic steroids (AAS) has been well-described and can be associated with significant complications. We report a 27-year-old Caucasian male who self-medicated with AAS in the form of intramuscular injections and oral testosterone for a one-year duration. He complained of persistent jaundice and moderate generalized itching for one month. On admission, his total bilirubin level was 11.4 mg/dl (normal: 0-1.2 mg/dl), and liver enzymes were slightly elevated. On follow-up, the patient stated complete resolution of symptoms and near-normalization of lab results after one month of conservative management.
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Anabolic-androgenic steroid use is associated with psychopathy, risk-taking, anger, and physical problems. Sci Rep 2022; 12:9133. [PMID: 35650220 PMCID: PMC9160254 DOI: 10.1038/s41598-022-13048-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/25/2022] [Indexed: 11/09/2022] Open
Abstract
Previous research has uncovered medical and psychological effects of anabolic-androgenic steroid (AAS) use, but the specific relationship between AAS use and risk-taking behaviors as well as between AAS use and psychopathic tendencies remains understudied. To explore these potential relationships, we anonymously recruited 492 biologically male, self-identified bodybuilders (median age 22; range 18-47 years) from online bodybuilding fora to complete an online survey on Appearance and Performance Enhancing Drug (APED) use, psychological traits, lifestyle choices, and health behaviors. We computed odds ratios and 95% confidence intervals using logistic regression, adjusting for age, race, education, exercise frequency, caloric intake, and lean BMI. Bodybuilders with a prior history of AAS use exhibited heightened odds of psychopathic traits, sexual and substance use risk-taking behaviors, anger problems, and physical problems compared to those with no prior history of AAS use. This study is among the first to directly assess psychopathy within AAS users. Our results on risk-taking, anger problems, and physical problems are consistent with prior AAS research as well as with existing frameworks of AAS use as a risk behavior. Future research should focus on ascertaining causality, specifically whether psychopathy is a risk associated with or a result of AAS use.
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Strogulski NR, Kopczynski A, de Oliveira VG, Carteri RB, Hansel G, Venturin GT, Greggio S, DaCosta JC, De Bastiani MA, Rodolphi MS, Portela LV. Nandrolone Supplementation Promotes AMPK Activation and Divergent 18[FDG] PET Brain Connectivity in Adult and Aged Mice. Neurochem Res 2022; 47:2032-2042. [PMID: 35415802 DOI: 10.1007/s11064-022-03592-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 11/29/2022]
Abstract
Decreased anabolic androgen levels are followed by impaired brain energy support and sensing with loss of neural connectivity during physiological aging, providing a neurobiological basis for hormone supplementation. Here, we investigated whether nandrolone decanoate (ND) administration mediates hypothalamic AMPK activation and glucose metabolism, thus affecting metabolic connectivity in brain areas of adult and aged mice. Metabolic interconnected brain areas of rodents can be detected by positron emission tomography using 18FDG-mPET. Albino CF1 mice at 3 and 18 months of age were separated into 4 groups that received daily subcutaneous injections of either ND (15 mg/kg) or vehicle for 15 days. At the in vivo baseline and on the 14th day, brain 18FDG-microPET scans were performed. Hypothalamic pAMPKT172/AMPK protein levels were assessed, and basal mitochondrial respiratory states were evaluated in synaptosomes. A metabolic connectivity network between brain areas was estimated based on 18FDG uptake. We found that ND increased the pAMPKT172/AMPK ratio in both adult and aged mice but increased 18FDG uptake and mitochondrial basal respiration only in adult mice. Furthermore, ND triggered rearrangement in the metabolic connectivity of adult mice and aged mice compared to age-matched controls. Altogether, our findings suggest that ND promotes hypothalamic AMPK activation, and distinct glucose metabolism and metabolic connectivity rearrangements in the brains of adult and aged mice.
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Affiliation(s)
- N R Strogulski
- Laboratory of Neurotrauma and Biomarkers, Departamento de Bioquímica, ICBS, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - A Kopczynski
- Laboratory of Neurotrauma and Biomarkers, Departamento de Bioquímica, ICBS, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - V G de Oliveira
- Laboratory of Neurotrauma and Biomarkers, Departamento de Bioquímica, ICBS, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - R B Carteri
- Laboratory of Neurotrauma and Biomarkers, Departamento de Bioquímica, ICBS, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - G Hansel
- Neuroinflammation and Neuroimmunology Laboratory, Brain Institute of Rio Grande Do Sul, Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - G T Venturin
- Brain Institute of Rio Grande Do Sul (BraIns), Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - S Greggio
- Brain Institute of Rio Grande Do Sul (BraIns), Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - J C DaCosta
- Brain Institute of Rio Grande Do Sul (BraIns), Pontifical Catholic University of Rio Grande Do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - M A De Bastiani
- Zimmer Neuroimaging Lab, Departamento de Bioquímica, ICBS, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - M S Rodolphi
- Laboratory of Neurotrauma and Biomarkers, Departamento de Bioquímica, ICBS, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - L V Portela
- Laboratory of Neurotrauma and Biomarkers, Departamento de Bioquímica, ICBS, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
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Severity of anabolic steroid dependence, executive function, and personality traits in substance use disorder patients in Norway. Drug Alcohol Depend 2022; 231:109275. [PMID: 35030506 DOI: 10.1016/j.drugalcdep.2022.109275] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Anabolic androgenic steroids (AAS), including testosterone and synthetic derivatives, are typically used to increase muscle mass. Many users develop a dependence on these substances, contributing to worsened physical and mental health outcomes. Aspects of personality and executive dysfunction may represent underlying vulnerabilities for developing dependence. OBJECTIVE To identify levels of AAS dependence within substance use disorder (SUD) treatment patients and assess the relationship between dependence severity and personality traits and executive function (EF). METHODS Data were collected from patients at 38 SUD treatment facilities in Norway. Questionnaires were completed for measures of personality and EF. Measures of symptoms of AAS dependence were used in latent class analysis to identify sub-groups of patients, which were evaluated for association with EF and personality traits, and compared with a group of non-AAS using SUD patients. RESULTS Three classes were identified; largely reflecting low, moderate, and high symptoms of dependence. Multinomial regression analyses indicated that moderate and high symptoms were associated with several measures of EF and personality traits, particularly self-monitoring, antagonism, disinhibition, and rigid perfectionism while users with low symptoms exhibited higher capacities for emotional control and shift, and lower negative affectivity, relative to non-AAS using SUD patients. Backward stepwise regressions indicated antagonism, and decreased self-monitoring as key personality and cognitive characteristics of SUD patients with severe AAS dependence. CONCLUSION Our findings indicate that specific executive dysfunctions and personality features, particularly those associated with poor emotional control, reduced empathy, and impulsivity are associated with more severe AAS dependence in the SUD population.
