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Dunn M, Bright D, Fletcher P. Investigating the methods and characteristics of the trafficking of performance and image enhancing drugs in Australia. Drug Alcohol Rev 2024; 43:278-282. [PMID: 37718272 DOI: 10.1111/dar.13751] [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: 04/02/2023] [Revised: 07/18/2023] [Accepted: 08/30/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION Using case law, the aims of this study were to document the methods for trafficking of performance and image-enhancing drugs (PIED) into Australia, and the characteristics of individuals and groups involved. METHODS Data was collected from judges' sentencing comments. Searches were conducted using the Australasian Legal Information Institute database across all states in Australia, for the period of January 2010 to December 2021. After removing duplicates and cases which did not meet the inclusion criteria, 31 cases were included in the analysis. RESULTS Across the 31 cases, 37 individuals were named as being involved in the supply and/or trafficking of PIEDs, with three cases involving an unknown number of individuals. One case named four actors involved in the supply and/or trafficking of PIEDs, three cases involved three actors, four cases involved two actors and 17 cases involved one actor. In 20 of the 31 cases, individuals operated alone. Over half (19 of the 37) of the individuals were health professionals. The majority (n = 17) of cases involved prescription as the method of acquisition, while seven cases involved the importation of PIEDs. DISCUSSION AND CONCLUSION The small number of cases identified, with the majority involving only a single actor, and half of the cases involving those in the medical profession. The findings suggest that discrete occurrences of trafficking involves individuals or small groups that do not appear to be linked to large-scale networks or networks involving the supply and trafficking of other illicit substances.
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Affiliation(s)
- Matthew Dunn
- School of Health and Social Development, Faculty of Health, Deakin University, Melbourne, Australia
- Institute for Health Transformation, Deakin University, Melbourne, Australia
| | - David Bright
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Melbourne, Australia
| | - Paige Fletcher
- College of Business, Government, and Law, Flinders University, Adelaide, Australia
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Crawford G, Lobo R, Maycock B, Brown G. More than mateship: exploring how Australian male expatriates, longer-term and frequent travellers experience social support. Int J Qual Stud Health Well-being 2023; 18:2251222. [PMID: 37643465 PMCID: PMC10467526 DOI: 10.1080/17482631.2023.2251222] [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: 12/19/2022] [Accepted: 08/18/2023] [Indexed: 08/31/2023] Open
Abstract
PURPOSE Those travelling overseas for work or leisure including male expatriates, longer-term and frequent travellers (ELoFTs) may be at heightened risk for a range of health and wellbeing issues. Social support may mediate this risk. However, from a public health perspective, little is written about how ELoFTs access health information and support and the role of their social networks in facilitating health and wellbeing outcomes. This research was part of a study examining social network processes of Australian male ELoFTs travelling, living, or working in Southeast Asia (SEA). METHODS Symbolic Interactionism and Grounded Theory were the conceptual framework and methodology supporting semi-structured, in-depth interviews (n = 25) conducted in Australia and Thailand with Australian male ELoFTs to SEA, aged 18 years or older. RESULTS Findings highlight supports that assist ELoFT transition and adjustment to country of destination or manage their transnational experience. Influential places, people, and points in the migration journey mediated engagement with social support. CONCLUSIONS ELoFT social networks and the support provided within them may provide a mechanism for intervention across a range of public health issues. Findings may support the development of policy and practice across industries charged with supporting successful ELoFT adjustment.
