A qualitative study of anabolic steroid use amongst gym users in the United Kingdom: motives, beliefs and experiences
Summary (2 min read)
Introduction
- The use of anabolic steroids and, more broadly, prohibited doping substances in elite sport has been well-known, and thoroughly debated, for decades.
- While doping techniques and specific substance use in competitive athletes varies tremendously (for example, depending on type of sport), the overarching aim of this form of drug use is to improve performance and to win.
- Of note is that concerns have been raised regarding the accuracy of these estimates (ACMD, 2010; Evans-1 Brown et al., 2012).
- Due to the growing use of anabolic steroids in the United Kingdom this study explores the experiences of the users and investigates their motives, beliefs and steroid-related experiences.
Background literature
- Use in women can lead to growth of body and facial hair, deepening of voice, clitoris enlargement, increased libido, menstruation irregularities, and reduced fertility (EvansBrown et al., 2012).
- Severity of effects is partly idiosyncratic, but would also appear to be dose dependent.
- This knowledge, based predominantly on personal experience and anecdotes, includes information on methods to reduce or avoid adverse effects (Monaghan, 2001).
Method
- Qualitative interviews with 24 users of anabolic steroids were conducted between 2009 and 2011 as part of a study of harm reduction services for anabolic steroid users in England and Wales (for an overview of respondents see Table 1).
- The study had ethical 2 approval granted by Liverpool John Moores Research Ethics Committee.
- Seven steroid users were recruited from fixed-site needle and syringe programmes; three from an outreach service; nine from steroid clinics; one from a gym; and, four from a prison.
Insert table 1
- Semi-structured interviews were conducted, lasting between 30 to 75 minutes, including questions on body (dis)satisfaction, motivations for steroid usage; patterns of steroid use, sources of steroid-related knowledge and accounts of health harms.
- Most interviews were recorded, and subsequently transcribed, except when prison regulation prohibited the use of electronic devices, or when respondents felt uncomfortable about discussing sensitive issues of using or supplying anabolic steroids.
- In such cases, a written record was compiled immediately after the interview.
- Written interview records were subjected to thematic content analysis in order to identify and verify themes relevant to the experiences of steroid usage (Burnard et al., 2008).
- Themes were continuously 3 developed and refined as the study progressed (Miles & Huberman, 1994).
Body satisfaction and drugs
- In line with previous research into the use of anabolic steroids (Grogan et al., 2006; EvansBrown & McVeigh, 2009), findings clearly indicated that anabolic steroid usage was linked to getting a better looking body.
- Importantly, reasons to use these drugs may shift over time, providing further insights into why users behave as they do:.
- At this moment in time, I’m not looking to get any bigger as a bodybuilder for example.
- I wouldn’t wish to be any heavier than that, 4 because carrying more than 15 stone, you are just going to give yourself health.
- The article presents quotes only from interviews recorded on audio.3.
Gaining and using knowledge
- Drug using patterns were complex and highly personalised with no two respondents reporting identical regimens.
- If I get problems with cholesterol, I’ll take statins, which is a drug that can lower cholesterol.
- (Steroid user aged 35) More complex drug regimens included the use of various anabolic steroids together with synthetic growth hormones and insulin to enhance muscle size and lose body fat.
- Additionally, some respondents included sexual enhancement products and skin darkening drugs in their drug repertoires (for an overview see Table 2).
Insert table 2
- An important part of acquiring knowledge about anabolic steroids—commonly referred to by respondents as doing ‘research’—was to ask other users for advice: (Steroid user aged 21) In fact, there were no indications that any of the respondents engaged in the use of steroids on their own.
- (Steroid user and competing bodybuilder aged 45) 8.
- Who kept detailed records of their steroid regimes, users also revealed elements of irrationality as they ignored the commonly accepted ‘guidelines’ for steroid use and in spur-of-the-moment behaviour adopted practices based on rumours which they perceived as ‘emerging evidence’.
- In other cases, recording specific regimes and doses of users presented difficulties (partly because of difficulties in remembering the exact duration of previous courses and partly because users were unaware of precise amounts or measurements).
Discussion
- Numerous factors including perceptions of the ideal body, steroid knowledge shared amongst users, the function of the illicit market, and personal assessments of health influenced the motivations and beliefs amongst steroid users.
- Overall, this appeared to serve multiple purposes, including questioning the trustworthiness of information about the potential harms of these drugs from health authorities, and coping with insecurities about the use of these drugs by increasing the sense of security and well-being (Wills, 1981).