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Amaral JMX, Deslandes AC, Padilha MC, Vieira Neto L, Osorio LE, Aquino Neto FR, Cruz MS. No association between psychiatric symptoms and doses of anabolic steroids in a cohort of male and female bodybuilders. Drug Test Anal 2022; 14:1079-1088. [PMID: 35092181 PMCID: PMC9303351 DOI: 10.1002/dta.3230] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 11/16/2022]
Abstract
The use of androgenic‐anabolic steroids (AAS) can be associated with psychiatric symptoms such as insomnia, anxiety and increased aggressiveness. Although dose‐dependent effects have been observed in some controlled studies, this association is not always seen in the ecological use of AAS. This study utilized WADA's steroid profile of suspicious use of AAS, urinary detection of AAS metabolites and measurement of sexual hormones to confirm recent use of AAS in a cohort of 103 bodybuilders (75 males, 28 females). The majority of participants (61.2%) presented symptoms of agitation, insomnia, increased aggressiveness or depression in the last 3 months. About one‐third of participants presented scores on the HAM‐A anxiety scale equivalent to moderate to severe symptoms of anxiety. A minority of participants (12.6%) presented high to moderate scores on the BPQ aggressiveness scale. The majority of participants (73.8%) presented hyperthymic temperament in the BRIEF‐TEMPS scale. There was no significant difference in the presence of psychiatric symptoms between males and females and no association between psychiatric symptoms and estimated weekly doses of AAS. A negative association was observed between scores on the BPQ scale (verbal aggression, anger and total score) and the time of AAS use. We discuss differences of AAS use between male and female bodybuilders and the screening of AAS use in the general population. Our findings highlight the importance of mental health awareness among people using AAS.
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Affiliation(s)
- JMX Amaral
- King’s College London. Institute of Psychiatry, Psychology and Neurosciences (IoPPN) London UK
- Federal University of Rio de Janeiro (UFRJ) ‐ Institute of Psychiatry Rio de Janeiro Brazil
| | - A. C. Deslandes
- Federal University of Rio de Janeiro (UFRJ) ‐ Institute of Psychiatry Rio de Janeiro Brazil
| | - M. C. Padilha
- Federal University of Rio de Janeiro – Chemistry Institute ‐ Brazilian Laboratory of Doping Control (LBCD – LADETEC, IQ ‐ UFRJ) Rio de Janeiro Brazil
| | - L. Vieira Neto
- Federal University of Rio de Janeiro (UFRJ) ‐ Department of Internal Medicine Rio de Janeiro Brazil
| | - L. E. Osorio
- Federal University of Rio de Janeiro (UFRJ) ‐ Department of Internal Medicine Rio de Janeiro Brazil
| | - F. R. Aquino Neto
- Federal University of Rio de Janeiro – Chemistry Institute ‐ Brazilian Laboratory of Doping Control (LBCD – LADETEC, IQ ‐ UFRJ) Rio de Janeiro Brazil
| | - M. S. Cruz
- Federal University of Rio de Janeiro (UFRJ) ‐ Institute of Psychiatry Rio de Janeiro Brazil
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Charkhgard N, Razaghi E. Opiates Possibly Boosted Human Civilization. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2021; 15. [DOI: 10.5812/ijpbs.114491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 07/24/2021] [Accepted: 08/17/2021] [Indexed: 09/01/2023]
Abstract
: Testosterone is a fundamental biological drive for human survival. Evidence documents an association between the evolutionary suppression of testosterone and the civilization processes, especially their socialization and family colonization abilities, among early humans. Interestingly, opiates suppress testosterone as a side effect. However, in clinical practice, clients undergoing opioid substitution therapy have subnormal, normal, or even above-normal testosterone. This paper discusses a possibility indicating that opiates promoted civilization processes among early humans. We further suggest that modern humans might have inherited the positive impact of opiates on early humans as a biological propensity for using opioids. Some users may use opioids for self-medication to decrease their extraordinarily high testosterone levels.
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Shimko KM, Piatkowski T, Thomas KV, Speers N, Brooker L, Tscharke BJ, O'Brien JW. Performance- and image-enhancing drug use in the community: use prevalence, user demographics and the potential role of wastewater-based epidemiology. JOURNAL OF HAZARDOUS MATERIALS 2021; 419:126340. [PMID: 34171672 DOI: 10.1016/j.jhazmat.2021.126340] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 05/24/2023]
Abstract
Performance- and image-enhancing drug (PIED) misuse is a significant public health issue. Currently, seizure data, surveys, anti-doping testing, and needle service provider data are used to estimate PIED use in populations. These methods are time consuming, single point-in-time measurements that often consist of small sample sizes and do not truly capture PIED prevalence. Wastewater-based epidemiology (WBE) has been used globally to assess and monitor licit and illicit drug consumption within the general community. This method can objectively cover large populations as well as specific subpopulations (gyms, music festivals, prisons), and has potential as a complementary monitoring method for PIED use. Information obtained through WBE could be used to aid public health authorities in developing targeted prevention and education programmes. Research on PIED analysis in wastewater is limited and presents a significant gap in the literature. The focus is on anabolic steroids, and one steroid alternative currently growing in popularity; selective androgenic receptor modulators. This encompasses medical uses, addiction, prevalence, user typology, and associated public health implications. An overview of WBE is described including its benefits, limitations and potential as a monitoring method for PIED use. A summary of previous work in this field is presented. Finally, we summarise gaps in the literature, future perspectives, and recommendations for monitoring PIEDs in wastewater.
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Affiliation(s)
- Katja M Shimko
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia.
| | - Timothy Piatkowski
- School of Psychology and Counselling and Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia; Centre for Youth Substance Abuse Research, Queensland University of Technology, Australia
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Naomi Speers
- Sport Integrity Australia (SIA), Unit 14, 5 Tennant Street, Fyshwick, ACT 2609, Australia
| | - Lance Brooker
- Australian Sports Drug Testing Laboratory (ASDTL), National Measurement Institute (NMI), 105 Delhi Road, North Ryde, NSW 2113, Australia
| | - Ben J Tscharke
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
| | - Jake W O'Brien
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD 4102, Australia
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Life-Threatening Intraparenchymal Hemorrhage of Steroid-Induced Hepatic Adenomas in a Healthy Man. ACG Case Rep J 2021; 8:e00601. [PMID: 34046510 PMCID: PMC8148419 DOI: 10.14309/crj.0000000000000601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 02/16/2021] [Indexed: 11/18/2022] Open
Abstract
Hepatocellular adenomas are uncommon benign epithelial tumors of the liver that are associated with several risk factors such as anabolic androgens and oral contraceptive pills. They may present as incidental findings, with abdominal pain or hemorrhage. This case report details the presentation and management of a life-threatening hepatocellular adenomas hemorrhage in a seemingly healthy 28-year-old man. After initial conservative management, a clinical deterioration prompted urgent reevaluation and successful embolization of the liver through transarterial embolization. As oral contraceptive pills use and anabolic steroid abuse have become more prevalent in recent decades, we may begin to see more of these presentations.
