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3 results

  • Chapter 8 - Exercise and the Use of Image- and Performance-Enhancing Drugs within the Gym Environment

  • from Section 1 - From Exercise to Addiction: An Introduction to the Phenomenon
  • Edited by Ornella Corazza, University of Hertfordshire and University of Trento, Italy, Artemisa Rocha Dores, Polytechnic Institute of Porto and University of Porto, Portugal
  • Book:
    The Body in the Mind
    Published online:
    30 March 2023
    Print publication:
    06 April 2023, pp 121-136

  • Summary

    Among the image- and performance-enhancing drugs (IPEDs), anabolic-androgenic steroids (AAS) are now a global public health issue. Once confined to sporting arenas and competitive bodybuilding, they have now reached an increasingly image-conscious general population. In addition to the well-documented evidence of physical harm caused by AAS, there is emerging evidence that in sustained high doses they affect the structure and functioning of the brain. For some of the newer drugs the potential long-term impact is unknown. The risks to health are compounded by polypharmacy, high levels of injecting, and variable product content and contamination resulting from the illicit market. Responses to the issue (i.e., the level and implementation of regulations, education and preventive activities, and treatment and harm reduction) vary. However, there are few data to inform the development of effective interventions, and there is a clear need to develop the evidence base, which requires effective engagement with drug-using populations.

  • Associations of anabolic-androgenic steroid use with other behavioral disorders: an analysis using directed acyclic graphs

  • Gen Kanayama, Harrison G. Pope, Jr, James I. Hudson
  • Journal:
    Psychological Medicine / Volume 48 / Issue 15 / November 2018
    Published online by Cambridge University Press:
    01 March 2018, pp. 2601-2608
  • Background

    Anabolic-androgenic steroid (AAS) use is known to be associated with other psychiatric disorders, such as body image disorders, conduct disorder/sociopathy, and other substance use disorders (SUD) – but the causal pathways among these conditions remain poorly delineated.

    Methods

    We created a directed acyclic graph to diagram hypothesized relationships among AAS use and dependence, body image disorder (BID), conduct disorder/sociopathy, and other SUD. Using proportional hazards models, we then assessed potentially causal relationships among these variables, using a dataset of 233 male weightlifters, of whom 102 had used AAS.

    Results

    BID and conduct disorder/sociopathy both strongly contributed to the development of AAS use, but did not appear to contribute further to the progression from AAS use to AAS dependence. Other SUD beginning prior to first AAS use – whether broadly defined or restricted only to opioids – failed to show an effect on AAS use or progression to AAS dependence. Conversely, AAS use contributed significantly to the subsequent first-time development of opioid use disorders but did not significantly increase the risk for first-time development of non-opioid SUD, taken as a whole.

    Conclusions

    Our analysis suggests that AAS use and other SUD are mutually attributable to underlying conduct disorder/sociopathy. SUD do not appear to represent a ‘gateway’ to subsequent AAS use. AAS use may represent a gateway to subsequent opioid use disorder, but probably not to other SUD.

  • Steroids, psychosis and poly-substance abuse

  • R. M. Duffy, B. D. Kelly
  • Journal:
    Irish Journal of Psychological Medicine / Volume 32 / Issue 2 / June 2015
    Published online by Cambridge University Press:
    13 October 2014, pp. 227-230
    Print publication:
    June 2015
  • Objective

    To review consequences of the changing demographic profile of anabolic-androgenic steroid (AAS) use.

    Method

    Case report and review of key papers.

    Results

    We report here a case of a 19-year-old Irish male presenting with both medical and psychiatric side effects of methandrostenolone use. The man had a long-standing history of harmful cannabis use, but had not experienced previous psychotic symptoms. Following use of methandrostenolone, he developed rhabdomyolysis and a psychotic episode with homicidal ideation.

    Discussion

    Non-medical AAS use is a growing problem associated with medical, psychiatric and forensic risks. The population using these drugs has changed with the result of more frequent poly-substance misuse, potentially exacerbating these risks.

    Conclusion

    A higher index of suspicion is needed for AAS use. Medical personnel need to be aware of the potential side effects of their use, including the risk of violence. Research is needed to establish the magnitude of the problem in Ireland.