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DOI:
10.3109/14659891.2014.911977
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Citation for published version (APA):
Kimergård, A. (2014). A qualitative study of anabolic steroid use amongst gym users in the United Kingdom:
Motives, beliefs and experiences. Journal of Substance Use, 20(4), 288-294.
https://doi.org/10.3109/14659891.2014.911977
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Download date: 10. Aug. 2022
A qualitative study of anabolic steroid use amongst gym users
in the United Kingdom: Motives, beliefs and experiences
Andreas Kimergård
1,2
1
Centre for Public Health, Liverpool John Moores University, Liverpool, United Kingdom
2
Department of Public Health, Aarhus University, Aarhus, Denmark
Correspondence: Andreas Kimergård, Centre for Public Health, Liverpool John Moores
University, Henry Cotton Campus, Level 2, 15-21 Webster Street, Liverpool, L3 2ET,
United Kingdom;
E-mail: A.Kimergard@ljmu.ac.uk
Running head: Anabolic steroid use: Motives, beliefs and experiences!
1
A qualitative study of anabolic steroid use amongst gym users
in the United Kingdom: Motives, beliefs and experiences
Abstract
The illicit use of anabolic steroids amongst the gym population continues to rise in the
United Kingdom presenting serious challenges to public health. This study used qualitative
interviews to explore the experiences of 24 users of anabolic steroids and investigate their
motives and experiences. Body satisfaction was a motivating factor in the use of anabolic
steroids. Anabolic steroid users’ drug use and associated behaviour were influenced by
numerous sources of information, in particular, first-hand accounts of their peers, along
with personal opinion and anecdotes on the Internet. As a result of this knowledge, users
expressed their belief that these drugs can be used relatively safely. The prevailing
viewpoint, that the harms associated with anabolic steroids can be managed and that this
behaviour is part of a healthy lifestyle, contributes to the potential health risks.
Keywords
Anabolic steroids, gym population, motivations for use.!
2
A qualitative study of anabolic steroid use amongst gym users
in the United Kingdom: Motives, beliefs and experiences
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. Yet most people who use anabolic steroids do not compete in
organised sport (Baker et al., 2006; Pope et al., in press) and most studies into anabolic
steroid usage indicate that the main reasons to use these drugs are to enhance the
performance of muscle, for example by increasing strength, or improving the appearance
of the body (Evans-Brown et al., 2012).
The use of anabolic steroids amongst gym users has been reported in countries in
Europe, Australasia, and North America (Sagoe et al., in press), and, more recently, in
countries such as Brazil (Santos et al., 2011), the United Arab Emirates (Al-Falasi et al.,
2008), and Iran (Allahverdipour et al., 2012). The Crime Survey for England and Wales
found that 0.2% of those aged 16-59, estimated at 59,000, had taken anabolic steroids in
the past year (2012/2013) (Home Office, 2013). Data collected from needle and syringe
1
programmes in Merseyside and Cheshire, North West England, shows a significant
increase in the number of new steroid injecting clients attending such harm reduction
services from the 1990s onwards (ACMD, 2010). These data, along with arrests of illicit
retailers, seizures of illicit market products, media reports, monitoring of discussion forums
on the Internet, and case reports/series of adverse events, indicate that the use of
anabolic steroids and other drugs for the purpose of human enhancement is steadily
growing (Evans-Brown et al., 2012).
Anabolic steroid usage in the gym population presents a challenge to public health, in
relation to adverse effects (both acute and chronic) amongst users (Pope et al., in press)
as well as potential exposure to blood borne viruses from the sharing of contaminated
Of note is that concerns have been raised regarding the accuracy of these estimates (ACMD, 2010; Evans-
1
Brown et al., 2012).
3
needles, syringes and drug vials (Hope et al., 2013). 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
Perceptions and management of anabolic steroid-related health harms
Case reports/series, along with observational studies, indicate that acute adverse
reactions from the pharmacotoxicological actions of anabolic steroids are diverse in their
characteristics and severity, and include acne, hair loss, gynaecomastia, disruption of
growth, damage to tendons and ligaments, testicular atrophy, erectile dysfunction, liver
damage (especially with oral products), and cardiovascular events (Pope et al., in press).
Use in women can lead to growth of body and facial hair, deepening of voice, clitoris
enlargement, increased libido, menstruation irregularities, and reduced fertility (Evans-
Brown et al., 2012). Adverse psychological effects have also been reported in the
literature, including increases in aggressive behaviour, and depression following the
cessation of use (Haug et al., 2004; ACMD, 2010). Severity of effects is partly
idiosyncratic, but would also appear to be dose dependent.
One survey conducted amongst members of 18 gyms in the United Arab Emirates
reported that 59% believed that the benefits of using anabolic steroids outweighed the
risks (Al-Falasi et al., 2008). A similar study included steroid users attending two needle
and syringe programmes in the United Kingdom, and found that nearly all of the
respondents said that they have been given information regarding the potential health
harms of anabolic steroids and yet more than half had no intention of stopping their use of
these drugs in the next 12 months (Walker & Joubert, 2011). While these and similar
studies are beneficial in determining the perceived hazards of steroid use, they offer little
insights into the reasons behind, and experiences with, the use of these drugs and the
potential impact on behaviour. In relation to motivation and drivers to use anabolic
steroids, a significant issue is the apparent relationship between social as well as cultural
ideals and body satisfaction in men (Mishkind et al., 1986). In terms of studies into body
image satisfaction, it has been shown that body dissatisfaction, along with the desire to
enhance muscularity, can prompt the use of anabolic steroids in men (Grogan, 2008). The
few existing qualitative studies show that users exchange anabolic steroid-related
knowledge and will often defer to opinion leaders (sometimes referred to as ‘steroid gurus’)
4