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Pope HG, Kanayama G, Hudson JI, Kaufman MJ. Review Article: Anabolic-Androgenic Steroids, Violence, and Crime: Two Cases and Literature Review. Am J Addict 2021; 30:423-432. [PMID: 33870584 DOI: 10.1111/ajad.13157] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/16/2021] [Accepted: 02/04/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Anabolic-androgenic steroid (AAS) use has become a major worldwide substance use disorder, affecting tens of millions of individuals. Importantly, it is now increasingly recognized that some individuals develop uncharacteristically violent or criminal behaviors when using AAS. We sought to summarize available information on this topic. METHODS We reviewed the published literature on AAS-induced behavioral effects and augmented this information with extensive observations from our clinical and forensic experience. RESULTS It is now generally accepted that some AAS users develop uncharacteristically violent or criminal behaviors while taking these drugs. Although these behaviors may partially reflect premorbid psychopathology, sociocultural factors, or expectational effects, accumulating evidence suggests that they are also attributable to biological effects of AAS themselves. The mechanism of these effects remains speculative, but preliminary data suggest a possible role for brain regions involved in emotional reactivity, such as the amygdala and regions involved in cognitive control, including the frontal cortex. For unknown reasons, these effects appear idiosyncratic; most AAS users display few behavioral effects, but a minority develops severe effects. CONCLUSION AND SCIENTIFIC SIGNIFICANCE Professionals encountering AAS users in clinical or forensic settings should be alert to the possibility of AAS-induced violence or criminality and should employ strategies to assess whether AAS is indeed a contributory factor in a given case. Further research is needed to elucidate the mechanism of AAS-induced violence and to explain why only a subset of AAS users appears vulnerable to these effects. (Am J Addict 2021;00:00-00).
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Affiliation(s)
- Harrison G Pope
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Gen Kanayama
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - James I Hudson
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Marc J Kaufman
- Harvard Medical School, Boston, Massachusetts.,McLean Imaging Center, McLean Hospital, Belmont, Massachusetts
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Sampaio F, Ssegonja R, Thiblin I, Nystrand C. A model for evaluating the economic value of prevention programs for illicit use of anabolic androgenic steroids. Health Policy 2021; 125:807-813. [PMID: 33838934 DOI: 10.1016/j.healthpol.2021.03.001] [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: 08/13/2020] [Revised: 12/27/2020] [Accepted: 03/04/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The illicit use of anabolic androgenic steroids (AAS) has become a societal concern. We developed a decision-analytic model for assessing the cost-effectiveness of preventive interventions targeting AAS-use. We used scenario analyses to demonstrate: a) the potential health economic consequences of AAS use in Sweden, and b) the cost-effectiveness of a hypothetical preventive intervention. METHODS A population-based cohort model compared a hypothetical preventive intervention targeting AAS with a 'no intervention' scenario, from a limited societal perspective. The model simulated how a cohort of 18 year-old males transitioned between different states and predicted their health status and complications until the age of 41. Health outcomes were estimated as quality-adjusted life-years (QALY). Costs included intervention costs, drug costs, and costs of complications. RESULTS Total yearly costs related to AAS use amounted to nearly half a million US$, with the largest cost borne by the healthcare sector. Results suggest that AAS prevention could entail large costs and benefits with a mean incremental cost-effectiveness ratio of $550 per QALY, in a scenario where the intervention would decrease the probability of initiating AAS use by 5%. CONCLUSION Results show large AAS related costs, and suggest that the implementation of a preventive intervention could offer good value for money given different effectiveness scenarios. This model can be used to estimate the value of interventions targeting AAS use.
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Affiliation(s)
- Filipa Sampaio
- Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, P.O Box 564, 751 22 Uppsala, Sweden.
| | - Richard Ssegonja
- Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, P.O Box 564, 751 22 Uppsala, Sweden
| | - Ingemar Thiblin
- Forensic Medicine, Department of Surgical Sciences Uppsala University, Uppsala, Sweden
| | - Camilla Nystrand
- Department of Public Health and Caring Sciences, Uppsala University, BMC, Husargatan 3, P.O Box 564, 751 22 Uppsala, Sweden
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Zoob Carter BN, Boardley ID, van de Ven K. The Impact of the COVID-19 Pandemic on Male Strength Athletes Who Use Non-prescribed Anabolic-Androgenic Steroids. Front Psychiatry 2021; 12:636706. [PMID: 33828494 PMCID: PMC8019803 DOI: 10.3389/fpsyt.2021.636706] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/22/2021] [Indexed: 12/24/2022] Open
Abstract
Background: One sub-population potentially affected by the COVID-19 pandemic are strength athletes who use anabolic-androgenic steroids (AAS). We examined links between disruption in AAS use and training due to the pandemic and mental health outcomes in this population, hypothesising: (a) the pandemic would be linked with reduced training and AAS use; and (b) athletes perceiving greater impact on their training and AAS use would report increases in detrimental mental health outcomes. Methods: Male strength athletes using AAS (N = 237) from 42 countries completed an online questionnaire in May 2020. A sub-sample (N = 90) from 20 countries participated again 4 months later. The questionnaire assessed pre-pandemic and current AAS use and training, alongside several mental health outcomes. Results: At Time 1, most participants perceived an impact of the pandemic on AAS use (91.1%) and/or training (57.8%). Dependent t-tests demonstrated significant reductions in training frequency (t = 7.78; p < 0.001) and AAS dose (t = 6.44; p < 0.001) compared to pre-pandemic. Linear regression showed the impact of the pandemic on training was a significant positive predictor of excessive body checking (B = 0.35) and mood swings (B = 0.26), and AAS dose was a significant positive predictor of anxiety (B = 0.67), insomnia (B = 0.52), mood swings (B = 0.37). At Time 2, fewer participants perceived an impact of the pandemic on AAS use (29.9%) and/or training (66.7%) than at Time 1. Training frequency (t = 3.02; p < 0.01) and AAS dose (t = 2.11; p < 0.05) were depressed in comparison to pre-pandemic. However, AAS dose had increased compared to Time 1 (t = 2.11; p < 0.05). Linear regression showed the impact of the pandemic on training/AAS use did not significantly predict any mental-health outcomes. However, AAS dose was a significant negative predictor of depressive thoughts (B = -0.83) and mood swings (B = -2.65). Conclusion: Our findings showed impact of the pandemic on the training and AAS use, reflected in reduced training frequency and AAS dose. However, whilst we detected some short-term consequential effects on mental health, these did not appear to be long-lasting.