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Affiliation(s)
- G Crawford
- Collaboration for Evidence, Research and Impact in Public Health, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - R Lobo
- Collaboration for Evidence, Research and Impact in Public Health, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - B Maycock
- College of Medicine & Health, University of Exeter, Devon, UK
| | - G Brown
- Collaboration for Evidence, Research and Impact in Public Health, Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Centre for Social Impact, UNSW Sydney, Sydney, New South Wales, Australia
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora Victoria, Australia
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Anabolic-androgenic steroid use among women - A qualitative study on experiences of masculinizing, gonadal and sexual effects. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 95:102876. [PMID: 32736958 DOI: 10.1016/j.drugpo.2020.102876] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/24/2020] [Accepted: 07/20/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND Female users of anabolic-androgenic steroids (AAS) are at risk of developing masculinizing side effects. This study explores how the development of masculinizing effects has been experienced and processed by women with current or previous AAS use. METHODS Individual, semi-structured interviews were undertaken among 16 current or previous AAS-using women. The interviews were recorded, transcribed verbatim and thematically analyzed. RESULTS Almost all of the women were introduced to AAS and advised about what substance(s) to use, how much to use and how to use it by a trusted male partner, friend or coach. For some, AAS initiation was an impulsive choice, while others wanted to overcome stagnation and/or prepare for fitness competitions. Many were unprepared for the unwanted masculinizing effects, but some experienced these to be outweighed by the desired effects. Masculinizing effects that could be mediated by hair removal or breast implants were easier to process than a deepened voice. As very few women were open with others about their AAS use, the voice change could disclose use and was often accompanied by feelings of shame and regret. Absence of menstruation and its return following cessation were used to monitor effect, normal function and safety when deciding when to start a new cycle. Clitoral enlargement gave rise to shame and reduced self-esteem, but negative emotions could be reduced by a positive partner response. Increased libido was common and gave rise to positive and negative experiences, depending on life situation, partner status, whether the partner used AAS simultaneously and whether genital changes had also been experienced. CONCLUSION Women who use AAS are at risk of developing irreversible masculinizing effects that are difficult to process and that may negatively influence self-esteem, social life and sexual function, both during and after use. More gender-specific information about women and AAS use is needed.
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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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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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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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Moore D, Hart A, Fraser S, Seear K. Masculinities, practices and meanings: A critical analysis of recent literature on the use of performance- and image-enhancing drugs among men. Health (London) 2019; 24:719-736. [PMID: 30922123 DOI: 10.1177/1363459319838595] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The use of performance- and image-enhancing drugs (PIEDs) has been a topic of considerable research interest since the 1980s, with the vast majority of PIED consumers being men. In this article, our departure point is a 2005 article by Helen Keane, in which she critically analyses 'the discursive constitution of male steroid users' as psychologically disordered subjects. We extend Keane's insightful feminist analysis by examining the constitution of masculinity in post-2005 social science research on PIEDs. We ask (1) to what extent do the discursive trends identified by Keane persist in the more recent literature on PIED use among men? (2) how have her insights been taken up in the post-2005 literature, and (3) to what extent does this work attend to the specificity and varied meanings of steroid practices? We argue that men who use PIEDs continue to be pathologised as insecure, inadequate and vulnerable, and marked by 'obsession', 'compensatory behaviours' and crisis. In some of the analysed texts, the male steroid user becomes doubly disordered as both insecure in his masculine body and at risk of drug dependence. Of the articles that engage with Keane's work, only two recognise the value of her insights. The others misinterpret or apply Keane's argument in inconsistent or incoherent ways. Finally, in some of the post-2005 texts, we begin to see attention to the wide variety of practices and meanings encompassed by the term 'PIED use' although much remains to be learned.
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Superheroes - Image and performance enhancing drug (IPED) use within the UK, social media and gym culture. J Forensic Leg Med 2019; 64:28-30. [PMID: 30921558 DOI: 10.1016/j.jflm.2019.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 03/18/2019] [Indexed: 11/21/2022]
Abstract
Anabolic androgenic steroids (AAS) are the drug of choice in many cultures of the UK. Whilst there is an abundance of evidence relating to the physiological and psychological effects of steroid abuse on the individual, surprisingly there is a paucity of information relating to the perspectives of steroid users regarding the social impact of steroid use on self and society. The lack of data from steroid users has implications for forensic and legal medicine. Specifically, evidence is limited in terms of the user's voice. This is a crucial omission; the unheard voices of steroid users have much to offer into future research. 24 IPED using participants (using substituted names to protect anonymity), engaged in semi structured interviews to discuss their own personal usage, culture issues, social media and more.
