Original article
Steroid and prescription medicine abuse in the health and fitness community: A regional study

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Abstract

Background

The purpose of this study was to identify the prevalence of abuse of certain prescription medicines (POM) amongst health club attendees. The non-therapeutic use of such medicines has previously been considered to be restricted to the professional athlete.

Methods

In the summer of 2005, health club users in the South Wales area were given questionnaires and asked to return them in a stamped, addressed envelope. Anonymity of the respondents was assured.

Results

From the distribution of 210 questionnaires, the response rate was 69.5% (146 questionnaires). The mean age of the sample was 33.6 ± 6.7 years (range 15–72 years). Anabolic-androgenic steroid (AAS) use is prominent amongst recreational gym users in this regional sample, with 70% (102 individuals) reporting AAS use, 65.8% (96 individuals) of whom were currently still using. Some 7% of respondents (10 individuals) were female and they also reported taking medication. This research demonstrated an enormous increase in the use of growth hormone (24%), insulin (14%), and tamoxifen (22%), with smaller increases in other drugs.

Conclusion

Drug users were from all levels of society and reported various physiological and psychological side effects from their use. The present study indicated that the most used medicine/drug from less than reputable sources was still AAS but that, as a consequence of the internet revolution, they were being caught up by the more expensive designer drugs, particularly growth hormone. Physicians and medical personnel must become aware that the use of AAS and other prescription medicines is on the increase and appears to be predominantly used for cosmetic reasons.

Introduction

Anabolic-androgenic steroids (AAS) are a powerful group of natural or synthetic compounds similar in chemical structure to the natural male steroid hormone testosterone. Synthetic steroids differ from the natural androgenic steroid testosterone by alterations in basic structure. These alterations include the addition of ethyl, methyl, hydroxyl, or benzyl groups at one or more sites along the synthetic steroid structure.

The risks from chronic administration of AAS may appear relatively low when compared to the use of socially acceptable drugs, such as tobacco and alcohol. The literature tends to rely heavily on specific case reports because of the private and personal nature of the abuse of this class of drug. Apart from the few desirable cosmetic effects, the use of AAS has undesirable effects, which have been extensively reviewed [1], [2].

The literature pertaining to non-therapeutic AAS use tends to be aimed at athletes of differing competitive sporting orientations, but there would appear to be little research to date on health club users in the UK. Much of the literature related to AAS use comes from studies conducted in the United States. Evidence from the US also indicates that AAS is not confined to the competitive athlete. AAS users can be found among health and fitness enthusiasts as well as collegiate and high school students. It was estimated [3] that, in the mid 1980s, approximately one million Americans were using AAS for physique enhancement. Sadly, no epidemiological study to date has demonstrated a decrease in AAS administration.

The first nationwide AAS survey in the UK [4] surveyed 21 gyms throughout Britain and found that 8% of respondents admitted having taken AAS at sometime, 5% of which were current users (9.1% of men and 2.3% of women). There was, however, considerable variability between gyms, ranging from no use in one gym to 46% in another. A survey of 100 AAS-using athletes was conducted in three South Wales counties [5], reporting high rates of polypharmacy (80%) with a wide array of other drugs amongst their sample group. A further study examined AAS use amongst 176 users in Cardiff (171 men and 5 women) and highlighted that 37% of respondents indicated a need for more knowledge among drug workers and a less prejudiced attitude from general practitioners [6].

Also, the use of other drugs, such as growth hormone and insulin, would appear to be increasing and their use is widespread in sport [7]. Most athletes competing at the highest level also use some form of dietary supplementation [8]. However, this is not just confined to athletic performance, and individuals on weight-reducing programmes, wishing to lose body fat, use dietary supplements as a standard therapy and also have knowledge of other more powerful hormones, such as growth hormone.

The purpose of this study was to establish which drugs, in addition to AAS, were being abused in health clubs and to determine whether the extent of the abuse was increasing.

Section snippets

Methods

Ethical approval for this study was granted by the University Ethics Committee. The health clubs were commercial fitness clubs attached to hotels in the South Wales area. The gymnasia included in this survey were chosen following information from current AAS users, already on the database from the previous research by Grace et al. in 2001 [9]. These were “hardcore” gymnasia, endowed with a wide variety of heavy-duty weight training equipment, as previously described [10], and were predominantly

Results

Some 210 health club users were offered a questionnaire, of which 146 were returned and completed, giving a response rate of 69.5%. Of the respondents, 70% (102/146) had used AAS within the previous year and 65.8% (96) were currently using. Seven percent (10/146) of the respondents were female. The demographic and social characteristics of the respondents indicated that AAS users were from differing socio-economic backgrounds. Eighty-five percent of the AAS users were in full-time employment

Discussion

The prevalence of AAS use in this study is the highest reported in any study to date in the UK, with 70% of the clientele being regular AAS users. The incidence of AAS use in this study is considerably higher than the most recent Welsh report, by Grace et al., of 53% [9] and of the 39% reported by Perry and Littlepage in 1992 [11].

There was a wide age range noted amongst the AAS users, with the youngest respondent being 15 years old. The prevalence of AAS use amongst children in South Wales is

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