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Affiliation(s)
- Barnaby N. Zoob Carter
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Ian D. Boardley
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Katinka van de Ven
- Centre for Rural Criminology, School of Humanities, Arts, and Social Sciences, University of New England, Armidale, NSW, Australia
- Drug Policy Modelling Program, Social Policy Research Centre, University of New South Wales, Sydney, NSW, Australia
- Human Enhancement Drugs Network, University of New England, Armidale, NSW, Australia
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Performance and image enhancing drug interventions aimed at increasing knowledge among healthcare professionals (HCP): reflections on the implementation of the Dopinglinkki e-module in Europe and Australia in the HCP workforce. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 95:103141. [PMID: 33549466 DOI: 10.1016/j.drugpo.2021.103141] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 12/15/2020] [Accepted: 01/25/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Healthcare professionals (HCPs) provide an important point of contact through which people who use performance and image enhancing drugs (PIEDs) could access reliable information, advice, and interventions on a range of PIEDs, their use and related harms. However, HCPs often report difficulties engaging and building rapport with people who use PIEDs, and research suggests that they often lack specialist knowledge on these substances. Providing credible evidence-based resources to support HCPs is thus important. However, educational materials in this area are generally absent and the ones that exist have not been assessed for their utility in the HCP workforce. This paper examines the acceptability and usability of a PIED e-learning module (the Dopinglinkki e-module) targeted at HCPs in three EU Member States and Australia. METHODS A standardised two stage, mixed methodology was implemented. Stage 1 involved HCPs completing the e-module and completing an online survey (N = 77). Stage 2 involved conducting individual structured interviews with a subset of survey respondents (N = 37). Normalisation Process Theory and the Theoretical Framework of Acceptability were used as conceptual lenses. FINDINGS The e-module provided information that was perceived as useful for HCPs' current and future practice. However, several individual, organisational and societal level barriers were reported as preventing the e-module becoming an accepted and normalised aspect of the HCP workforce, including the need for up to date evidence, the time-consuming nature of completing the e-module, lack of organisational support, the use of over-complex language, and the module's potential to reinforce the stigmatisation of PIEDs. CONCLUSION Providing credible evidence-based resources to support HCPs' knowledge development is important. Evidence-based and theory informed interventions are needed to equip HCPs with knowledge that can aid culturally sensitive interactions and effective engagement with people who use PIEDs. Reflecting on our study findings, it is important that the development of interventions should include the voices of both HCP and those using PIEDs, and that careful consideration is given to the various factors that may act as a barrier to effective implementation.
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Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review. Healthcare (Basel) 2021; 9:healthcare9010097. [PMID: 33477800 PMCID: PMC7832337 DOI: 10.3390/healthcare9010097] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/03/2021] [Accepted: 01/11/2021] [Indexed: 12/19/2022] Open
Abstract
Anabolic-androgenic steroids (AASs) are a large group of molecules including endogenously produced androgens, such as testosterone, as well as synthetically manufactured derivatives. AAS use is widespread due to their ability to improve muscle growth for aesthetic purposes and athletes’ performance, minimizing androgenic effects. AAS use is very popular and 1–3% of US inhabitants have been estimated to be AAS users. However, AASs have side effects, involving all organs, tissues and body functions, especially long-term toxicity involving the cardiovascular system and the reproductive system, thereby, their abuse is considered a public health issue. The aim of the proposed review is to highlight the most recent evidence regarding the mechanisms of action of AASs and their unwanted effects on organs and lifestyle, as well as suggesting that AAS misuse and abuse lead to adverse effects in all body tissues and organs. Oxidative stress, apoptosis, and protein synthesis alteration are common mechanisms involved in AAS-related damage in the whole body. The cardiovascular system and the reproductive system are the most frequently involved apparatuses. Epidemiology as well as the molecular and pathological mechanisms involved in the neuropsychiatric side-effects of AAS abuse are still unclear, further research is needed in this field. In addition, diagnostically reliable tests for AAS abuse should be standardized. In this regard, to prevent the use of AASs, public health measures in all settings are crucial. These measures consist of improved knowledge among healthcare workers, proper doping screening tests, educational interventions, and updated legislation.
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Risks of Serious Injury with Testosterone Treatment. Am J Med 2021; 134:84-94.e6. [PMID: 32926849 DOI: 10.1016/j.amjmed.2020.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/31/2020] [Accepted: 07/31/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Injury causes significant morbidity and mortality that is sometimes attributed to testosterone and violence. We hypothesized that prescribed testosterone might be associated with the subsequent risk of serious injury. METHODS We conducted a self-matched individual-patient exposure-crossover analysis comparing injury risks before and after initiation of testosterone. We selected adults treated with testosterone in Ontario, Canada, from October 1, 2012, to October 1, 2017 (enrollment) and continued until October 1, 2018 (follow-up). The primary outcome was defined as an acute traumatic event that required emergency medical care. RESULTS A total of 64,386 patients were treated with testosterone of whom 89% were men with a median age of 52 years. We identified 34,439 serious injuries during the baseline interval before starting testosterone (584 per month) and 7349 serious injuries during the subsequent interval after starting testosterone (565 per month). Rates of injuries were substantially above the population norm in both intervals with no significant increased risk after starting testosterone (relative risk = 1.00; 95% confidence interval: 0.96-1.04, P = 0.850). The unchanged risk extended to diverse patients, was observed for different formulations and applied to all injury mechanisms. In contrast, testosterone treatment was associated with a 48% increased risk of a thromboembolic event (relative risk = 1.48; 95% confidence interval: 1.25-1.74, P < 0.001). CONCLUSIONS Testosterone treatment was associated with a substantial baseline risk of serious injury that did not increase further after starting therapy. Physicians prescribing testosterone could consider basic safety reminders to mitigate injury risks.
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Piatkowski TM, White KM, Hides LM, Obst PL. Australia's Adonis: Understanding what motivates young men's lifestyle choices for enhancing their appearance. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12451] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Timothy M. Piatkowski
- School of Psychology and Counselling and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,
- Centre for Youth Substance Abuse Research, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Katherine M. White
- School of Psychology and Counselling and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Leanne M. Hides
- Centre for Youth Substance Abuse Research, Queensland University of Technology, Brisbane, Queensland, Australia,
- Centre for Youth Substance Abuse Research, School of Psychology and Counselling, University of Queensland, Brisbane, Queensland, Australia,
| | - Patricia L. Obst
- School of Psychology and Counselling and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,
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Omolaoye TS, du Plessis SS. Male infertility: A proximate look at the advanced glycation end products. Reprod Toxicol 2020; 93:169-177. [DOI: 10.1016/j.reprotox.2020.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 12/19/2019] [Accepted: 02/05/2020] [Indexed: 01/07/2023]
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Hauger LE, Westlye LT, Bjørnebekk A. Anabolic androgenic steroid dependence is associated with executive dysfunction. Drug Alcohol Depend 2020; 208:107874. [PMID: 31972519 DOI: 10.1016/j.drugalcdep.2020.107874] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/07/2020] [Accepted: 01/11/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Anabolic androgenic steroid (AAS) dependence is associated with a high prevalence of intra- and interpersonal problems, hence it is central to identify cognitive factors related to the development and maintenance of dependence. METHODS The study explores executive functions (EFs) in a sample of 174 male weightlifters, divided into three groups; 1) AAS dependents; n = 58, 2) AAS non-dependents; n = 38 and 3) AAS non-users; n = 78, using a targeted battery of neuropsychological (NP) tests, and self-report questionnaires assessing EFs in everyday life, ADHD symptoms and psychological distress. RESULTS Multivariate analysis of variance showed significant between-group differences on several EFs, including working memory [F (2, 169) = 13.79, p < .001, ηp² = 0.14], mental flexibility [F (2, 169) = 4.82, p = .009, ηp² = 0.05], problem-solving [F (2, 169) = 4.77 p = .010, ηp² = 0.05] and inhibition [F (2, 163) = 4.15, p = .017, ηp² = 0.05]. Additionally, significant between-group differences were seen for self-reported problems with EFs [F (2, 124) = 4.38 p = .015, ηp² = 0.07], ADHD symptoms [F (2, 124) = 7.02 p = .001, ηp² = 0.10], and psychological distress [F (2, 124) = 4.11 p = .019, ηp² = 0.06]. Post hoc tests showed that AAS dependents exhibited poorer EFs and reported more psychological distress compared to non-users. CONCLUSION AAS dependence is associated with executive dysfunction, which might be related to continued abuse despite adverse side-effects and social consequences. Increased awareness of executive dysfunction could have important implications for treatment and rehabilitation.