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Bates G, Tod D, Leavey C, McVeigh J. An evidence-based socioecological framework to understand men’s use of anabolic androgenic steroids and inform interventions in this area. DRUGS: EDUCATION, PREVENTION AND POLICY 2018. [DOI: 10.1080/09687637.2018.1488947] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Geoff Bates
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - David Tod
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Conan Leavey
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Jim McVeigh
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom of Great Britain and Northern Ireland
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van de Ven K, Koenraadt R. Exploring the relationship between online buyers and sellers of image and performance enhancing drugs (IPEDs): Quality issues, trust and self-regulation. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 50:48-55. [DOI: 10.1016/j.drugpo.2017.09.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 08/25/2017] [Accepted: 09/11/2017] [Indexed: 10/18/2022]
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Brennan R, Wells JSG, Van Hout MC. The injecting use of image and performance-enhancing drugs (IPED) in the general population: a systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:1459-1531. [PMID: 26806443 DOI: 10.1111/hsc.12326] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/16/2015] [Indexed: 05/25/2023]
Abstract
Injecting use of image and performance-enhancing drugs (IPED) in the general population is a public health concern. A wide and varied range of IPED are now easily accessible to all through the online market. A comprehensive literature review was undertaken according to Critical Appraisal Skills Programme (CASP) guidelines for systematic review, to identify the relevant literature. No date restrictions were placed on the database search in the case of human growth hormone melanotan I and II, and oil and cosmetic injectables. In the case of anabolic androgenic steroids search dates were restricted to January 2014-2015. Publications not in English and with a lack of specificity to the topic were excluded. The review yielded 133 relevant quantitative and qualitative papers, clinical trials, clinical case presentations and editorials/reports. Findings were examined/reviewed under emergent themes which identified/measured extent of use, user profiling, sourcing, product endorsement, risk behaviours and health outcomes in users. Motivation for IPED use may be grounded in appearance, pursuit of health and youth, and body image disturbance. IPED users can practice moderated use, with pathological use linked to high-risk behaviours, which may be normalised within IPED communities. Many IPED trajectories and pathways of use are not scientifically documented. Much of this information may be available online in IPED specific discussion forums, an underutilised setting for research, where uncensored discourse takes place among users. This review underscores the need for future internet and clinical research to investigate prevalence and patterns of injecting use, and to map health outcomes in IPED users. This paper provides community-based clinical practice and health promotion services with a detailed examination and analysis of the injecting use of IPED, highlighting the patterns of this public health issue. It serves to disseminate updated publication information to health and social policy makers and those in health service practice who are involved in harm reduction intervention.
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Affiliation(s)
- Rebekah Brennan
- School of Sport, Health and Exercise Science, Waterford Institute of Technology, Waterford, Ireland
| | - John S G Wells
- School of Sport, Health and Exercise Science, Waterford Institute of Technology, Waterford, Ireland
| | - Marie Claire Van Hout
- School of Sport, Health and Exercise Science, Waterford Institute of Technology, Waterford, Ireland
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Tighe B, Dunn M, McKay FH, Piatkowski T. Information sought, information shared: exploring performance and image enhancing drug user-facilitated harm reduction information in online forums. Harm Reduct J 2017; 14:48. [PMID: 28732534 PMCID: PMC5521146 DOI: 10.1186/s12954-017-0176-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 07/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is good evidence to suggest that performance and image enhancing drug (PIED) use is increasing in Australia and that there is an increase in those using PIEDs who have never used another illicit substance. Peers have always been an important source of information in this group, though the rise of the Internet, and the increased use of Internet forums amongst substance consumers to share harm reduction information, means that PIED users may have access to a large array of views and opinions. The aim of this study was to explore the type of information that PIED users seek and share on these forums. METHODS An online search was conducted to identify online forums that discussed PIED use. Three discussion forums were included in this study: aussiegymjunkies.com, bodybuildingforums.com.au, and brotherhoodofpain.com. The primary source of data for this study was the 'threads' from the online forums. Threads were thematically analysed for overall content, leading to the identification of themes. RESULTS One hundred thirty-four threads and 1716 individual posts from 450 unique avatars were included in this analysis. Two themes were identified: (1) personal experiences and advice and (2) referral to services and referral to the scientific literature. CONCLUSIONS Internet forums are an accessible way for members of the PIED community to seek and share information to reduce the harms associated with PIED use. Forum members show concern for both their own and others' use and, where they lack information, will recommend seeking information from medical professionals. Anecdotal evidence is given high credence though the findings from the scientific literature are used to support opinions. The engagement of health professionals within forums could prove a useful strategy for engaging with this population to provide harm reduction interventions, particularly as forum members are clearly seeking further reliable information, and peers may act as a conduit between users and the health and medical profession.
