This article is a condensed version of a university assignment I submitted (as part of one of my assessments last semester) on Androgenic Anabolic Steroid Usage.
*Disclaimer*
This is not an attempt to bash or throw a dig at someone who uses AAS. This is just a review of a meta analysis, which I am hoping to inform and educate my readers with this blog post.
Just because this is a meta analysis, it does not mean we should take its word for it. We should be critical of how it was made, the potential bias of the researcher(s), and the level of rigor for the methodology (validity and reliability).
Remember I am discussing this in the context of recreational usage of AAS, not in the context of competitive sports (they are two entirely different topics of discussion) and as a competitive athlete and member of UK Anti-Doping I am not in favor of using AAS in a tested sporting environment to gain an unfair and non sportsmanship advantage over one's opponent.
Enjoy reading!
*Disclaimer*
This is not an attempt to bash or throw a dig at someone who uses AAS. This is just a review of a meta analysis, which I am hoping to inform and educate my readers with this blog post.
Just because this is a meta analysis, it does not mean we should take its word for it. We should be critical of how it was made, the potential bias of the researcher(s), and the level of rigor for the methodology (validity and reliability).
Remember I am discussing this in the context of recreational usage of AAS, not in the context of competitive sports (they are two entirely different topics of discussion) and as a competitive athlete and member of UK Anti-Doping I am not in favor of using AAS in a tested sporting environment to gain an unfair and non sportsmanship advantage over one's opponent.
Enjoy reading!
Methodology of Literature
Review
A
literature search was carried out on Sports Discus, Google Scholar and Science
Direct with
using keywords “AAS”, “Anabolic Steroids”, “Muscle Dysmorphia”,
“Body Image”, and “Anabolic
Steroids Meta-Analysis”. Through analyzing the
literature search, the Meta-Analysis entitled
“The global epidemiology of
anabolic-androgenic steroid use: a meta-analysis and meta-regression
analysis” (2014)
was found.
Sagoe, D., Molde, H., Andreassen, C.S., Torsheim, T. and Pallesen, S., 2014. The global epidemiology of anabolic-androgenic steroid use: a meta-analysis and meta-regression analysis. Annals of epidemiology, 24(5), pp.383-398. This reviewed 271 papers and was deemed a suitable reference for
analyzing
AAS trends over time. To do this, in Appendix 1 the adapted Data Inclusion and
Exclusion Criteria was imposed upon the 271 Journals, 61 of which met the
criteria. These papers
were across the following two defined time periods;
1.
1985 – 1999
2.
2000 – 2015
The
reason for the two time periods is to compare usage at the turn of the century
and then review a
new generation of “AAS users” - 15 years later which may
highlight new trends. In addition, the
introduction of certain external factors
has made getting AAS easier in the 21st Century. These
time periods are also
cross-referenced geographically as follows:
1. United
Kingdom
2.
North America
3.
Rest of World
This
is for comparison within each region as different countries have dissimilar
laws on accessibility
for AAS. E.g. in
the UK it is easier to obtain AAS than in America (Kokkevi, et al, 2008).
Furthermore, data between each geographical area and can be found in Appendices
2 and 3 which
formulated the Flow – Chart 1.0
and 2.0 below.
How
has there been such an increase in AAS usage over the last 15 years
compared to
1985-1999? There is no one simple answer as there are plenty of
contributing multi factorial issues.
If I was to pick three;
• Internet
Access: This has to lead to an increase of buying steroids and the most
popular place
for internet users is off black market sites and the dark web
(DuRant et al., 1993: 923).
• Influence
of Social Media: The encouragement of the steroid user has been negatively
influenced by unrealistic images and beliefs circulated on social media. These
have massive cult
followings (Instagram) behind them due to their lavish, appealing and large than life lifestyles,
thus encouraging those with already frail perceptions of their masculinity to follow them. (Field et al, 2005). Again with reference to symbolic violence.
• Job
Roles: Police, army, fire service, private security, construction, etc use
steroids for their
physical jobs, but there is an increase in other professions
such as doctors, coaches and teachers to
use AAS to look and feel powerful and
authoritative when dealing with clients or patients
(Kimmel and Mahalik, 2004; Magnolia
Pictures & Magnet Releasing, 2008).
Future Research
Recommendations and Summary
In
order to raise awareness and to help those suffering with BI, MD or perhaps an addiction to AAS,
the Image and Performance Enhancing Drugs (IPEDs) publish literature reviews and steroid awareness guides within the UK to educate and inform users or potential users as part of the
Lifeline Project
(Lifeline, 2017). Another example of a successful scheme is Drugs in
Sport Clinic and User Support (DISCUS) in Durham (Frank, 2016). It ran for fifteen years educating the public on how to train, eat correctly, use AAS safely and the potential negative side effects of using AAS, but its funding was cut. This is an issue when one of the local towns (Middlesbrough) which was named the UK capital for steroid usage (GazetteLive, 2016).
Across
the pond, the Adolescents Training and Learning to Avoid Steroids (ATLAS) study
in
America (1996) was created to reduce the increase in steroid usage at school
level. At the end of
the program, students reported better understanding of the
effects (positive and negative) and
also encouraged better lifestyle (diet and
training) habits (Goldberg et al, 1996). Regrettably, a
year after the ATLAS
program, the American Paediatrician Association stated “to our knowledge,
no
study has identified an adolescent population without the temptation and risks
of anabolic steroid
use. Furthermore, no study has been published showing a
decrease in the prevalence of anabolic
steroid use over time” (Miller et al
2002). This can be evidenced with the data shown in Flow -
Chart 1.0 and 2.0.