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Affiliation(s)
- Lisa E Hauger
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, Norway.
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Postbox 1094, Blindern, Norway; NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4956, Nydalen, Norway
| | - Astrid Bjørnebekk
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, Norway
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Kahal A, Allem R, Zahzeh T, Koriche S, Kouri A, Douani A, Kassoul H, Ababou A. Evolutions in cardiac and gonadal ultra-structure during a "cycle" of androgenic anabolic abuse in adult male mice. Steroids 2020; 155:108571. [PMID: 31901424 DOI: 10.1016/j.steroids.2019.108571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 12/27/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The importance of the present study comes from the lack of sufficient information about the reversibility of the potential histopathological alterations which may result from anabolic androgenic drugs abuse by "Cycling" protocol. So, the aim of this study is to explore the negative effects of Deca-Durabolin abuse in cardiac and gonadal ultra-structures during an administration cycle. METHODS For our purpose, study was performed on 40 male adult mices. Animals were divided into five groups of 8 animals each treated weekly by Deca-Durabolin (nandrolone decanoate) at 30 g/kg of BW during one month (GI); during two months (GII); during three months (GIII); during three months followed by six weeks of treatment discontinuation (GIV) and Control (C). Cytohistological examinations to determine the histopathological damage properties of the heart and tests were performed. RESULTS Our results showed that the animals supported very well the administrated substance. Our study showed important degenerative changes in cardiac and gonadal tissues after one months of androgen abuse. These damages increases with the duration of treatment with well marked cell lesions, and worsen again 6 weeks after stopping treatment in cardiac tissue, whereas the gonadal tissue does not recover completely during this period. CONCLUSION These results ported that the use of AAS with "Cycling" may lead to irreversibly destroy the heart tissue. Either, "Cycling" does not ensure the complete recovery of fertility in AAS abusers.
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Affiliation(s)
- Aida Kahal
- Laboratory of Natural Bioresources, Faculty of Science of Nature and Life, Department of Biology, University of Hassiba Ben Bouali, BP 151, 02000 Chlef, Algeria.
| | - Rachida Allem
- Laboratory of Natural Bioresources, Faculty of Science of Nature and Life, Department of Biology, University of Hassiba Ben Bouali, BP 151, 02000 Chlef, Algeria
| | - Touria Zahzeh
- Laboratory of Molecular Microbiology, Proteomics and Health, Department of Biology, University of Djillali Liabes Sidi Bel Abbès, Algeria
| | - Sana Koriche
- Faculty of Science of Nature and Life, Department of Biology, University of Hassiba Ben Bouali, Chlef, Algeria
| | - Amina Kouri
- Faculty of Science of Nature and Life, Department of Biology, University of Hassiba Ben Bouali, Chlef, Algeria
| | - Asma Douani
- Faculty of Science of Nature and Life, Department of Biology, University of Hassiba Ben Bouali, Chlef, Algeria
| | - Hadjira Kassoul
- Faculty of Science of Nature and Life, Department of Biology, University of Hassiba Ben Bouali, Chlef, Algeria
| | - Adda Ababou
- Faculty of Science of Nature and Life, Department of Biology, University of Hassiba Ben Bouali, Chlef, Algeria
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Viega BL, Rocha AM, Düsman E. Cosmetics with hormonal composition for bioindicators Artemia salina L. and Allium cepa L. toxic potential. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:6659-6666. [PMID: 31873903 DOI: 10.1007/s11356-019-07392-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
The emerging pollutants cover a wide range of synthetic chemicals that are indispensable to modern society but with little known effects for aquatic animals and for people who consume polluted waters with these products. Gels manipulated with hormones are widely used for hormone replacement, muscle growth, among other purposes. However, only a small part of these hormones are absorbed into the skin, and so these can be transferred to the domestic sewage during the washing of exposed body regions. Thus, the aim of this study was to evaluate the toxicity levels for the bioindicator Artemia salina L., and cytotoxicity and mutagenicity for the bioindicator Allium cepa L. of gels handled with 1% testosterone and 0.1% estradiol. Data from immobile/dead A. salina numbers after 24 h of exposure showed that the highest concentrations of testosterone (10 and 25 μg/mL) and the highest concentration of estradiol (15 μg/mL) were toxic to this bioindicator. For the bioindicator A. cepa, mitotic indices and chromosomal aberrations did not indicate statistical differences between the groups treated with the testosterone gels (1, 10, 50 μg/mL) and estradiol (0.03, 0.30, 1.5 μg/mL) and the control group. However, all concentrations of the testosterone-containing gel decreased the percentage of cell division in relation to the time 0 h of each treatment and to the time 24 h of the negative control. Therefore, it is concluded that rivers or aquatic environments can be polluted if wastewater with the toxic concentrations found of these hormonal gels is discarded without previous treatment, compromising the life of organisms that live there. And, it encourages the development of techniques for treating sewage and water to reduce/eliminate the hormones present in them.
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Affiliation(s)
- Bruna Luiza Viega
- Academic of Chemical Engineering, Federal Technological University of Paraná, Campus Francisco Beltrão, Francisco Beltrão, Paraná, Brazil
| | - Amanda Michells Rocha
- Academic of Chemical Engineering, Federal Technological University of Paraná, Campus Francisco Beltrão, Francisco Beltrão, Paraná, Brazil
| | - Elisângela Düsman
- Academic Department of Chemistry and Biology, Federal Technological University of Paraná, Linha Santa Bárbara s/n, Caixa Postal 165, Francisco Beltrão, PR, CEP 85601-970, Brazil.
