The Anabolic Androgenic Steroid Treatment Gap: A National Study of Substance Use Disorder Treatment

Ingrid Amalia Havnes; Marie Lindvik Jørstad; Jim McVeigh; Marie-Claire Van Hout; Astrid Bjørnebekk

doi:10.1177/1178221820904150

The Anabolic Androgenic Steroid Treatment Gap: A National Study of Substance Use Disorder Treatment

Subst Abuse. 2020 Feb 18:14:1178221820904150. doi: 10.1177/1178221820904150. eCollection 2020.

Authors

Ingrid Amalia Havnes¹, Marie Lindvik Jørstad¹, Jim McVeigh², Marie-Claire Van Hout³, Astrid Bjørnebekk¹

Affiliations

¹ The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
² Substance Use and Associated Behaviours, Department of Sociology, Manchester Metropolitan University, Manchester, UK.
³ Public Health Institute, Faculty of Education, Health & Community, Liverpool John Moores University, Liverpool, UK.

Abstract

Background: Anabolic androgenic steroid (AAS) use is associated with serious mental and physical health problems. Evidence indicates that AAS use among people who use psychoactive substances is higher than in the general population. This study aims to estimate lifetime AAS use among patients in substance use disorder (SUD) treatment, compare characteristics of AAS and non-AAS users and identify whether AAS use was addressed during treatment.

Methods: This cross-sectional survey included 563 (142 women, 24.2%) patients in 38 SUD treatment facilities in Norway. Respondents reported on AAS and substance use, and treatment experiences.

Results: Lifetime AAS use was reported by 156 (28.3%) SUD patients, thereof 35.6% of the men and 8.0% of the women. Lifetime AAS use was highest among men with stimulants (55.8%) as preferred substance, and lowest among men who preferred alcohol (14.6%). Initiation of AAS use due to getting thinner following substance use was reported by 44.5% of the AAS using men. AAS users reported more severe substance use than non-AAS users. More than half (58%) of all patients had not been asked about AAS use, and 42.4% of those who were asked, experienced that treatment providers lacked expertise about AAS.

Conclusion: Lifetime AAS use in this sample of SUD patients is common practice and comprise an underrecognized problem in SUD treatment. Given the deleterious implications to the individual and society that concomitant use of AAS may cause, it would be essential to raise the awareness about AAS use among SUD patients, and the level of competence among health professionals.

Keywords: anabolic androgenic steroids; health services; human enhancement drugs; image and performance enhancing drugs; substance use disorder; substances use disorder treatment.