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Piatkowski T, Benn S, Ayurzana L, King M, McMillan S, Hattingh L. Exploring the role of community pharmacies as a harm reduction environment for anabolic-androgenic steroid consumers: triangulating the perspectives of consumers and pharmacists. Harm Reduct J 2024; 21:59. [PMID: 38481218 PMCID: PMC10935940 DOI: 10.1186/s12954-024-00972-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/22/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND While community pharmacies have been successful in providing harm reduction support for illicit substance consumers, little research has explored their role in addressing the needs of anabolic-androgenic steroid (AAS) consumers. OBJECTIVE This study aimed to triangulate the attitudes and experiences of AAS consumers and community pharmacist's regarding AAS harm reduction. METHODS Semi-structured interviews were conducted with AAS consumers (n = 8) and community pharmacists (n = 15) between December 2022 and August 2023 in Australia. Interview data were analysed using reflexive thematic analysis. RESULTS While consumers emphasised easy access to pharmacies, particularly in urban areas, challenges were noted in rural regions. AAS consumers expressed a preference for community pharmacies, perceiving them as less confronting and a feasible avenue for accessing professional advice, highlighting the potential role of pharmacists in nurturing therapeutic alliances with AAS consumers. Similarly, pharmacists expressed receptivity to providing harm reduction information but acknowledged knowledge gaps, suggesting a need for tailored education programs to support AAS consumers effectively. CONCLUSIONS Community pharmacies can be an important environment for AAS harm reduction. Strategies include utilising private spaces for open discussions with AAS consumers and enhancing pharmacists' understanding of AAS to foster trust and support. Further research is needed to address knowledge gaps and training needs for pharmacy staff, with the aim of creating a safer environment for AAS consumers.
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Affiliation(s)
- Timothy Piatkowski
- School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia.
- Griffith Centre for Mental Health, Griffith University, Brisbane, QLD, Australia.
| | - Sarah Benn
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Lkhagvadulam Ayurzana
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Michelle King
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Sara McMillan
- Griffith Centre for Mental Health, Griffith University, Brisbane, QLD, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Laetitia Hattingh
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
- Pharmacy Department, Gold Coast Health, Southport, QLD, 4215, Australia
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2
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Nourse G, Fraser S, Moore D. Masculine enhancement as health or pathology: gender and optimisation discourses in health promotion materials on performance and image-enhancing drugs (PIEDs). HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2024:1-17. [PMID: 38286142 DOI: 10.1080/14461242.2023.2297046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 12/03/2023] [Indexed: 01/31/2024]
Abstract
The consumption of performance and image-enhancing drugs (PIEDs) is commonly pathologised in public health discourse as stemming from an unhealthy relationship to masculinity, and is often framed as intrinsically 'risky' and fundamentally at odds with 'good health'. This article examines Australian health promotion materials on PIEDs to analyse their role in shaping notions of good health, normal gender and appropriate self-improvement. To do so, it draws on the work of Butler, Law and Latour to consider how these materials co-constitute men and their health, often in problematic ways. First, we examine the ways in which PIEDs are constituted via a politics of the 'natural', then consider how the health promotion materials on PIEDs participate in the regulation of appropriate, healthy masculinity, and conclude by examining how adolescent masculinity is co-constituted with PIEDs. We observe a key tension between health promotion's avowed interest in improvement and optimisation and its treatment of PIED consumers as aberrant, vulnerable and insecure subjects whose drive to enhance and optimise is characterised by pathology and addiction. We conclude by arguing that health promotion materials on PIEDs fail to acknowledge the exceedingly normative character of enhancement practices in contemporary society.
