Anabolic-androgenic steroid users receiving health-related information; health problems, motivations to quit and treatment desires

Havnes, Ingrid Amalia; Jørstad, Marie Lindvik; Wisløff, Christine

doi:10.1186/s13011-019-0206-5

Cited by 59 publications

(72 citation statements)

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“…A considerable number of (former) AAS abusers seeking help have mental problems. Havnes et al showed that mental problems such as depression, anxiety, behavioural change and AAS dependence are reported even more frequently than physical problems (20). By the patient, these symptoms are mostly attributed to hormonal disturbances such as testosterone deficiency, but this may not always be the case.…”

Section: What To Do?mentioning

confidence: 99%

Anabolic androgenic steroid abuse in young males

Ronde

Smit

2020

Endocrine Connections

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This review summarizes 10 years experience with male abusers of anabolic androgenic steroids (AAS). The typical user of AAS is male, aged between 20 and 40 and lifting weights. Illegal AAS are cheap and easily obtained via internet or local suppliers. AAS are mostly used in cycles with a duration between 6 and 18 weeks. Most AAS cycles contain multiple agents, used simultaneously in a dose vastly exceeding a substitution dose. A variety of other performance and image-enhancing drugs are commonly used, including human growth hormone, thyroid hormone, tamoxifen, clomiphene citrate and human chorionic gonadotrophin. Short-term clinical and biochemical side effects are well established. Long-term side effects are uncertain, but may include heart failure, mood-and anxiety disorders, hypogonadism and subfertility. We share our views on the management of common health problems associated with AAS abuse.

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Section: What To Do?mentioning

confidence: 99%

Anabolic androgenic steroid abuse in young males

Ronde

Smit

2020

Endocrine Connections

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“…Service users emphasized that being informed about what SUD treatment is or may be was useful. In addition, receiving help to initiate the treatment entry process through information about treatment rights, the referral process and establishing contact with SUD treatment providers who have experience with treatment of the patient group, was important (Havnes, Jørstad, and Wisløff 2019).…”

Section: Discussionmentioning

confidence: 99%

“…This article forms part of an exploratory qualitative study focusing on experiences with AAS use, health problems, and health services, and in particular SUD treatment. A subset of data from this study has been published in a mixed methods paper (Havnes, Jørstad and Wisløff 2019) describing how use of an information service may facilitate SUD treatment-seeking.…”

Section: Methodsmentioning

confidence: 99%

“…Lifetime AAS use is higher among men than among women and is reported to be widespread across the globe (Sagoe et al 2014). In Norway, lifetime use is estimated to be 1-3% among men (Bilgrei and Sandøy 2015;, but is found to be many times higher among inmates (Lundholm et al 2010) and patients in substance use disorder (SUD) treatment (Dodge and Hoagland 2011, Kanayama et al 2003, Nøkleby and Skårderud 2013, Havnes et al 2019.…”

Section: Introductionmentioning

confidence: 99%

“…It is important to note that few users seek any health services (Pope, Khalsa, and Bhasin 2017;Zahnow et al 2017), despite being concerned for their health (Zahnow et al 2017). Barriers include fear of stigmatization (Dunn, Henshaw and Mc Kay 2016;Yu, Hildebrandt, and Lanzieri 2015), unknowledgeable staff (Jørstad, Skogheim, and Bergsund 2018;Pope et al 2004), sanctions (Havnes, Jørstad and Wisløff 2019), belief that the treatment provider cannot/will not help, or belief that the health problem is not serious enough (Zahnow et al 2017). Yet, among a sample of Norwegian AAS users where mental health problems were the most common motivation for AAS cessation and treatment seeking, three out of four desired SUD treatment after receiving information tailored to AAS users about side effects, treatment options and potential outcomes (Havnes, Jørstad and Wisløff).…”

Section: Introductionmentioning

confidence: 99%

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Alienation and Lack of Trust

Havnes¹,

Skogheim

2020

JEA

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Anabolic-androgenic steroid (AAS) use became illegal when the Norwegian Drug Act was amended in 2013, and AAS and other image- and performance-enhancing drugs were included in the politics and treatment of substance use. Few individuals with AAS-related health problems seek substance use disorder (SUD) treatment. This article aims to explore understandings of AAS dependence, barriers to treatment-seeking, and experiences of entering SUD treatment among a sample of men with AAS-related health problems struggling to cease AAS use. Seeking treatment for AAS-related health problems within SUD treatment services was described as alienating. First, because the participants experienced their struggle to quit using AAS to be different from being dependent upon psychoactive substances. They linked their struggles to symptoms of hormonal disturbance, need for a certain body size, and/or the sense of wellbeing provided by AAS and which enable them to function socially. Second, they experienced alienation because of their healthy identities, bodies and lifestyles, as opposed to how they viewed individuals with severe SUDs and emaciated bodies. A major barrier to treatment-seeking was participants’ lack of trust that SUD treatment providers had the knowledge and the means to provide treatment of their AAS-related health problems and struggle to quit AAS use. Experienced barriers towards seeking SUD treatment should be taken into account when planning, organizing and implementing health services for individuals with AAS-related health problems.

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Clustering psychopathology in male anabolic–androgenic steroid users and nonusing weightlifters

et al. 2023

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Introduction Prior research has demonstrated that personality disorders and clinical psychiatric syndromes are common among users of anabolic–androgenic steroids (AAS). However, the prevalence, expression, and severity of psychopathology differ among AAS users and remain poorly understood. In this study, we examine the existence of potential clinically coherent psychopathology subgroups, using cluster procedures. Methods A sample of 118 male AAS users and 97 weightlifting nonusers was assessed using the Millon Clinical Multiaxial Inventory‐III (MCMI‐III), measuring personality disorders and clinical syndromes. Group differences in MCMI‐III scales were assessed using Wilcoxon‐Mann–Whitney tests and Fisher's exact test. Agglomerative hierarchical clustering was used to identify clusters based on MCMI‐III scale scores from the whole sample. Results AAS users displayed significantly higher scores on all personality disorder (except narcissistic) and clinical syndrome scales compared to nonusing weightlifters. The clustering analysis found four separate clusters with different levels and patterns of psychopathology. The “no psychopathology” cluster was most common among nonusing weightlifters, while the three other clusters were more common among AAS users: “severe multipathology,” “low multipathology,” and “mild externalizing.” The “severe multipathology” cluster was found almost exclusively among AAS users. AAS users also displayed the highest scores on drug and alcohol dependence syndromes. Conclusions AAS users in our sample demonstrated greater psychopathology than the nonusing weightlifters, with many exhibiting multipathology. This may pose a significant challenge to clinical care for AAS users, particularly as there appears to be significant variation in psychopathology in this population. Individual psychiatric profiles should be taken into consideration when providing treatment to this group. Significant Outcomes As a group, AAS users displayed markedly greater psychopathology than nonusing weightlifters. Multipathology was common among AAS users. Four different subgroups of personality profiles were identified with distinct patterns of pathology and severity. Limitations The cross‐sectional nature of the study precludes inferences about causality. The study is limited by possible selection bias, as participants choosing to be involved in research may not be entirely representative for the group as a whole. The study is vulnerable to information bias, as the results are based on self‐report measures and interviews.

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Anabolic-androgenic steroid users receiving health-related information; health problems, motivations to quit and treatment desires

Cited by 59 publications

References 58 publications

Anabolic androgenic steroid abuse in young males

Anabolic androgenic steroid abuse in young males

Alienation and Lack of Trust

Clustering psychopathology in male anabolic–androgenic steroid users and nonusing weightlifters

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