Polydrug use and polydrug markets amongst image and performance enhancing drug users: Implications for harm reduction interventions and drug policy

Salinas, Mike; Floodgate, William; Ralphs, Robert

doi:10.1016/j.drugpo.2019.01.019

Cited by 47 publications

(45 citation statements)

References 31 publications

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“…It is well established that AAS use is not restricted to men and while rates amongst women are much lower [203], the complexities of treatment and care are undoubtedly much higher [23, 204, 205]. Prevalence of AAS use is higher amongst groups with specific characteristics such as professions where size or strength is an asset [206–209], amongst gay and bisexual men [20, 22, 29, 210, 211] and those using or who have previously used other drugs [212] [30, 33, 67, 212–214]. These “sub groups” may or may not require specific interventions and may merely illustrate the complexities of human nature.…”

Section: Discussionmentioning

confidence: 99%

Treatments for people who use anabolic androgenic steroids: a scoping review

et al. 2019

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Background: A growing body of evidence suggests that anabolic androgenic steroids (AAS) are used globally by a diverse population with varying motivations. Evidence has increased greatly in recent years to support understanding of this form of substance use and the associated health harms, but there remains little evidence regarding interventions to support cessation and treat the consequences of use. In this scoping review, we identify and describe what is known about interventions that aim to support and achieve cessation of AAS, and treat and prevent associated health problems.Methods: A comprehensive search strategy was developed in four bibliographic databases, supported by an iterative citation searching process to identify eligible studies. Studies of any psychological or medical treatment interventions delivered in response to non-prescribed use of AAS or an associated harm in any setting were eligible. Results: In total, 109 eligible studies were identified, which included case reports representing a diverse range of disciplines and sources. Studies predominantly focussed on treatments for harms associated with AAS use, with scant evidence on interventions to support cessation of AAS use or responding to dependence. The types of conditions requiring treatment included psychiatric, neuroendocrine, hepatic, kidney, cardiovascular, musculoskeletal and infectious. There was limited evidence of engagement with users or delivery of psychosocial interventions as part of treatment for any condition, and of harm reduction interventions initiated alongside, or following, treatment. Findings were limited throughout by the case report study designs and limited information was provided.Conclusion: This scoping review indicates that while a range of case reports describe treatments provided to AAS users, there is scarce evidence on treating dependence, managing withdrawal, or initiating behaviour change in users in any settings. Evidence is urgently required to support the development of effective services for users and of evidence-based guidance and interventions to respond to users in a range of healthcare settings. More consistent reporting in articles of whether engagement or assessment relating to AAS was initiated, and publication within broader health-or drug-related journals, will support development of the evidence base.

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Section: Discussionmentioning

confidence: 99%

Treatments for people who use anabolic androgenic steroids: a scoping review

et al. 2019

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“…prescription drugs as part of multi-drug enterprises, whereas others specialize in the sale of specific prescription drugs only (See Pearson and Hobbs, 2001;Antonopoulos and Hall, 2016;Salinas et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Social media markets for prescription drugs: platforms as virtual mortars for drug types and dealers

Demant

Bakken

Hall

2020

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Purpose Internet use has changed the mechanics of drug dealing. Although this has spurred some initial academic interest in how markets and their users have been changing, the issue is still under-researched. The purpose of this paper is to understand how the organisation of the distribution of prescription drugs and other illegal drugs overlap in these online markets by analysing data gathered from observation of the Swedish Facebook drug market and its participants. Design/methodology/approach Data were gathered during three months of digital ethnography conducted among Swedish Facebook posters supplemented by 25 interviews with sellers (20) and buyers (5). Screenshots and interview data were coded by carrying out an NVivo-based content analysis. The analysis is based on descriptive statistics of drug types, co-occurrence with other drugs, group size and the demographic characteristics of sellers. Additionally, the interviewees’ descriptions of the marketplace and their drug dealing or buying activities were included in the analysis. Findings In total, 57 Swedish Facebook groups that sold illegal substances were located. The groups rarely specialised in specific drug types, but were convened around demographic factors, such as specific cities and locales. The sales of prescription drugs were part of the overall activity of groups selling other illegal drugs, but they were more often sold in separate Facebook posts, possibly by specialist sellers. Swedish Facebook sales primarily concerned alprazolam, tramadol, pregabalin and clonazepam, and were sold by both professional and amateur sellers. Originality/value This study reports findings from a Nordic comparative study on social media drug dealing, representing the first in-depth study of digitally mediated prescription drug dealing outside of cryptomarkets.

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“…24,25 AAS use is associated with use of other image and performance enhancing drugs and psychoactive substances use, [26][27][28] and such a poly-drug taking repertoire is common. [29][30][31] For instance, high levels of psychoactive substance use, in particular stimulants, have been identified in cohorts of AAS users. 32,33 Comorbidity between use of psychoactive substances and AAS is complex and may reflect shared underlying brain deficits, 34 genetic vulnerabilities including personality factors, and/or early exposure to stress or trauma.…”

Section: Introductionmentioning

confidence: 99%

The Anabolic Androgenic Steroid Treatment Gap: A National Study of Substance Use Disorder Treatment

et al. 2020

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Background: Anabolic androgenic steroid (AAS) use is associated with serious mental and physical health problems. Evidence indicates that AAS use among people who use psychoactive substances is higher than in the general population. This study aims to estimate lifetime AAS use among patients in substance use disorder (SUD) treatment, compare characteristics of AAS and non-AAS users and identify whether AAS use was addressed during treatment. Methods: This cross-sectional survey included 563 (142 women, 24.2%) patients in 38 SUD treatment facilities in Norway. Respondents reported on AAS and substance use, and treatment experiences. Results: Lifetime AAS use was reported by 156 (28.3%) SUD patients, thereof 35.6% of the men and 8.0% of the women. Lifetime AAS use was highest among men with stimulants (55.8%) as preferred substance, and lowest among men who preferred alcohol (14.6%). Initiation of AAS use due to getting thinner following substance use was reported by 44.5% of the AAS using men. AAS users reported more severe substance use than non-AAS users. More than half (58%) of all patients had not been asked about AAS use, and 42.4% of those who were asked, experienced that treatment providers lacked expertise about AAS. Conclusion: Lifetime AAS use in this sample of SUD patients is common practice and comprise an underrecognized problem in SUD treatment. Given the deleterious implications to the individual and society that concomitant use of AAS may cause, it would be essential to raise the awareness about AAS use among SUD patients, and the level of competence among health professionals.

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Polydrug use and polydrug markets amongst image and performance enhancing drug users: Implications for harm reduction interventions and drug policy

Cited by 47 publications

References 31 publications

Treatments for people who use anabolic androgenic steroids: a scoping review

Treatments for people who use anabolic androgenic steroids: a scoping review

Social media markets for prescription drugs: platforms as virtual mortars for drug types and dealers

The Anabolic Androgenic Steroid Treatment Gap: A National Study of Substance Use Disorder Treatment

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