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Affiliation(s)
- Gemma Nourse
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Suzanne Fraser
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - David Moore
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
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3
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Cox L, Gibbs N, Turnock LA. “Emerging anabolic androgenic steroid markets; the prominence of social media”. DRUGS: EDUCATION, PREVENTION AND POLICY 2023. [DOI: 10.1080/09687637.2023.2176286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Affiliation(s)
- Luke Cox
- Faculty of Movement & Rehabilitation Sciences (FaBeR), KU Leuven, Leuven, Belgium
| | - Nick Gibbs
- Leeds Trinity University, Leeds, England
| | - Luke A Turnock
- School of Social and Political Sciences / College of Social Science, University of Lincoln, Lincoln, England
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Hearne E, Atkinson A, Boardley I, McVeigh J, Van Hout MC. ‘Sustaining masculinity’: a scoping review of anabolic androgenic steroid use by older males. DRUGS: EDUCATION, PREVENTION AND POLICY 2022. [DOI: 10.1080/09687637.2022.2132135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Evelyn Hearne
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Amanda Atkinson
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Ian Boardley
- Department of Sociology, Manchester Metropolitan University, Manchester, UK
| | - Jim McVeigh
- School of Sport Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Marie Claire Van Hout
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK
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5
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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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6
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Butzke I, Iff S, Zitzmann M, Quednow BB, Claussen MC. [Interdisciplinary and Psychiatric Treatment of Anabolic Androgenic Steroids Users]. PRAXIS 2022; 111:339-344. [PMID: 35473320 DOI: 10.1024/1661-8157/a003867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Interdisciplinary and Psychiatric Treatment of Anabolic Androgenic Steroids Users Abstract. The prevalence of anabolic androgenic steroid (AAS; anabolic steroids) use in recreational sports is underestimated. Due to the influence of social media, an increase in AAS use in recreational sports and in the general population is to be expected. AAS use is associated with significant physical and mental health consequences, and the psychiatric consequences include the risk of developing addictive behaviour. The widespread stigmatization of AAS use also by professionals often undermines users' trust in physicians and drives them into the arms of so-called "gurus." The tightening of anti-doping practices in sports and an exclusively prohibitive stance have so far failed to convincingly curb the problem in recreational sports. Harm reduction strategies could help patients to get the help they need from primary care providers.
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Affiliation(s)
- Ingo Butzke
- Klinik für Psychose und Abhängigkeit, PZM Psychiatriezentrum Münsingen AG, Münsingen, Schweiz
| | - Samuel Iff
- Klinik für Psychose und Abhängigkeit, PZM Psychiatriezentrum Münsingen AG, Münsingen, Schweiz
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Psychiatrische Universitätsklinik Zürich, Universität Zürich, Zürich, Schweiz
| | - Michael Zitzmann
- Centrum für Reproduktionsmedizin und Andrologie, Abteilung für Klinische und Operative Andrologie, Universitätsklinikum Münster, Westfälische Wilhelms-Universität Münster, Münster, Deutschland
| | - Boris B Quednow
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Psychiatrische Universitätsklinik Zürich, Universität Zürich, Zürich, Schweiz
| | - Malte Christian Claussen
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Psychiatrische Universitätsklinik Zürich, Universität Zürich, Zürich, Schweiz
- Privatklinik Wyss AG, Münchenbuchsee, Schweiz
- Erwachsenenpsychiatrie, Psychiatrische Dienste Graubünden, Chur, Schweiz
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7
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Butzke I, Iff S, Zitzmann M, Quednow BB, Claussen MC. Interdisciplinary and Psychiatric Treatment of Anabolic Androgenic Steroids Users. PRAXIS 2022; 111:e339-e344. [PMID: 35473322 DOI: 10.1024/1661-8157/a003868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The prevalence of anabolic androgenic steroid (AAS; anabolic steroids) use in recreational sports is underestimated. Due to the influence of social media, an increase in AAS use in recreational sports and in the general population is to be expected. AAS use is associated with significant physical and mental health consequences, and the psychiatric consequences include the risk of developing addictive behaviour. The widespread stigmatization of AAS use also by professionals often undermines users' trust in physicians and drives them into the arms of so-called "gurus." The tightening of anti-doping practices in sports and an exclusively prohibitive stance have so far failed to convincingly curb the problem in recreational sports. Harm reduction strategies could help patients to get the help they need from primary care providers.