- The accounts of steroid users revealed tremendous inconsistencies in the perception of the harms of anabolic steroids between users and health authorities, the media and policymakers with serious implications for the promotion of public health.
- This may also offer a potential opportunity to deliver accurate information via an established and credible communication network.
- Considering these limitations is important when extrapolating the findings to the wider population of anabolic steroid users.
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Citations
4 citations
Cites background from "A qualitative study of anabolic ste..."
...…competition, coaches’ emphasis and pressure, and attempts to attract the attention of sports fans are the most important factors related to the consumption of illicit drugs (Bijeh et al., 2014; Jalilian et al., 2012; Atarodi & Rohani, 2012; Halabchi, 2007; Kimergård, 2015; Blank et al., 2016)....
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4 citations
4 citations
Cites result from "A qualitative study of anabolic ste..."
...The results of this study further elucidate the variation in fitness doping experiences, reasons for commencing doping, and negotiation of the meaning of drug use practices (see also, Coquet et al., 2018; Kimergård, 2015; Sagoe et al., 2014)....
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3 citations
Cites background from "A qualitative study of anabolic ste..."
...advice of peers, in conjunction with their own personal opinion, users viewed the harms of AAS to be manageable and thus considered AAS safe to consume (Kimergård, 2014)....
[...]
...Although users of AAS do so because of perceived benefits such as improved body strength and increased body mass, many overlook the risky side effects resulting from the drug (Al-Falasi et al., 2008; DuRant et al., 1993; Kimergård, 2014)....
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...Kimergård (2014) conducted a qualitative study of gym goers who used AAS and found that users generally did not express anxiety over possible side effects because they hear of other users also minimize the side effects....
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...By seeking the advice of peers, in conjunction with their own personal opinion, users viewed the harms of AAS to be manageable and thus considered AAS safe to consume (Kimergård, 2014)....
[...]
...Although users of AAS do so because of perceived benefits such as improved body strength and increased body mass, many overlook the risky side effects resulting from the drug (Al-Falasi et al., 2008; DuRant et al., 1993; Kimergård, 2014)....
[...]
3 citations
Cites background or result from "A qualitative study of anabolic ste..."
...Another important factor is probably psychological dependency with body image pathology, and in long-term AAS use also the development of muscle dysmorphia (Greenway & Price, 2018; Grogan, Shepherd, Evans, Wright, & Hunter, 2006; Kanayama, Barry, Hudson, & Pope, 2006; Kimergård, 2015; Papp, Urbán, Czeglédi, & Babusa, 2013; Santos & Coomber, 2017)....
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...Motivations leading to the first and subsequent AAS use in our sample correspond to the results of other studies dealing with this topic (e.g. Kimergård, 2015; Petersson, Bengtsson, Voltaire-Carlsson, & Thiblin, 2010; Van Hout & Kean, 2016; Watt & Ricciardelli, 2012)....
[...]
...…dependency with body image pathology, and in long-term AAS use also the development of muscle dysmorphia (Greenway & Price, 2018; Grogan, Shepherd, Evans, Wright, & Hunter, 2006; Kanayama, Barry, Hudson, & Pope, 2006; Kimergård, 2015; Papp, Urbán, Czeglédi, & Babusa, 2013; Santos & Coomber, 2017)....
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References
41,986 citations
"A qualitative study of anabolic ste..." refers methods in this paper
...Written interview records were subjected to thematic content analysis in order to identify and verify themes relevant to the experiences of steroid usage (Burnard et al., 2008).3 Themes were continuously developed and refined as the study progressed (Miles & Huberman, 1994)....
[...]
2,763 citations
"A qualitative study of anabolic ste..." refers methods in this paper
...Written interview records were subjected to thematic content analysis in order to identify and verify themes relevant to the experiences of steroid usage (Burnard et al., 2008).3 Themes were continuously developed and refined as the study progressed (Miles & Huberman, 1994)....
[...]
2,430 citations
"A qualitative study of anabolic ste..." refers background in this paper
...ness of information about the potential harms of these drugs from health authorities, and coping with insecurities about the use of these drugs by increasing the sense of security and well-being (Wills, 1981)....
[...]
...Overall, this appeared to serve multiple purposes, including questioning the trustworthiness of information about the potential harms of these drugs from health authorities, and coping with insecurities about the use of these drugs by increasing the sense of security and well-being (Wills, 1981)....
[...]
1,668 citations