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