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Affiliation(s)
- Boden Tighe
- School of Health and Social Development, Deakin University, Geelong, Australia
| | - Matthew Dunn
- School of Health and Social Development, Deakin University, Geelong, Australia. .,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia. .,School of Health and Social Development, Geelong Waterfront Campus, Locked Bag 20000, Geelong, Victoria, 3220, Australia.
| | - Fiona H McKay
- School of Health and Social Development, Deakin University, Geelong, Australia
| | - Timothy Piatkowski
- Queensland University of Technology, Brisbane, Australia.,Centre for Youth Substance Abuse Research (CYSAR), Brisbane, Australia
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Hanley Santos G, Coomber R. The risk environment of anabolic-androgenic steroid users in the UK: Examining motivations, practices and accounts of use. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 40:35-43. [PMID: 27955960 DOI: 10.1016/j.drugpo.2016.11.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 10/21/2016] [Accepted: 11/14/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND The numbers using illicit anabolic-androgenic steroids are a cause of concern for those seeking to reduce health harms. Using the 'risk environment' as a conceptual framework to better comprehend how steroid users' practices and perspectives impact on health risks, this paper examines steroid user motivations, patterns of use, and the ways in which these practices are accounted for. METHODS As part of a wider mixed-method study into performance and image enhancing drug (PIED) use and supply in one mid-sized city in South West England, qualitative interviews were undertaken with 22 steroid users. Participants were recruited from a local safer injecting service, rather than bodybuilding gyms, in order to access a wider cross-section of steroid users. A limitation of this approach is potential sample bias towards those showing more health optimising behaviours. RESULTS The research findings highlight that patterns of steroid use varied according to motivation for use, experience and knowledge gained. Most reported having had little or no knowledge on steroids prior to use, with first use being based on information gained from fellow users or suppliers-sometimes inaccurate or incomplete. In accounting for their practices, many users differentiated themselves from other groups of steroid users-for example, older users expressed concern over patterns of use of younger and (what they saw as) inexperienced steroid users. Implicit in these accounts were intimations that the 'other' group engaged in riskier behaviour than they did. CONCLUSION Examining social contexts of use and user beliefs and motivations is vital to understanding how 'risk' behaviours are experienced so that this, in turn, informs harm reduction strategies. This paper examines the ways in which use of steroids is socially situated and the implications of this for policy and practice.
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Affiliation(s)
- Gisella Hanley Santos
- School of Law, Criminology and Government, Plymouth University, Drake Circus, Plymouth PL4 8AA, UK.
| | - Ross Coomber
- Griffith Criminology Institute, Griffith University, Mt Gravatt Campus, Queensland 4122, Australia
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Christiansen AV, Vinther AS, Liokaftos D. Outline of a typology of men’s use of anabolic androgenic steroids in fitness and strength training environments*. DRUGS-EDUCATION PREVENTION AND POLICY 2016. [DOI: 10.1080/09687637.2016.1231173] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Ask Vest Christiansen
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark and
| | - Anders Schmidt Vinther
- Department of Health and Culture, Aalborg Antidoping, Aalborg Municipality, Aalborg, Denmark
| | - Dimitris Liokaftos
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark and
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Baggio S, Mohler-Kuo M, Dupuis M, Henchoz Y, Studer J, N'Goran AA, Gmel G. Substance use capital: Social resources enhancing youth substance use. Rev Epidemiol Sante Publique 2016; 64:255-62. [PMID: 27594693 DOI: 10.1016/j.respe.2016.01.101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 01/04/2016] [Accepted: 01/15/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Social capital is described as a protective factor against youth substance use, but it may also be associated with behaviours that do not enhance health. The present study hypothesized that 'substance use capital', i.e. resources favourable to substance use, is a risk factor for substance use and misuse. METHODS We used baseline data from the ongoing Cohort Study on Substance Use Risk Factors (C-SURF) that included a representative sample of young Swiss men (n=5623). Substance use (alcohol, cannabis, 15 illicit drugs, lifetime use, hazardous use and dependence), substance use capital (parental and peer attitudes towards substance use, parental and peer drug use, perceived norms of substance use) and aspects of social capital (relationships with parents and peers) were assessed. Logistic regressions were used to examine the associations between substance-related resources and social resources, and substance use. RESULTS Results showed that substance-related resources were associated with an increased risk of substance use (OR between 1.25 and 4.67), whereas social resources' associations with substance use were commonly protective but weaker than substance-related resources. Thus, a drug-friendly environment facilitated substance use and misuse. Moreover, the results showed that peer environments were more drug-friendly than familial environments. CONCLUSION In conclusion, this study highlighted a concept of 'substance use capital', which may be useful for advancing both theoretical and applied knowledge of substance use. Indeed, substance use is not only associated with a lack of social resources, but also with specific drug-friendly social resources coming from environment and background.