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Affiliation(s)
- Ingo Butzke
- Clinic for Psychosis and Dependence, PZM Psychiatry Center Münsingen AG, Münsingen, Switzerland
| | - Samuel Iff
- Clinic for Psychosis and Dependence, PZM Psychiatry Center Münsingen AG, Münsingen, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Zitzmann
- Center for Reproductive Medicine and Andrology, Department of Clinical and Operative Andrology, University Hospital Münster, Westfälische Wilhelms-Universität Münster, Germany
| | - Boris B Quednow
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Malte Christian Claussen
- Clinic for Psychosis and Dependence, PZM Psychiatry Center Münsingen AG, Münsingen, Switzerland
- Private Clinic Wyss AG, Münchenbuchsee, Switzerland
- Adult Psychiatry, Psychiatric Services Grisons, Chur, Switzerland
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8
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McVeigh J, Hearne E, Boardley I, Bates G, Hope V, Ralphs R, Van Hout MC. Generating evidence on the use of Image and performance enhancing drugs in the UK: results from a scoping review and expert consultation by the Anabolic Steroid UK network. Harm Reduct J 2021; 18:107. [PMID: 34657627 PMCID: PMC8522223 DOI: 10.1186/s12954-021-00550-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/23/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The use of anabolic androgenic steroids (AAS) and associated image and performance enhancing drugs (IPEDs) is now a global phenomenon. There is a need to develop evidence to support the development of interventions to prevent the commencement of use, to minimise the potential harms or to support those in their cessation of use. While the United Kingdom (UK) is no exception to this issue, its public health and legislative response to the phenomenon differs to other countries and requires the examination of research specific to the UK. Therefore, a scoping review has been conducted to examine the recent relevant literature to help inform the development and evaluation of effective interventions to reduce the harmful use of IPEDs. METHODS A comprehensive search strategy was developed for multiple bibliographic databases, supported by and iterative citation searching process and complimented by expert input from the Anabolic Steroid UK Network. Research conducted by or UK academics or within the UK were eligible, if published in the previous five years. RESULTS In total 87 eligible outputs were identified, including 26 review articles, 25 qualitative papers and 24 quantitative papers. together with small numbers of clinical studies/case reports (6) and commentaries/correspondence (6). The most common topics of research were public health, treatment and harm reduction (41), followed by studies focusing on epidemiology, sub-groups of people using IPEDs and motivations for use (34). The studies illustrated the diverse populations of people who use a range of enhancement drugs including concomitant psychoactive drug use. A number of papers focused on blood borne viruses and associated issues, while others reported on the uptake of needle and syringe programmes. No effectiveness evaluations related to any aspect of treatment, harm reduction or other intervention were published during study period. CONCLUSION There is a need for the development of effectiveness evaluations of current interventions and any future service provision for people using image and performance enhancing drugs. While there have been no studies of this nature to date, this review illustrates the rich data that has been gathered through diverse methodologies, that will assist in the development of future effectiveness evaluations.
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Affiliation(s)
- Jim McVeigh
- Substance Use & Associated Behaviours, Department of Sociology, Manchester Metropolitan University, Manchester, UK.
| | - Evelyn Hearne
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Ian Boardley
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Geoff Bates
- Institute for Policy Research, University of Bath, Bath, UK
| | - Vivian Hope
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Rob Ralphs
- Substance Use & Associated Behaviours, Department of Sociology, Manchester Metropolitan University, Manchester, UK
| | - Marie Claire Van Hout
- Faculty of Health, Public Health Institute, Liverpool John Moores University, Liverpool, UK
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9
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Kayser B, De Block A. Would Relaxation of the Anti-doping Rule Lead to Red Queen Effects? SPORT, ETHICS AND PHILOSOPHY 2021. [DOI: 10.1080/17511321.2020.1770846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Bengt Kayser
- Institute of Sport Sciences, University of Lausanne, Synathlon, Uni-Centre, Lausanne, Switzerland
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10
