21.06.2017 Outline of a typology of men’s use of anabolic androgenic steroids in fitness and strength training environments International Conference on Doping Ask Vest Christiansen Sectionfor Sport Science, and Public Health Department of Public Health Oslo 7‐9 June Aarhus University [email protected] 1 Outline 1) What characterises users of anabolic androgenic steroids? 2) A typology of men’s use of AAS 3) Should interventions differ according to type of approach to use? 1 21.06.2017 Quantitative surveystudies Qualiative interview studies So, if you are a politician or a professional working with interventions, what The use of anabolic do you learn about users androgenic steroids (AAS) of AAS from these in fitness environments studies? 3 4 2 21.06.2017 What characterises AAS users? ‐ Cohen et al. (2007): Internet surveyof 1,955 AAS users. The typical user was a Caucasian, highly‐educated, gainfully employed professional approximately 30 years of age, who was earning an above‐average income, was not active in organized sports ‐ Barland& Tangen(2009): Survey at conscription. Users are 19 years; Grew up in a foster family; More often used tobacco, alcohol and marijuana; More often ended up in trouble than their peers. ‐ Pallesenet al. (2006). Survey high school students. Use of AAS were strongly related to use of other drugs such as alcohol, nicotine, and narcotics. Useis part of a general pattern of drug use and risk‐taking behavior. Myth that use of anabolic steroids is associated with a healthy athletic lifestyle. 5 What characterises AAS users? ‐ Parkinsson& Evans. (2006): US Internet survey among AAS users. 75% began AAS use after the age of 20; 99% experienced side effects, 78% did not participate in organised sport; 64% had routine health checks; 95% took other drugs to counter AAS induced side effects. ‐ Pope et al. (2014): US Meta survey. AAS use begins later than most drugs; 22% of users starting before age 20; Male/female ratio of about 50 to 1. Overall, 2.9–4.0 million Americans may have used AAS. ‐ EHFA (2012). Survey, +8,000 fitness customers. 2.5% had used AAS; The peak age group was 25‐49 years and not 15‐24; Use of recreational drugs by fitness customers is much lower than the general population; 42% of AAS users played another sport. 6 3 21.06.2017 What characterises AAS users – quantitative studies? ‐ Answering that question is a prerequisite for efficient policy interventions ‐ The answer depends on what studies you rely on ‐ Ranging from: ‐ ASS users are risk taking teenagers, often ending up in fights and using other kinds of recreational drugs ‐ To… ‐ AAS users are white, male professionals in their late 20s who otherwise leads a healthy life but take AAS for image enhancing reasons 7 Barland& Tangen, 2009; Bilard, Ninot, & Hauw, 2011; Christiansen & Bojsen‐Møller, 2012; Cohen et al., 2007; Grogan, Numerous qualitative studies, Shepherd, Evans, Wright, & Hunter, 2006; Ip, Barnett, for example… Tenerowicz, & Perry, 2011; Kimergård, 2015; Kimergård& McVeigh, 2014; Nøkleby& Skårderud, 2013; Petrocelli, Oberweis, & Petrocelli, 2008; Sagoe, Andreassen, & Pallesen, 2014). • These many qualitative studies paint a diverse picture of AAS use based on different experiences, motives, aims, strategies, and approaches • Contrasts with the one‐sided representations conjured in most media reports. 8 4 21.06.2017 What characterises AAS users – qualitative studies? Sport type users ‐ Bodybuilders ‐ Professional athletes ‐ Recreational athletes ‐ Strongman contesters Vocational users ‐ Doormen, bouncers ‐ Police officers ‐ Fire figthers ‐ Male strippers ‐ Models ‐ Soldiers ‐ … ‐ Anti‐ageing users 9 What happens if you begin looking for types of approach to AAS use, rather than individual parameters such as population, sport or vocation? 10 5 21.06.2017 Max Weber’s ideal typology as a way forward ‐ A typology is concerned with general or ideal‐ typical traits found in persons with similar approaches and motives ‐ Looking at AAS use: The purpose of the typology is to facilitate an understanding of otherwise confusing and multi‐facetted motives via the construction of types that emphasise the most consistent patterns of AAS users’ motives, approaches and behaviour. ‐ The typology is a heuristic devise that does not Max Weber 1864‐1920 necessarily describe real‐world people but is a way of learning about the real world. 11 Multifaceted individual voices and lifestyles… I went from listening to other [steroid] users to Well, it was the steroids that had our focus on study it myself. How does it work? Why does it weekdays. It was Saturdays we went downtown. work? What should be taken into account and We gathered after our training sessions. Then we so on? It’s been a process where I over the began to drink, and eventually amphetamine course of seven to eight years have built up was put on the table… Sometimes one of us knowledge. Actually, by now I think I could take would take some Winstrolbefore leaving, just, a minor degree in the body’s hormonal system. you know, to feel a bit more ripped and all that. What would you prefer to win, GP2 or Formula 1? I skip the GP2 step, because I can see that I’m good enough to be up there. Competition It is not a question of being a hugely muscular wise I can see that I want to be in the big class, giant. Now I just want to have a feeling of because I can get up there. I’ve got the talent, wellbeing. the genetics and the mentality. 