Generating evidence on the use of Image and performance enhancing drugs in the UK: results from a scoping review and expert consultation by the Anabolic Steroid UK network

Abstract

Background The use of anabolic androgenic steroids (AAS) and associated image and performance enhancing drugs (IPEDs) is now a global phenomenon. There is a need to develop evidence to support the development of interventions to prevent the commencement of use, to minimise the potential harms or to support those in their cessation of use. While the United Kingdom (UK) is no exception to this issue, its public health and legislative response to the phenomenon differs to other countries and requires the examination of research specific to the UK. Therefore, a scoping review has been conducted to examine the recent relevant literature to help inform the development and evaluation of effective interventions to reduce the harmful use of IPEDs. Methods A comprehensive search strategy was developed for multiple bibliographic databases, supported by and iterative citation searching process and complimented by expert input from the Anabolic Steroid UK Network. Research conducted by or UK academics or within the UK were eligible, if published in the previous five years. Results In total 87 eligible outputs were identified, including 26 review articles, 25 qualitative papers and 24 quantitative papers. together with small numbers of clinical studies/case reports (6) and commentaries/correspondence (6). The most common topics of research were public health, treatment and harm reduction (41), followed by studies focusing on epidemiology, sub-groups of people using IPEDs and motivations for use (34). The studies illustrated the diverse populations of people who use a range of enhancement drugs including concomitant psychoactive drug use. A number of papers focused on blood borne viruses and associated issues, while others reported on the uptake of needle and syringe programmes. No effectiveness evaluations related to any aspect of treatment, harm reduction or other intervention were published during study period. Conclusion There is a need for the development of effectiveness evaluations of current interventions and any future service provision for people using image and performance enhancing drugs. While there have been no studies of this nature to date, this review illustrates the rich data that has been gathered through diverse methodologies, that will assist in the development of future effectiveness evaluations.

Exploring the Impacts of Rurality on Service Access and Harm Among Image and Performance Enhancing Drug (IPED) Users in a Remote English Region

“…These trends in contemporary IPED use are important to understand, since these drugs come with a range of potential health risks, from cardiovascular strain and hepatotoxicity, to psychological harms such as depression (Kanayama et al, 2018; McVeigh, Hearne, et al, 2021; McVeigh, Salinas, & Ralphs, 2021). Additionally, with many of the most popular IPEDs being injected, these further carry associated risks of infection, and potential exposure to blood borne viruses (BBV; Bates & McVeigh, 2016; Hope et al, 2013), even if BBV risk is lower for those injecting steroids (via intramuscular (IM) injections) than for intravenous (IV) drug users (see Underwood, 2019).…”

“…While academic discourse around IPEDs increasingly acknowledges the importance of harm reduction for users (Bates et al, 2022), it is clear there remain gaps in our understanding regarding how best to serve specific populations (Hope et al, 2022;McVeigh, Hearne, et al, 2021). With IPED use being highly heterogenous (van de Ven et al, 2019), much work has acknowledged the extent to which interventions must be tailored to the different practices, motivations and harm profiles of users (Christiansen et al, 2017;Harvey et al, 2021;Vinther & Christiansen, 2019).…”

‘Sustaining masculinity’: a scoping review of anabolic androgenic steroid use by older males

“…However recent research has identified different populations of people who use AAS that are not consistent with the stereotypical young male who uses AAS (McVeigh et al, 2021). The global presence of OMAAS within studies in this scoping review highlight the need for age-specific research and recommendations to inform future policy and practice pertaining to this older cohort.…”

Beyond the law: Exploring the impact of criminalising anabolic–androgenic steroid use on help-seeking and health outcomes in Australia

“…For example, among AAS injectors, almost 60% had recently used psychoactive substances and were significantly younger, less educated, and more likely to have experienced redness at an injection site in the previous 12 months (van de Ven et al, 2018). AAS injecting is associated with a range of side effects, such as elevated blood pressure, reproductive issues, and the transmission of blood-borne viruses such as hepatitis C (McVeigh et al, 2021; van de Ven et al, 2018). Recently, an e-module has been implemented for the healthcare provider workforce which provides credible evidence-based resources to support their knowledge around AAS (Atkinson et al, 2021).…”