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Aziz SA. Attitude and health issue awareness of anabolic androgenic steroids use among male gym users in some gym centers in Sulaymaniyah city, Iraq. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1879294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Sadat Abdulla Aziz
- Department of Basic Sciences, College of Veterinary Medicine, University of Sulaimani, Sulaymaniyah, Iraq
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11
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Henning A, Andreasson J. Preventing, producing, or reducing harm? Fitness doping risk and enabling environments. DRUGS-EDUCATION PREVENTION AND POLICY 2020. [DOI: 10.1080/09687637.2020.1865273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- April Henning
- Faculty of Health Sciences and Sport, Sports Studies, University of Stirling, Stirling, UK
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12
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Hibbert MP, Brett CE, Porcellato LA, Hope VD. Image and performance enhancing drug use among men who have sex with men and women who have sex with women in the UK. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 95:102933. [PMID: 32912823 DOI: 10.1016/j.drugpo.2020.102933] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/16/2020] [Accepted: 08/13/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The use of image and performance enhancing drugs (IPEDs) among men who have sex with men (MSM) and women who have sex with women (WSW) is rarely studied, with most of this research focused on anabolic androgenic steroid use among MSM. To address this gap, the extent of recent IPED use and the associated factors are explored in a community-recruited sample of MSM and WSW METHODS: Data from the UK LGBT Sex and Lifestyles Survey was used, which recruited through social-media advertising and community organisations (April-June 2018). Participants were asked if they had taken any IPEDs (e.g. anabolic steroids, growth hormone, hCG, Melanotan, non-prescribed diet pills) in the past 12 months. Factors associated with recent (in past 12 months) IPED use among MSM and WSW were investigated using stepwise binary logistic regression. RESULTS 1,658 MSM and 1,507 WSW were included in the analysis. Among MSM, 3.4% (n = 57) had recently taken IPEDs, 60% of those taking IPEDs had used psychoactive drugs. In the multivariable analysis, IPED use among MSM was associated with psychoactive drug use, Viagra use, higher body dissatisfaction, and lower sexual satisfaction. Among WSW, 4.1% (n = 62) had recently taken IPEDs, and 50% of those taking IPEDs had used psychoactive drugs. In the multivariable analysis, IPED use among WSW was associated with being aged 45 years and over, recent STI diagnosis, recent sexual contact without consent, and higher body dissatisfaction. CONCLUSION IPED use was reported by around 1-in-25 MSM and WSW, and was associated with a number of health and psychological problems. Research to better understand the drivers and impacts of IPED use among MSM and WSW, and how this compares to use among heterosexual people is needed.
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Affiliation(s)
- Matthew Peter Hibbert
- Public Health Institute, Liverpool John Moores University, Exchange Station, Liverpool, L2 2QP, United Kingdom.
| | - Caroline E Brett
- School of Natural Sciences and Psychology, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, United Kingdom
| | - Lorna A Porcellato
- Public Health Institute, Liverpool John Moores University, Exchange Station, Liverpool, L2 2QP, United Kingdom
| | - Vivian D Hope
- Public Health Institute, Liverpool John Moores University, Exchange Station, Liverpool, L2 2QP, United Kingdom
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Bonny-Noach H, Berkovitz R, Shapira B. Evaluation of performance-enhancing drugs seized by Israeli enforcement agencies 2012-2017: implications for policy and regulatory change. Isr J Health Policy Res 2020; 9:14. [PMID: 32362275 PMCID: PMC7197109 DOI: 10.1186/s13584-020-00369-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 03/02/2020] [Indexed: 11/23/2022] Open
Abstract
Background Illicit performance-enhancing substances are used mostly by athletes to enhance performance in sports, and by bodybuilders to gain muscle and body mass. Among performance-enhancing substances, the most common and known substances are anabolic-androgenic steroids, which are associated with a range of short and long-term adverse medical and psychiatric effects. While the sale and distribution of performance-enhancing substances are considered criminal offenses per the Israeli local pharmacy ordinance, the use and personal possession of these substances are not. Presently, the Division of Enforcement and Inspection of the Israel Ministry of Health cooperates with police and customs agents in performance-enhancing substance-related enforcement activities, which chiefly include seizures carried out at suspicious