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Cunningham J, Broglio SP, O'Grady M, Wilson F. History of Sport-Related Concussion and Long-Term Clinical Cognitive Health Outcomes in Retired Athletes: A Systematic Review. J Athl Train 2020; 55:132-158. [PMID: 31935139 DOI: 10.4085/1062-6050-297-18] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Sport-related concussions (SRCs) are known to have short-term effects on cognitive processes, which can result in diverse clinical presentations. The long-term effects of SRC and repeated exposure to head impacts that do not result in SRC on specific cognitive health outcomes remain unclear. OBJECTIVES To synthesize and appraise the evidence base regarding cognitive health in living retired athletes with a history of head-impact exposure or SRC. DATA SOURCES A systematic search of the EMBASE, PsycINFO, MEDLINE/PubMed, CINAHL, Cochrane Central Register of Controlled Trials, and Web of Science databases was conducted from inception to April 2018 using common key words and medical subject headings related to 3 components: (1) the participant (eg, retired athlete), (2) the primary outcome measure (eg, cognitive test used), and (3) the secondary outcome measure (eg, history of sport concussion). STUDY SELECTION Cross-sectional studies of living retired male or female athletes in which at least 1 cognitive test was used as an outcome measure were included. Two reviewers independently screened studies. DATA EXTRACTION Data extraction was performed using Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Methodologic quality was assessed independently by 2 reviewers using the Downs and Black tool. DATA SYNTHESIS The search yielded 46 cross-sectional observational studies that were included in a qualitative synthesis. Most included studies (80%, n = 37) were published in the 5 years before our review. A large proportion of these studies (n = 20) included retired American National Football League players. The other research investigated professional, university, high school, and amateur retired athletes participating in sports such as American and Australian football, boxing, field and ice hockey, rugby, and soccer. The total sample consisted of 13 975 participants: 7387 collision-sport athletes, 662 contact-sport athletes, 3346 noncontact-sport athletes, and 2580 participants classified as controls. Compared with control participants or normative data, retired athletes displayed worse performance in 17 of 31 studies (55%) of memory, 6 of 11 studies (55%) of executive function, and 4 of 6 studies (67%) of psychomotor function and increased subjective concerns about cognitive function in 11 of 14 studies (79%). The authors of 13 of 46 investigations (28%) reported a frequency-response relationship, with poorer cognitive outcomes in athletes who had greater levels of exposure to head impacts or concussions. However, these results must be interpreted in light of the lack of methodologic rigor and moderate quality assessment of the included studies. CONCLUSIONS Evidence of poorer cognitive health among retired athletes with a history of concussion and head-impact exposure is evolving. Our results suggest that a history of SRC may more greatly affect the cognitive domains of memory, executive function, and psychomotor function. Retired athletes appeared to have increased self-reported cognitive difficulties, but the paucity of high-quality, prospective studies limited the conclusions that could be drawn regarding a cause-and-effect relationship between concussion and long-term health outcomes. Future researchers should consider a range of cognitive health outcomes, as well as premorbid ability, in diverse samples of athletes with or without a history of concussion or head-impact exposure to delineate the long-term effects of sport participation on cognitive functioning.
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Affiliation(s)
- Joice Cunningham
- Trinity Centre for Health Sciences, St James Hospital, Trinity College Dublin, Ireland
| | | | - Megan O'Grady
- Trinity Centre for Health Sciences, St James Hospital, Trinity College Dublin, Ireland
| | - Fiona Wilson
- Trinity Centre for Health Sciences, St James Hospital, Trinity College Dublin, Ireland
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Balgoma D, Zelleroth S, Grönbladh A, Hallberg M, Pettersson C, Hedeland M. Anabolic androgenic steroids exert a selective remodeling of the plasma lipidome that mirrors the decrease of the de novo lipogenesis in the liver. Metabolomics 2020; 16:12. [PMID: 31925559 PMCID: PMC6954146 DOI: 10.1007/s11306-019-1632-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/31/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The abuse of anabolic androgenic steroids (AASs) is a source of public concern because of their adverse effects. Supratherapeutic doses of AASs are known to be hepatotoxic and regulate the lipoproteins in plasma by modifying the metabolism of lipids in the liver, which is associated with metabolic diseases. However, the effect of AASs on the profile of lipids in plasma is unknown. OBJECTIVES To describe the changes in the plasma lipidome exerted by AASs and to discuss these changes in the light of previous research about AASs and de novo lipogenesis in the liver. METHODS We treated male Wistar rats with supratherapeutic doses of nandrolone decanoate and testosterone undecanoate. Subsequently, we isolated the blood plasma and performed lipidomics analysis by liquid chromatography-high resolution mass spectrometry. RESULTS Lipid profiling revealed a decrease of sphingolipids and glycerolipids with palmitic, palmitoleic, stearic, and oleic acids. In addition, lipid profiling revealed an increase in free fatty acids and glycerophospholipids with odd-numbered chain fatty acids and/or arachidonic acid. CONCLUSION The lipid profile presented herein reports the imprint of AASs on the plasma lipidome, which mirrors the downregulation of de novo lipogenesis in the liver. In a broader perspective, this profile will help to understand the influence of androgens on the lipid metabolism in future studies of diseases with dysregulated lipogenesis (e.g. type 2 diabetes, fatty liver disease, and hepatocellular carcinoma).
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Affiliation(s)
- David Balgoma
- Analytical Pharmaceutical Chemistry, Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden.
- Uppsala Biomedicinska Centrum BMC, Husargatan 3, Box 574, 751 23, Uppsala, Sweden.
| | - Sofia Zelleroth
- The Beijer Laboratory, Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Alfhild Grönbladh
- The Beijer Laboratory, Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Mathias Hallberg
- The Beijer Laboratory, Biological Research on Drug Dependence, Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Curt Pettersson
- Analytical Pharmaceutical Chemistry, Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Mikael Hedeland
- Analytical Pharmaceutical Chemistry, Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
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El-Shamarka MES, Sayed RH, Assaf N, Zeidan HM, Hashish AF. Combined neurotoxic effects of cannabis and nandrolone decanoate in adolescent male rats. Neurotoxicology 2020; 76:114-125. [PMID: 31704101 DOI: 10.1016/j.neuro.2019.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 11/03/2019] [Accepted: 11/04/2019] [Indexed: 12/21/2022]
Abstract
Polydrug use among adolescence is a widespread phenomenon and has increased in the last few years. In particular, most nandrolone decanoate (Nan) abusers combine its use with cannabis (Can); thus, studying the consequences of this combination in adolescent subjects is important because potentiation of their effects may increase their neurotoxicity. The present study was designed to study the neurotoxic effects of Nan and Can, alone and in combination, in adolescent male rats by studying the behavioural, biochemical, and histopathological effects. Nan (15 mg/kg, s.c.) and Can (20 mg/kg, s.c.) were given alone or in combination to rats once daily for one month. The combined administration of Can and Nan induced learning and spatial memory deficits, hypo-locomotion, anxiety and aggression in adolescent rats as evidenced by the Morris water maze, open field, elevated plus maze, and defensive aggression tests. In parallel, rats treated with the combination showed severe deleterious effects in the hippocampal and prefrontal cortex (PFC) neural architecture along with a decrease in brain-derived neurotropic factor. Furthermore, combined administration of Can and Nan increased oxidative stress (significantly increased malondialdehyde and nitric oxide levels and reduced glutathione content), elevated brain pro-inflammatory cytokines (tumour necrosis factor alpha and interleukin 1 beta), and upregulated caspase-3, caspase-8, and caspase-9 mRNA expression and cytochrome c levels. In conclusion, abuse of both Can and Nan conferred greater neurotoxic effects than either drug alone that were at least partially attributed to oxidative stress, inflammation, and intrinsic and extrinsic apoptosis in the hippocampus and PFC of rats.