What
is required is a data analysis on a large scale to determine behavioral
tendencies of the 21st
century AAS user. The government needs to recognize this matter and its ultimate effect it will have
on the NHS if unchecked. That way, new intervention programmes can be put into immediate effect at hospitals and drug/alcohol clinics. This should minimize any increase in ujnderground AAS usage, eventually reducing it over time whilst decreasing MD and related issues. However, this is easier said than done as getting access to this data requires having trust within the gym and fitness sub-cultures to open up about the stigma that surrounds MD and AAS usage and acquisition.
Appendices
Appendix
1: Data Collection Inclusion and Exclusion Criteria to formulate argument:
61 studies were included
in this review. Inclusion of these studies was due to them meeting the
following;
I)
Male and female included in data
collection within respective journals.
II)
N sample size value shown (showing both
male and female breakdown).
III)
% breakdown of AAS used by males and
females.
IV)
Paper had to contain either one or more of
the following keywords; High School/School/
Adolescents/Gym/General/Prison/Ex
Prisoner/Prisoner/Drug User/Athlete/Athletics/NFL/Sports.
V)
Studies must be within 1985 – 2015.
VI)
Studies must show survey response rates.
210 Studies were excluded
from the data analysis if they did not meet the following;
I)
Studies did not show AAS prevalence rates
II)
Studies did not show survey response rates
III)
Studies did not show any gender breakdown
of sample population
IV)
Studies did not show sample sizes
Appendix 2.0 Limitations of the Literature and Data
Within any study or methodology there are some limitations to the data collection which are
identified as follows: regarding questionnaires, it is to be assumed people can lie and that they are
limited to what they can answer (Beiske, 2002) due to the questions that are set. Each studies’
questions will be different to some degree bar a few standardised statements requiring answers.
The can be duplicated if subjects are used more than once, however this is unknown as
participants’ are left out in accordance with the Data Protection Act (Act, 1998). There is
more research being done in the 21st Century on AAS than in previous years.
This can be shown in the papers
This is due to the popularity of AAS being used and studied at an academic level. Regrettably
this places bias and an unfavorable slant to presenting any case. The data gathered is from
multiple populations so one cannot assume that all AAS users are all athletes, teenagers, males or
females etc. The main purpose was to identify the difference in usage over time. Considering
some of the studies, a few had very poor replies to their questionnaires whereas others were
excellent. These ranged from a 2.7% response to up to 100%.
This no doubt effects the reliability of the study. Adding to that, some studies had very small
sample sizes thus also presenting potentially unrealistic or misleading data (Beiske, 2002). A
significant majority of the studies analysed did not meet the criteria. If they did, the data may
have changed significantly (in favour of an increase usage of AAS). Finally, as previously
mentioned, different countries have different laws on steroid availability and accessibility
(Anabolics.com Advanced Science of Muscle Building, 2017 and Sted-Ed Steroid Education,
2017) which may also affect recruitment numbers for data collection.
To see the breakdown of the papers and the stats they are at the bottom of the page. There is a
big break in the text as the tables extend across the page. Do allow the table to be fully seen
we have had to knock them way down so no adverts down the side will interfere with
them. Apologies for this presentation error bu eblogger does not support formatting tables.
 Once both my final Master projects are completed I will write them up on this as it goes more into detail into AAS culture, gym culture, negatives of social media.
Appendix 3 Table 2.0 Data of all AAS
and Non AAS users across 21 Studies over a 15 year period.
Appendix 4 Table 3.0 Data of all AAS and Non AAS users across 40 Studies over a 15 year period.
Andrew Richardson, Founder of Strength is Never a Weakness Blog  I have a BSc (Hons) in Applied Sport Science and a Merit in my MSc in Sport and Exercise Science and I passed my PGCE at Teesside University. Now I will be commencing my PhD into "Investigating Sedentary Lifestyles of the Tees Valley" this October 2019. I am employed by Teesside University Sport and WellBeing Department as a PT/Fitness Instructor. My long term goal is to become a Sport Science and/or Sport and Exercise Lecturer. I am also keen to contribute to academia via continued research in a quest for new knowledge. My most recent publications: My passion is for Sport Science which has led to additional interests incorporating Sports Psychology, Body Dysmorphia, AAS, Doping and Strength and Conditioning. Within these respective fields, I have a passion for Strength Training, Fitness Testing, Periodisation and Tapering. I write for numerous websites across the UK and Ireland including my own blog Strength is Never a Weakness.  I had my own business for providing training plans for teams and athletes. I was one of the Irish National Coaches for Powerlifting, and have attained two 3rd places at the first World University Championships, in Belarus in July 2016.Feel free to email me or call me as I am always looking for the next challenge. Contact details below; Facebook: Andrew Richardson (search for) Facebook Page: @StrengthisNeveraWeakness Twitter: @arichie17 Instagram: @arichiepowerlifting Snapchat: @andypowerlifter Email: a.s.richardson@tees.ac.uk Linkedin: https://www.linkedin.com/in/andrew-richardson-b0039278 Research Gate: https://www.researchgate.net/profile/Andrew_Richardson7 |
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