sites. Moreover, the Division of Enforcement and Inspection provides professional guidance, lab analysis services, and expert opinions on the toxicological and pharmaceutical nature of products seized. This paper presents a contemporary sub-analysis of registered seizures of performance-enhancing substances carried-out by Israel enforcement agencies. The main aim of this analysis is to characterize current patterns of performance-enhancing substances, thus providing the possibility of better assessment of current enforcement and health policy. Methods A sub-analysis of 712 seizures of performance-enhancing substances seized by Israeli enforcement authorities during a six-year period ranging from January 2012 to December 2017. Results This study demonstrates that Israel faces a challenge regarding the importation and distribution of illicit performance-enhancing substances. The most common substances seized were anabolic androgenic steroids (N = 539). Most seizures were carried out in the central mail processing sites, (38.4%), followed by seizures in private premises such as homes and warehouses (29.6%). Significant differences were found between anabolic-androgenic steroids and other substances, relating to place and year of seizure. Among seizures with known sources (N = 355), the most frequent geographic region given as the source of substances was Eastern Europe (47.6%), followed by East Asia (24.8%), West Asia (19.4%), and Western Europe (5.9%). Bulgaria was the country with the highest frequency of seizures (N = 71) followed by Jordan (N = 45), Thailand (N = 37) and Moldova (N = 36). Significant regional differences were found based on the variables of gender, place of seizure, and type of substance. The most frequent month of seizures was August (N = 129), followed by July (N = 119), and June (N = 118). Conclusions While data analysis focused on the supply side of the performance-enhancing substances market, the high number of seizures of performance-enhancing substances in Israel represents evidence of the existence of a high demand and a large consumer base for these products. Consequently, there is a need for developing further enforcement, treatment, and prevention policies that do not currently exist in Israel. Policymakers should consider prioritizing law enforcement action and incentivizing intelligence sharing to monitor suspected shipment sources and specific points of entry. Additionally, the results demonstrate that there is a need in reforming the penal law to discourage the use of performance-enhancing substances. Similar measures have already been applied in countries like Spain, Italy, and Belgium. Furthermore, policy-makers should consider enhancing health ministry agencies with a higher enforcement capacity by giving them further investigative and inquiry authority. Due to the troubling magnitude of the phenomenon, policymakers should also prioritize educational and prevention strategies.
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Affiliation(s)
- Hagit Bonny-Noach
- The Department of Criminology, School of Social Sciences, Ariel University, Ariel, Israel. .,Israeli society of Addiction Medicine (ILSAM), Ramat-Gan, Israel. .,Israel National Anti-Doping Organization (ISR-NADO), Tel-Aviv, Israel.
| | - Ronny Berkovitz
- Israel National Anti-Doping Organization (ISR-NADO), Tel-Aviv, Israel.,Division of Enforcement and Inspection, Israel Ministry of Health, Jerusalem, Israel
| | - Barak Shapira
- Israel National Anti-Doping Organization (ISR-NADO), Tel-Aviv, Israel.,Division of Enforcement and Inspection, Israel Ministry of Health, Jerusalem, Israel
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14
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Anabolic-Androgenic Steroid Use in the Eastern Mediterranean Region: a Scoping Review of Extant Empirical Literature. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00217-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AbstractThe use of image- and performance-enhancing drugs particularly anabolic-androgenic steroids (AAS) is not a new phenomenon. AAS use is not limited to athletes, with mainstream populations using these drugs for aesthetic purposes. Prevalence has been predominantly in Western countries, with some recent studies indicating a rise in popularity in the Eastern Mediterranean region. A scoping review of extant empirical literature from the Eastern Mediterranean region described and mapped what is known about the extent of AAS in the region. Four themes emerged from the review: (1) profile of AAS users; (2) AAS within gymnasium practice; (3) AAS regimes of use; and (4) knowledge and understanding of the AAS concept and related adverse effects. The review highlights a relatively new phenomenon of AAS use in the Eastern Mediterranean. The review underscores the need to carry out further research, particularly qualitative and quantitative studies with both genders, and cognisant of the complexities of culture and religiosity.