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Affiliation(s)
- S Baggio
- University of Lausanne, Geopolis building, 1015 Lausanne, Switzerland; Alcohol treatment centre, Lausanne university hospital, CHUV, 21 bis, avenue Beaumont, Pavillon 2, 1011 Lausanne, Switzerland.
| | - M Mohler-Kuo
- Institute of social and preventive medicine, university of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
| | - M Dupuis
- University of Lausanne, Geopolis building, 1015 Lausanne, Switzerland.
| | - Y Henchoz
- Alcohol treatment centre, Lausanne university hospital, CHUV, 21 bis, avenue Beaumont, Pavillon 2, 1011 Lausanne, Switzerland.
| | - J Studer
- Alcohol treatment centre, Lausanne university hospital, CHUV, 21 bis, avenue Beaumont, Pavillon 2, 1011 Lausanne, Switzerland.
| | - A A N'Goran
- Alcohol treatment centre, Lausanne university hospital, CHUV, 21 bis, avenue Beaumont, Pavillon 2, 1011 Lausanne, Switzerland.
| | - G Gmel
- Alcohol treatment centre, Lausanne university hospital, CHUV, 21 bis, avenue Beaumont, Pavillon 2, 1011 Lausanne, Switzerland; Addiction Switzerland, Case postale 870, 1001 Lausanne, Switzerland; Centre for addiction and mental health, 250, College street, M5T 1R8 Toronto, Ontario, Canada; University of the West of England, Frenchay Campus, Coldharbour Lane, BS16 1QY Bristol, United Kingdom.
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van de Ven K, Mulrooney KJD. Social suppliers: Exploring the cultural contours of the performance and image enhancing drug (PIED) market among bodybuilders in the Netherlands and Belgium. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 40:6-15. [PMID: 27574781 DOI: 10.1016/j.drugpo.2016.07.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/29/2016] [Accepted: 07/27/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND This paper explores the understudied phenomenon of performance and image enhancing drug (PIED) markets by examining the structure and formation of the market for PIEDs among bodybuilders in the Netherlands and Belgium. This article specifically seeks to account for individual reasons and motivations for dealing PIEDs within these bodybuilding subcultures. Understanding illicit PIED markets is important for policy decisions as knowledge on the production and distribution of these substances may assist in designing law enforcement efforts, harm reduction initiatives and treatment options. METHODS This article draws on two years of fieldwork in various bodybuilding settings, 47 semi-structured interviews with individuals who are directly or indirectly involved in the PIED market and 64 PIED dealing cases initiated by criminal justice agencies in the Netherlands and Belgium. FINDINGS The data indicates that PIED dealing groups and individuals are often driven by motivations stemming from their social and cultural embeddedness in the bodybuilding subculture. Specifically, these PIED dealers are 'over-socialized' into the structure and culture of bodybuilding and follow the cultural scripts that come with their group affiliation and organization. As a result of the cultural context in which these transactions occur, PIED dealing networks among bodybuilders in the Netherlands and Belgium are more likely to consist of friends or 'friends of friends' tied together by threads of collective meaning found within the bodybuilding subculture. CONCLUSION We argue that efforts seeking to explain the structure, formation and motivations of illicit PIED dealing must learn to appreciate how culture mediates structural forces and thereby influences individual and collective action. Policy makers, health care professionals and other relevant parties should consider a plurality of factors (social, economic and cultural) when designing and evaluating PIED-related interventions such as law enforcement efforts, harm reduction initiatives and treatment options.