6 21.06.2017 Typology on the use of anabolic androgenic steroids Risk YOLO type Athlete type Well, it was the steroids that had our focus on What would you prefer to win, GP2 or Formula 1? weekdays. It was Saturdays we went downtown. We I skip the GP2 step, because I can see that I’m gathered after our training sessions. Then we began to good enough to be up there. Competition wise I drink, and eventually amphetamine was put on the can see that I want to be in the big class, because table… Sometimes one of us would take some Winstrol I can get up there. I’ve got the talent, the before leaving, just, you know, to feel a bit more ripped genetics and the mentality. and all that. Effectiveness Wellbeing type Expert type I went from listening to other [steroid] users to study it myself. How does it work? Why does it It is not a question of being a hugely muscular work? What should be taken into account and so giant. Now I just want to have a feeling of on? It’s been a process where I over the course of wellbeing. seven to eight years have built up knowledge. Actually, by now I think I could take a minor degree in the body’s hormonal system. Expert type ”Most people know that you “I went from listening to other shouldn’t just take a steroid and users to study it myself. How does then you grow. It actually does it work? Why does it work? What something to your body. There should be taken into account and are adverse effects. No matter so on? It’s been a process where I what people say: steroids are bad over the course of seven to eight for your body. I’m not trying to years have built up knowledge. hide that. But there are ways to Actually, by now I think I could protect yourself, so you can move take a minor degree in the body’s beyond the side effects promoted hormonal system.” by the media.” 14 7 21.06.2017 Expert type ”I find the medical science “I measure my blood pressure behind it fascinating, and I can at home every other day, and come up with many excuses then I make a note simply to for how I justified using gear see if it’s going up or down. [AAS], but I like the idea of Everyone should do that. At putting theory into practice least if you’re on a cycle [of and see if you have learned steroids]. And you should also enough by reading online… if be doing it when you reach a you can put that into practice. certain age in life. Because And I could. So, I think it’s nice you cannot really feel elevated that you can learn such things blood pressure.” by yourself. ” 15 Expert type – Summary 1. Motivated by lay scientific curiosity and a fascination with pharmacological performance enhancement 2. Focus on muscularity, learning and knowledge sharing 3. Very concerned with side effects and wants to play it safe 4. Aims at optimising benefits with a perceived sensible drug regimen 5. High level of knowledge –based on various sources including scientific papers 6. Values health and monitors his body systematically (e.g. in collaboration with physician) 7. Offers advice on harm reduction to others and seeks recognition as a source of expertise on AAS 16 8 21.06.2017 Typology on the use of AAS in gyms Risk Effectiveness Expert type 1. Motivated by lay scientific curiosity and a fascination with pharmacological performance enhancement 2. Focus on muscularity, learning and knowledge sharing 3. Very concerned with side effects and wants to play it safe 4. Aims at optimising benefits with a perceived sensible drug regimen 5. High level of knowledge –based on various sources including scientific papers 6. Values health and monitors his body systematically (e.g. in collaboration with physician) 7. Offers advice on harm reduction to others and seeks recognition as a source of expertise on AAS Wellbeing type “Well, I was born with an injury‐ “I think it helps you to stay young, prone body, and I’ve had all kinds of right? You feel a little better, and injuries throughout my life. But you feel more rested in the since I started training and taking morning. Your skin becomes more steroids, I’ve had nothing. My youthful to look at, and your energy general well‐being has improved a level is generally higher. I see it as a lot, so the training and the steroids supplement for well‐being, so I’m really made a difference. I feel much not using it [hGH] to gain size but better than I did before. The pain in mostly to improve my own well‐ my back is completely gone. I had being.” chronic back‐pain before, that’s just gone now because I spend so much time in the gym.” 18 9 21.06.2017 Wellbeing type “I’ll most likely be using it [AAS and hGH] for the rest of my life. At least ” It is not a question of being a as long as I’m able to take care of hugely muscular giant. Now I just myself and to continue training. But want to have a feeling of wellbeing”. I think now I’m more reflexive about the substances and dosages that I use. And as I’ve grown older it is now also more a question of well‐ being and of maintaining my level of fitness rather than setting unrealistic goals that can only be achieved by taking massive doses of something really toxic.” 19 Wellbeing type – Summary 1. Motivatedby vanity and/or wishes for restoration or rejuvenation 2. Focus on well‐being, moderation and peer recognition (e.g. during summertime) 3. Considers side effects and wants to play it safe 4. Aims at slight improvements 5. Medium level of knowledge –based on own experience, online fora and other users 6. Wants to improve his quality of life and has a relaxed take on nutrition 7. Focus on healthy living and are typically older than the other types 20 10
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