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Pereira E, Moyses SJ, Ignácio SA, Mendes DK, Silva DSDA, Carneiro E, Hardy AMTG, Rosa EAR, Bettega PVC, Johann ACBR. Prevalence and profile of users and non-users of anabolic steroids among resistance training practitioners. BMC Public Health 2019; 19:1650. [PMID: 31818274 PMCID: PMC6902556 DOI: 10.1186/s12889-019-8004-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/26/2019] [Indexed: 11/10/2022] Open
Abstract
Background To verify the prevalence and profile of users and non-users of anabolic steroid (AS) among resistance training practitioners. Methods An observational, cross-sectional survey was performed in 100 gyms in Curitiba city, involving 5773 individuals and self-administered questionnaires. The chi-square and z-tests of proportions were used for comparison between the groups (p < 0.05). Results 83.2% did not use, 9.1% formerly used, 3.4% currently used, and 4.3% intended used AS. The prevalence of former or current AS users was 16.9 and 6.5% among men and women, respectively. The prevalence ratios were as follows: 1) 2.6 male users for each woman; 2) 3.3 individuals aged 30–44 years and 2.8 individuals aged 18–29 years for each individual aged over 45 years. Beginners were not interested in using AS, but individuals who had trained longer had higher prevalence of AS use. Conclusions The gym environment encouraged the use of AS owing to aesthetic appeal. Thus, suggesting the need for actions to prevent abusive use of AS considering the practitioners profile (practitioners were young, university and single).
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Affiliation(s)
- Ericson Pereira
- Graduate Program, Life Sciences School, Pontifical Catholic University of Parana, Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, CEP 8021, Brazil
| | - Samuel Jorge Moyses
- Graduate Program, Life Sciences School, Pontifical Catholic University of Parana, Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, CEP 8021, Brazil
| | - Sérgio Aparecido Ignácio
- Graduate Program, Life Sciences School, Pontifical Catholic University of Parana, Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, CEP 8021, Brazil
| | - Daniel Komarchewski Mendes
- Graduate Program, Life Sciences School, Pontifical Catholic University of Parana, Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, CEP 8021, Brazil
| | - Diego Sgarbi D A Silva
- Graduate Program, Life Sciences School, Pontifical Catholic University of Parana, Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, CEP 8021, Brazil
| | - Everdan Carneiro
- Graduate Program, Life Sciences School, Pontifical Catholic University of Parana, Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, CEP 8021, Brazil
| | | | - Edvaldo Antônio Ribeiro Rosa
- Graduate Program, Life Sciences School, Pontifical Catholic University of Parana, Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, CEP 8021, Brazil
| | - Patrícia Vida Cassi Bettega
- Graduate Program, Life Sciences School, Pontifical Catholic University of Parana, Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, CEP 8021, Brazil
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Ribas CR, Rymovicz AUM, Rosa RT, Peña LC, Bianchini LF, Rosa EAR. Increments in virulence of Candida albicans induced by androgenic anabolic steroids. Steroids 2019; 152:108501. [PMID: 31545962 DOI: 10.1016/j.steroids.2019.108501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 09/16/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Cristina Rauen Ribas
- Brazilian Army. 20(th) Armored Infantry Battalion, Brazil; Xenobiotics Research Unit, School of Life Sciences, The Pontifical Catholic University of Paraná, Brazil
| | | | - Rosimeire Takaki Rosa
- Xenobiotics Research Unit, School of Life Sciences, The Pontifical Catholic University of Paraná, Brazil
| | - Lorena Carolina Peña
- Xenobiotics Research Unit, School of Life Sciences, The Pontifical Catholic University of Paraná, Brazil
| | - Luiz Fernando Bianchini
- Xenobiotics Research Unit, School of Life Sciences, The Pontifical Catholic University of Paraná, Brazil
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Pereira E, Moyses SJ, Ignácio SA, Mendes DK, da Silva DS, Carneiro E, Hardy AMTG, Rosa EAR, Bettega PVC, Johann ACBR. Anabolic steroids among resistance training practitioners. PLoS One 2019; 14:e0223384. [PMID: 31618245 PMCID: PMC6795452 DOI: 10.1371/journal.pone.0223384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/02/2019] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To compare the use of anabolic steroids (AS), the motivation to use them, their side effects, the source of information and the form in which AS were obtained, the medical follow-up, and the periodic examinations in resistance training practitioners who are either current or former users of AS. METHODS A prevalence survey was performed in the gyms of the city of Curitiba, including 719 current and former AS users who self-administered a questionnaire. The chi-square and z of proportions (p <0.05) statistical tests were conducted. RESULTS Esthetics was the main motivation associated with AS intake, leading to satisfactory results. The information about the form in which to use AS was provided by doctors and AS were either purchased at the pharmacy with a prescription or illegally. Current users reported a higher number of cycles and doses, a longer duration of use, as well as larger economical investments into AS. This shows a higher consumption of such drugs, regardless of the medical follow-up and post-cycle therapy. CONCLUSION Given that a change in the usage pattern was observed when increasing the AS consumption, this should be considered in the elaboration of public policies to inhibit such a trend.