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Affiliation(s)
- Katinka van de Ven
- School of Social Sciences, Birmingham City University, Birmingham, United Kingdom.
| | - Kyle J D Mulrooney
- Doctorate in Cultural and Global Criminology at University of Kent and the Universität, Hamburg, United Kingdom
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van de Ven K. ‘Blurred lines’: Anti-doping, national policies, and the performance and image enhancing drug (PIED) market in Belgium and The Netherlands. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.peh.2016.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Van Hout MC, Kean J. An exploratory study of image and performance enhancement drug use in a male British South Asian community. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:860-7. [PMID: 25827056 DOI: 10.1016/j.drugpo.2015.03.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 03/03/2015] [Accepted: 03/07/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Consumerism of image and performance enhancement drugs (IPEDs) is a world-wide public health concern. Given anecdotal reporting of increased normalisation of IPED use and uptake of British South Asian male IPED users at UK needle and syringe exchange services, the study aimed to explore use of IPEDs among this under-researched ethnic group. METHODS 20 in depth interviews were conducted with a purposive sample of British South Asian males attending harm reduction outreach in the North East of England. The interviews explored motives for use of IPEDs, sourcing routes, information seeking, injecting behaviours and cultural and community sensitivities around IPED use among this group. The data was collected and analysed using the Interpretative Phenomenological Analysis approach (IPA). RESULTS Motives for use centred on the achievement of enhanced definition and density of muscle, and improved recovery from training and injuries. All participants reported initial stimulation of interest and triggers to seek information on IPEDs due to social media, community and peer messages. Diverse forms of IPED use were described, with rational and moderated use common among older participants. In contrast younger participants adopted more excessive use in seeking short cuts to attaining muscle size. Sourcing of androgenic-anabolic steroids (AAS) and growth hormones from originating countries (Pakistan, India) was reported, along with diversification of entrepreneurial activity into IPED dealing networks. Sellers were generally reported to provide effective and reliable products and mentoring to inexperienced users. Group injecting practices were common. IPED use was observed by some as health promotion medium within religious contexts. Crime deterrence and drug abstinence occurred for some while involved in AAS cycles. CONCLUSIONS The study is intended to contribute to health policy and practice debate around the targeting of dedicated education, outreach and harm reduction for ethnic groups engaged in IPED use.
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Affiliation(s)
- Marie Claire Van Hout
- Department of Health, Sport and Exercise Science, School of Health Sciences, Waterford Institute of Technology, Waterford, Ireland.
| | - Joseph Kean
- Unity Recovery Centre, 30 Manningham Lane, Bradford BD1 3DN, UK
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Maycock B. Understanding the public's health problems: applications of symbolic interaction to public health. Asia Pac J Public Health 2014; 27:24-8. [PMID: 25475083 DOI: 10.1177/1010539514561086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Public health has typically investigated health issues using methods from the positivistic paradigm. Yet these approaches, although they are able to quantify the problem, may not be able to explain the social reasons of why the problem exists or the impact on those affected. This article will provide a brief overview of a sociological theory that provides methods and a theoretical framework that has proven useful in understanding public health problems and developing interventions.
