Executive summary

The use of anabolic-androgenic steroids (AAS) has gained widespread attention because of its use in the sporting arena, with high profile sporting identities testing positive to one or more banned anabolic substance. In addition, links have been made between the illicit use of these compounds with aggressive and often violent behaviour in animals and humans. The present study of 100 anabolic-androgenic steroid users sought to address the paucity of research into anabolic-androgenic steroid use in Australia by examining the patterns and correlates of anabolic-androgenic steroid use by a variety of groups in the community.

The present study has identified AAS as a very discrete sub-group of illicit drug users. This sample of AAS users were more likely to be male, homosexual, in a stable relationship, well educated and in full or part-time employment than other groups of injecting drug users recently studied in Australia. This sample also had a substantially higher disposable income than the general Australian community, with only 27% earning less than $30,000 per annum. In common with other illicit drug users, however, in addition to the perceived benefits of the drug, they experience significant negative health and psychological effects of their AAS use. In a small, but important, proportion of AAS users this includes the development of problems with dependence and withdrawal and irreversible side-effects. This study also reported the first documented case of AAS dependence in a woman using a variety of measures.

Although the majority of subjects in the study felt that the benefits of their AAS use outweighed any negative aspects of use, there were still significant numbers of side effects reported by the sample. These included irreversible side-effects in women of deepening of the voice and clitoral enlargement. Nearly half of the participants reported that their behaviour was more aggressive when using AAS and 26% reported experiencing the phenomenon known as `roid rages'.

AAS users tend to be a very health conscious group who use low levels of other psychoactive drugs and engage in rigorous physical exercise and training on a regular basis. Subjects reported that the most likely deterrent to AAS use was health concerns and this was idenified as an important issue to be discussed in harm reduction activities.

A number of activities that the AAS users in the present sample engaged in, however, were potentially harmful. These include self-taught injection procedures; injecting specific muscles for localised muscle growth (calves, biceps); concurrent use of AAS (stacking) and use of high doses; use of other drugs such as clenbuterol, thyroxine, insulin and human growth hormone, nutritional supplements; and among the gay group in particular, concurrent use of recreational drugs, both licit and illicit.

The AAS user is actively involved in the seeking out of information that is relevant to their patterns of use, with the objective of increasing the benefits and reducing the side effects. Many users in this study expressed a desire to access a well informed medical practitioner as their most preferred source of information. The most common sources of information utilised, however, were not entirely reliable. There is much scope, therefore, for the improvement of harm reduction information to this eager group.

The present study has suggested a number of fruitful avenues for further research and intervention activities which will assist in the reduction of harm experienced by anabolic-androgenic steroid users.