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Affiliation(s)
- Ericson Pereira
- Department of Physical Education, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Samuel Jorge Moyses
- Department of Dentistry, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Sérgio Aparecido Ignácio
- Department of Dentistry, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Daniel Komarchewski Mendes
- Department of Physical Education, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Diego Sgarbi da Silva
- Department of Dentistry, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Everdan Carneiro
- Department of Dentistry, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Ana Maria Trindade Grégio Hardy
- Department of Pharmacology, College of Pharmacy and Pharmaceutical Sciences, The University of Toledo, Toledo, Ohio, United States of America
| | - Edvaldo Antônio Ribeiro Rosa
- Department of Dentistry, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Patrícia Vida Cassi Bettega
- Department of Physical Education, Graduate Program, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
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Pany S, Panigrahi SK, Rao EV, Patnaik L, Sahu T. Anabolic Androgenic Steroid Abuse and their Health Impacts: A Cross-sectional Study among Body Builders in a City of Eastern India. Int J Prev Med 2019; 10:178. [PMID: 32133096 PMCID: PMC6826677 DOI: 10.4103/ijpvm.ijpvm_524_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 01/30/2018] [Indexed: 11/11/2022] Open
Abstract
Background: Anabolic-androgenic steroids (AASs), when taken in supraphysiologic doses, increase muscle strength and athletic performance. Evidence suggests that long-term use of AAS in supraphysiologic doses have adverse effects on health. Therefore, the study was conducted to find crude estimate of the prevalence of AAS use among attendees of the gymnasium, the factors that could have influenced them for AAS abuse and to assess the short- and long-term side effects as perceived by them. Methods: A cross-sectional study was conducted in selected gymnasiums of a smart city of India using a predesigned and pretested questionnaire. Snowball sampling method was undertaken. The study was from July 2015 to June 2016. Informed written consent was taken. The analysis was done using SPSS v. 20.0. Results: Of 84 bodybuilders approached, 74 participants used AAS. All users were male with mean age of 26.5 + 0.55 years. The mean age of initiation of AAS abuse was 23 years, and 66.2% (49) were unmarried. Eighty-five percent (63) preferred injectable. Seventy percent (52) abusers were influenced by trainers for abuse. Most commonly abused was Nandrolone decanoate (55.4%). Seventy-three percent were not aware of any legal ban on steroids. Reported benefits include increased strength, muscle size, and power, while harms were increased acne, deepening of voice, swelling of feet, increased irritability, depressive thoughts, impaired judgment, panic disorder, and withdrawal effect. Conclusions: Frequency of ASS use was substantial among young bodybuilders. Awareness about side effects was not a deterrent factor. Abusers were highly influenced by coaches. Efforts should be made for preventing easy access to AAS.
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Affiliation(s)
- Subraham Pany
- Department of Community Medicine, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Sandeep Kumar Panigrahi
- Department of Community Medicine, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - E Venkata Rao
- Department of Community Medicine, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Lipilekha Patnaik
- Department of Community Medicine, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
| | - Trilochan Sahu
- Department of Community Medicine, Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, Odisha, India
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Hauger LE, Sagoe D, Vaskinn A, Arnevik EA, Leknes S, Jørstad ML, Bjørnebekk A. Anabolic androgenic steroid dependence is associated with impaired emotion recognition. Psychopharmacology (Berl) 2019; 236:2667-2676. [PMID: 30941469 DOI: 10.1007/s00213-019-05239-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/22/2019] [Indexed: 01/22/2023]
Abstract
RATIONALE Illicit use of anabolic androgenic steroids (AAS) has grown into a serious public health concern throughout the Western World. AAS use is associated with adverse medical, psychological, and social consequences. Around 30% of AAS users develop a dependence syndrome with sustained use despite adverse side effects. AAS dependence is associated with a high frequency of intra- and interpersonal problems, and it is central to identify factors related to the development and maintenance of dependence. METHODS The present study investigated the ability to recognize emotion from biological motion. The emotional biological motion task was administered to male AAS dependent users (AAS dependents; n = 45), AAS non-dependent users (AAS non-dependents; n = 38) and a comparison-group of non-using weightlifters (non-users; n = 69). RESULTS Multivariate analysis of variance showed a general impairment in emotion recognition in AAS dependents, compared to the non-using weightlifters, whereas no significant impairment was observed in AAS non-dependents. Furthermore, AAS dependents showed impaired recognition of fearful stimuli compared to both AAS non-dependents and non-using weightlifters. The between-group effect remained significant after controlling for Intelligence Quotient (IQ), past 6 months of non-AAS drug use, antisocial personality problems, anxiety, and depression. CONCLUSION AAS dependents show impaired emotion recognition from body movement, fear in particular, which could potentially contribute to higher frequency of interpersonal problems and antisocial behaviors in this population.
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Affiliation(s)
- Lisa E Hauger
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, 0424, Oslo, Norway.
| | - Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Anja Vaskinn
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Espen A Arnevik
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, 0424, Oslo, Norway
| | - Siri Leknes
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Marie L Jørstad
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, 0424, Oslo, Norway
| | - Astrid Bjørnebekk
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, 0424, Oslo, Norway
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Hauger LE, Westlye LT, Fjell AM, Walhovd KB, Bjørnebekk A. Structural brain characteristics of anabolic-androgenic steroid dependence in men. Addiction 2019; 114:1405-1415. [PMID: 30955206 PMCID: PMC6767448 DOI: 10.1111/add.14629] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/15/2018] [Accepted: 03/29/2019] [Indexed: 12/31/2022]
Abstract
AIM To identify differences in brain morphology between dependent and non-dependent male anabolic-androgenic steroid (AAS) users. DESIGN This study used cross-sectional data from a longitudinal study on male weightlifters. PARTICIPANTS Oslo University Hospital, Norway. SETTING Eighty-one AAS users were divided into two groups; AAS-dependent (n = 43) and AAS-non-dependent (n = 38). MEASUREMENTS Neuroanatomical volumes and cerebral cortical thickness were estimated based on magnetic resonance imaging (MRI) using FreeSurfer. Background and health information were obtained using a semi-structured interview. AAS-dependence was evaluated in a standardized clinical interview using a version of the Structured Clinical Interview for DSM-IV, adapted to apply to AAS-dependence. FINDINGS Compared with non-dependent users, dependent users had significantly thinner cortex in three clusters of the right hemisphere and in five clusters of the left hemisphere, including frontal, temporal, parietal and occipital regions. Profound differences were seen in frontal regions (left pars orbitalis, cluster-wise P < 0.001, right superior frontal, cluster-wise P < 0.001), as has been observed in other dependencies. Group differences were also seen when excluding participants with previous or current non-AAS drug abuse (left pre-central, cluster-wise P < 0.001, left pars orbitalis, cluster-wise P = 0.010). CONCLUSION Male dependent anabolic-androgenic steroid users appear to have thinner cortex in widespread regions, specifically in pre-frontal areas involved in inhibitory control and emotional regulation, compared with non-dependent anabolic-androgenic steroid users.
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Affiliation(s)
- Lisa E. Hauger
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and AddictionOslo University HospitalOsloNorway
| | - Lars T. Westlye
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical MedicineUniversity of OsloNorway,Department of PsychologyUniversity of OsloOsloNorway
| | - Anders M. Fjell
- Research Group for Lifespan Changes in Brain and Cognition, Department of PsychologyUniversity of OsloOsloNorway,Department of Radiology and Nuclear MedicineOslo University HospitalOsloNorway
| | - Kristine B. Walhovd
- Research Group for Lifespan Changes in Brain and Cognition, Department of PsychologyUniversity of OsloOsloNorway,Department of Radiology and Nuclear MedicineOslo University HospitalOsloNorway
| | - Astrid Bjørnebekk
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and AddictionOslo University HospitalOsloNorway
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