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Affiliation(s)
- Bruce Maycock
- School of Public Health, Curtin University, Perth, Western Australia, Australia
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Coomber R, Pavlidis A, Santos GH, Wilde M, Schmidt W, Redshaw C. The supply of steroids and other performance and image enhancing drugs (PIEDs) in one English city: Fakes, counterfeits, supplier trust, common beliefs and access. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.peh.2015.10.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sagoe D, Andreassen CS, Pallesen S. The aetiology and trajectory of anabolic-androgenic steroid use initiation: a systematic review and synthesis of qualitative research. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2014; 9:27. [PMID: 24984881 PMCID: PMC4091955 DOI: 10.1186/1747-597x-9-27] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 06/26/2014] [Indexed: 12/31/2022]
Abstract
Background To our knowledge, there has never been a systematic review and synthesis of the qualitative literature on the trajectory and aetiology of nonmedical anabolic-androgenic steroid (AAS) use. Methods We systematically reviewed and synthesized qualitative literature gathered from searches in PsycINFO, PubMed, ISI Web of Science, Google Scholar, and reference lists of relevant literature to investigate AAS users’ ages of first use and source(s), history prior to use, and motives/drives for initiating use. We adhered to the recommendations of the UK Economic and Social Research Council’s qualitative research synthesis manual and the PRISMA guidelines. Results A total of 44 studies published between 1980 and 2014 were included in the synthesis. Studies originated from 11 countries: the United States (n = 18), England (n = 8), Australia (n = 4), Sweden (n = 4), both England and Wales (n = 2), and Scotland (n = 2). One study each originated from Brazil, Bulgaria, Canada, France, Great Britain, and Norway. The majority of AAS users initiated use before age 30. Sports participation (particularly power sports), negative body image, and psychological disorders such as depression preceded initiation of AAS use for most users. Sources of first AAS were mainly users’ immediate social networks and the illicit market. Enhanced sports performance, appearance, and muscle/strength were the paramount motives for AAS use initiation. Conclusions Our findings elucidate the significance of psychosocial factors in AAS use initiation. The proliferation of AAS on the illicit market and social networks demands better ways of dealing with the global public health problem of AAS use.
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Affiliation(s)
- Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5015 Bergen, Norway.
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Rostila M, Almquist YB, Östberg V, Edling C, Rydgren J. Social network characteristics and daily smoking among young adults in Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:6517-33. [PMID: 24351786 PMCID: PMC3881128 DOI: 10.3390/ijerph10126517] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 11/10/2013] [Accepted: 11/12/2013] [Indexed: 12/31/2022]
Abstract
A large number of studies have shown that friends' smoking behavior is strongly associated with an individual's own risk for smoking. However, few studies have examined whether other features of social networks, independently or conjointly with friends' smoking behavior, may influence the risk for smoking. Because it is characterized by the growing importance of friendship networks, the transition from adolescence to young adulthood may constitute a particularly relevant period on which to focus our investigation of network influences on smoking behavior. The aim of this study was therefore to examine the consequences of peer smoking as well as other network characteristics (friends' other health behaviors, relationship content, and structural aspects of the network) on the risk for smoking among young adults. The data was based on a cross-sectional survey of Swedish 19-year-olds carried out in 2009 (n = 5,695) with a response rate of 51.6%. Logistic regression was the primary method of analysis. The results show that having a large percentage of smokers in one's network was by far the most important risk factor for daily smoking. The risk of daily smoking was 21.20 (CI 14.24. 31.54) if 76%-100% of the network members smoked. Having a high percentage of physically active friends was inversely associated with daily smoking. The risk of smoking was 0.65 (CI 0.42. 1.00) if 76%-100% of the network members were physically active. No main associations between the other network characteristics (relationship content and structural aspects of the network) and smoking were found. However, there was an interaction between the percentage of smokers in the network and relationship content (i.e., trust, relationship quality and propensity to discuss problems): positive relationship content in combination with peer smoking may increase the risk of smoking. Women with a high percentage of smokers in their networks were also at higher risk of daily smoking than were men with many smoking friends. Hence, it is important to consider the interplay between peer smoking and other network characteristics on the risk of smoking, where features of networks which traditionally are seen as constructive may occasionally provide the impetus to smoke. Future studies should use longitudinal data to study whether these findings reflect peer selection or peer influence.
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Affiliation(s)
- Mikael Rostila
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sveaplan, Sveavägen 160, Stockholm SE-106 91, Sweden; E-Mails: (Y.B.A.); (V.Ö.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +46-(0)8-164-416; Fax: +46-(0)8-162-600
| | - Ylva B. Almquist
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sveaplan, Sveavägen 160, Stockholm SE-106 91, Sweden; E-Mails: (Y.B.A.); (V.Ö.)
| | - Viveca Östberg
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sveaplan, Sveavägen 160, Stockholm SE-106 91, Sweden; E-Mails: (Y.B.A.); (V.Ö.)
