Polypharmacy among anabolic-androgenic steroid users: a descriptive metasynthesis

Abstract

BackgroundAs far as we are aware, no previous systematic review and synthesis of the qualitative/descriptive literature on polypharmacy in anabolic-androgenic steroid(s) (AAS) users has been published.MethodWe systematically reviewed and synthesized qualitative/descriptive literature gathered from searches in electronic databases and by inspecting reference lists of relevant literature to investigate AAS users’ polypharmacy. We adhered to the recommendations of the UK Economic and Social Research Council’s qualitative research synthesis manual and the PRISMA guidelines.ResultsA total of 50 studies published between 1985 and 2014 were included in the analysis. Studies originated from 10 countries although most originated from United States (n = 22), followed by Sweden (n = 7), England only (n = 5), and the United Kingdom (n = 4). It was evident that prior to their debut, AAS users often used other licit and illicit substances. The main ancillary/supplementary substances used were alcohol, and cannabis/cannabinoids followed by cocaine, growth hormone, and human chorionic gonadotropin (hCG), amphetamine/meth, clenbuterol, ephedra/ephedrine, insulin, and thyroxine. Other popular substance classes were analgesics/opioids, dietary/nutritional supplements, and diuretics. Our classification of the various substances used by AAS users resulted in 13 main groups. These non-AAS substances were used mainly to enhance the effects of AAS, combat the side effects of AAS, and for recreational or relaxation purposes, as well as sexual enhancement.ConclusionsOur findings corroborate previous suggestions of associations between AAS use and the use of other licit and illicit substances. Efforts must be intensified to combat the debilitating effects of AAS-associated polypharmacy.

Identifying a typology of men who use anabolic androgenic steroids (AAS)

“…Instrumental use refers to use that is based on the effects of the drug for a specific purpose. For example, stimulants such as amphetamine may be used to facilitate training, enhance fat loss and suppress appetite (Sagoe et al, 2015). The Athlete type are noted for combining steroids with other enhancement drugs (polypharmacy), therefore instrumental use of psychoactive drugs would be in line with the profile.…”

“…However, as we were unable to discern the purpose of psychoactive drug use from our data we cannot determine whether or not the use of psychoactive substances was primarily motivated by recreational or instrumental goals. Instrumental use of psychoactive substances has been noted among bodybuilding samples and may be occurring among this group (Sagoe et al, 2015). Instrumental use refers to use that is based on the effects of the drug for a specific purpose.…”

Community pharmacist experiences of providing needle and syringe programmes in Ireland

“…There are indications that Ireland, like the United Kingdom, will experience increases in those injecting PIEDs, a widening pharmacopeia 54 including anabolic steroids, growth hormones and tanning agents, together with an ever changing array of novel psychoactive substances. 55 It is essential that the changing profile of injectors is acknowledged and appropriate training developed and delivered…”

“Mer hjelp, mindre moralpreken”

“…Andre studier har dokumentert at mange brukere jevnlig tar medisinske undersø-kelser under bruk, men at en ofte ikke diskuterer selve bruken med lege, på grunn av en opplevelse av manglende kunnskap om AAS (Cohen et al, 2007;Parkinson & Evans, 2006). Svaert mange forsøker også å selvmedisinere bort bivirkninger i stedet for å avslutte bruk av AAS (Parkinson & Evans, 2006;Sagoe et al, 2015). En tidligere kvalitativ studie peker på at opplevelsen av manglende kunnskap om AAS blant helsepersonell, kan føre til at brukere i større grad vender seg til andre brukere når de trenger råd eller informasjon om AAS (Monaghan, 1999).…”