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
59 citations
Cites methods from "A qualitative study of anabolic ste..."
...Most research has described users as motivated to use IPEDs by desires to achieve a ‘better looking body’ (Kimergård, 2015, p. 289), a bigger or ‘ripped’ body (Petrocelli, 2008), increased muscle mass and strength (Jennings, Patten, Kennedy, & Kelly, 2014, p. vi), and ‘enhanced definition and…...
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50 citations
Cites background or result from "A qualitative study of anabolic ste..."
...Here, the availability of knowledge within groups of steroid users seemed to act as a barrier to information from health authorities, which resonates with previous findings that health services are not usually seen as credible sources of information.(7) 14 16 22 Services must identify more appropriate ways of providing credible information that will be valued and result in positive behaviour change....
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...As a consequence, many users ignore or perceive the risk of steroid usage as relatively minor.(7) 15–17 Steroid users who seek the support of peer users but avoid social censure by keeping their use of drugs a secret from others may also serve as a mechanism that promotes harm....
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44 citations
41 citations
39 citations
Cites background from "A qualitative study of anabolic ste..."
...Reasons for initiating use include body dissatisfaction (Kimergård, 2015), low confidence or poor self-esteem (Cohen, Collins, Darkes, & Gwartney, 2007; Maycock & Howat, 2009), safety and security (Maycock & Howat, 2009), to improve social status (Griffiths, Henshaw, McKay, & Dunn, 2015; Maycock &…...
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...These types of discussions may also help to identify reasons for AAS use such as body dissatisfaction, insecurities, bullying, and/or pressure to perform (Hanley Santos & Coomber, 2016; Holland-Hall, 2007; Ip et al., 2015; Kanayama & Pope, 2012a; Kimergård, 2015; Maycock & Howat, 2009)....
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...Reasons for initiating use include body dissatisfaction (Kimergård, 2015), low confidence or poor self-esteem (Cohen, Collins, Darkes, & Gwartney, 2007; Maycock & Howat, 2009), safety and security (Maycock & Howat, 2009), to improve social status (Griffiths, Henshaw, McKay, & Dunn, 2015; Maycock & Howat, 2009; Seer, Fraser, Moore, & Murphy, 2015), or to fit into a “fitness” lifestyle or identity (Ravn & Coffey, 2016)....
[...]
...These types of discussions may also help to identify reasons for AAS use such as body dissatisfaction, insecurities, bullying, and/or pressure to perform (Hanley Santos & Coomber, 2016; Holland-Hall, 2007; Ip et al., 2015; Kanayama & Pope, 2012a; Kimergård, 2015; Maycock & Howat, 2009)....
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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)....
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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)....
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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