| | - Christofer Edling
- Department of Sociology, Lund University, Box 114, Lund SE-22100, Sweden; E-Mail:
| | - Jens Rydgren
- Department of Sociology, Stockholm University, Stockholm SE-106 91, Sweden; E-Mail:
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Dodge T, Stock M, Litt D. Judgments about illegal performance-enhancing substances: Reasoned, reactive, or both? J Health Psychol 2012; 18:962-71. [DOI: 10.1177/1359105312445079] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study applied aspects of the Theory of Reasoned Action and the Prototype/Willingness model to understand cognitions associated with the use of illegal performance-enhancing substances. There were two study objectives. One was to investigate whether the illegal-is-effective heuristic (i.e. belief that illegal performance-enhancing substances are more effective than legal performance-enhancing substances) affects willingness to use illegal performance-enhancing substances. The second was to examine whether attitudes, norms, and prototypes influence the willingness and intentions to use illegal performance-enhancing substances. The illegal-is-effective heuristic was a significant predictor of willingness but was not a significant predictor of intentions. Implications for future research and prevention efforts are discussed.
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Affiliation(s)
- Tonya Dodge
- The George Washington University, USA
- Skidmore College
| | | | - Dana Litt
- The George Washington University, USA
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A resource-based theory of social capital for health research: Can it help us bridge the individual and collective facets of the concept? SOCIAL THEORY & HEALTH 2011. [DOI: 10.1057/sth.2011.4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Peer-based programs are increasingly used by community organisations to support vulnerable youth who are at risk of developing mental health problems. Such programs are as diverse as the populations they support and include: drop-in services; peer education; as well as camps and online discussion forums for hard-to-reach populations that may not access more conventional forms of support, owing to issues of stigma or accessibility (for example, same-sex-attracted youth and teenage parents). There has been limited evaluation of peer-based community programs. Therefore, the lack of evidence of program effectiveness makes it difficult for service providers to secure continuous funding and threatens program sustainability. This article reports on a study designed to investigate barriers and enablers associated with evaluating peer-based youth programs. The resulting implications for policy, practice and research are discussed.
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Petróczi A, Aidman E. Psychological drivers in doping: the life-cycle model of performance enhancement. Subst Abuse Treat Prev Policy 2008; 3:7. [PMID: 18331645 PMCID: PMC2315642 DOI: 10.1186/1747-597x-3-7] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Accepted: 03/10/2008] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Performance enhancement (PE) is a natural and essential ingredient of competitive sport. Except for nutritional supplement contamination, accidental use of doping is highly unlikely. It requires deliberation, planning and commitment; and is influenced by a host of protective and risk factors. HYPOTHESIS In the course of their career, athletes constantly set goals and make choices regarding the way these goals can be achieved. The cycle of choice - goal commitment - execution - feedback on goal attainment - goal evaluation/adjustment has numerous exit points, each providing an opportunity for behaviour change, which may or may not be related to the use of prohibited methods. The interplay between facilitating and inhibiting systemic and personality factors, constantly influenced by situational factors could result in an outcome vector of 'doping attitudes', which combines with subjective norms to influence intentions to choose prohibited PE methods. These influences also vary from one stage of athlete development to the next, making some athletes more vulnerable to engaging in doping practices than others, and more vulnerable at certain time periods - and not others. TESTING THE HYPOTHESIS Model-testing requires a series of carefully planned and coordinated studies. Correlational studies can establish relationships where the directionality is not-known or not important. Experimental studies with the manipulation of doping expectancies and risk factors can be used to demonstrate causality and evaluate potential intervention strategies. The final model can be tested via a behavioural simulation, with outcomes compared to those expected from literature precedence or used as a simulated computer game for empirical data collection. IMPLICATIONS A hypothesized life-cycle model of PE identifies vulnerability factors across the stages of athlete development with the view of informing the design of anti-doping assessment and intervention. The model suggests that, instead of focusing on the actual engagement in prohibited PE practices, deterrence strategies are likely to be more effective if they target the influencing factors at the appropriate stage and identify groups of athletes and their respective career stages, which pose particular risks of engagement in doping practices. This enables a more effective intervention approach by targeting specific risk factors and expectancies.
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Affiliation(s)
- Andrea Petróczi
- Kingston University, Faculty of Science, School of Life Sciences, Penrhyn Road, Kingston upon Thames, Surrey, KT1 2EE, UK
| | - Eugene Aidman
- University of Adelaide, School of Psychology, North Terrace Campus, SA 5005, Australia
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