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15
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Steroid Madness- has the dark side of anabolic-androgenic steroids (AAS) been over-stated? ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.peh.2019.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Salinas M, Floodgate W, Ralphs R. Polydrug use and polydrug markets amongst image and performance enhancing drug users: Implications for harm reduction interventions and drug policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 67:43-51. [DOI: 10.1016/j.drugpo.2019.01.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/26/2018] [Accepted: 01/16/2019] [Indexed: 11/30/2022]
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17
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Bates G, Tod D, Leavey C, McVeigh J. An evidence-based socioecological framework to understand men’s use of anabolic androgenic steroids and inform interventions in this area. DRUGS: EDUCATION, PREVENTION AND POLICY 2018. [DOI: 10.1080/09687637.2018.1488947] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Geoff Bates
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - David Tod
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Conan Leavey
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Jim McVeigh
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
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18
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Van de Ven K, Maher L, Wand H, Memedovic S, Jackson E, Iversen J. Health risk and health seeking behaviours among people who inject performance and image enhancing drugs who access needle syringe programs in Australia. Drug Alcohol Rev 2018; 37:837-846. [DOI: 10.1111/dar.12831] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 06/03/2018] [Accepted: 06/06/2018] [Indexed: 02/02/2023]
Affiliation(s)
- Katinka Van de Ven
- Drug Policy Modelling Program; National Drug and Alcohol Research Centre, UNSW Sydney; Sydney Australia
| | - Lisa Maher
- The Kirby Institute for Infection and Immunity, UNSW Sydney; Sydney Australia
| | - Handan Wand
- The Kirby Institute for Infection and Immunity, UNSW Sydney; Sydney Australia
| | - Sonja Memedovic
- Drug Policy Modelling Program; National Drug and Alcohol Research Centre, UNSW Sydney; Sydney Australia
- The Kirby Institute for Infection and Immunity, UNSW Sydney; Sydney Australia
| | - Eva Jackson
- Nepean Blue Mountains Local Health District, NSW Ministry of Health; Sydney Australia
| | - Jenny Iversen
- The Kirby Institute for Infection and Immunity, UNSW Sydney; Sydney Australia
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Abstract
PURPOSE OF REVIEW To systematically review current epidemiological literature on androgen abuse. Estimates from 32 empirical epidemiological articles were reviewed. RECENT FINDINGS Generally, androgen abuse epidemiology and prevalence is higher in Europe, the Middle East, North America (the USA), Oceania (Australia and New Zealand), and South America (Brazil) and lower in Africa and Asia. In contrast to the general population, androgen abuse epidemiology and prevalence is higher among athletes, injection drug users, recreational sportspeople, and sexual and gender minorities. SUMMARY From the 1970s, androgen abuse spread from athletes into the general population. Consistent with previous evidence, reviewed studies suggest that androgen abuse epidemiology and prevalence is higher in Western cultural contexts, the Middle East, and South America (Brazil) and lower in Africa and Asia. Evidence also corroborates indications that androgen abuse is less prevalent among women (vs. men), and in the general population in contrast to particular subpopulations consisting of athletes, injection drug users, recreational sportspeople, and sexual and gender minorities. Adolescents' androgen abuse should be of special concern. Androgen abuse in some nonsports occupations (e.g. security workers) requires further exploration. Polypharmacy and the Internet proliferation of androgens and other PIEDs require surveillance for prevention and harm reduction.
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Affiliation(s)
- Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
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Anderson LJ, Tamayose JM, Garcia JM. Use of growth hormone, IGF-I, and insulin for anabolic purpose: Pharmacological basis, methods of detection, and adverse effects. Mol Cell Endocrinol 2018; 464:65-74. [PMID: 28606865 PMCID: PMC5723243 DOI: 10.1016/j.mce.2017.06.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 06/02/2017] [Accepted: 06/08/2017] [Indexed: 12/24/2022]
Abstract
Hormones with anabolic properties such as growth hormone (GH), insulin-like growth factor-1 (IGF-I), and insulin are commonly abused among professional and recreational athletes to enhance physical ability. Performance enhancing drugs (PEDs) such as these are also commonly used by recreational athletes to improve body aesthetics. The perception of increased muscle mass due to supraphysiologic hormone supplementation, or doping, is widespread among PED users despite a paucity of evidence-based data in humans. Even still, athletes will continue to abuse PEDs in hopes of replicating anecdotal results. It is important to educate the general public and potential treating physicians of the risks of PED use, including the dangers of polypharmacy and substance dependence. It will also be important for the research community to address the common challenges associated with studying PED use such as the ethical considerations of PED administration, the general reticence of the PED-using community to volunteer information, and the constant need to improve or create new detection methods as athletes continually attempt to circumvent current methods. This review highlights the anabolic mechanisms and suggestive data implicating GH, IGF-I, and insulin for use as PEDs, the specific detection methods with cutoff ranges that may be utilized to diagnose abuse of each substance, and their respective side effects.
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Affiliation(s)
- Lindsey J Anderson
- Geriatric Research, Education and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, United States
| | - Jamie M Tamayose
- Geriatric Research, Education and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, United States
| | - Jose M Garcia
- Geriatric Research, Education and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, WA, United States; Department of Medicine, Division of Gerontology & Geriatric Medicine, University of Washington School of Medicine, Seattle, WA, United States.
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