1
|
Paoli L, Joseph Cox LT. Across the spectrum of legality: The market activities of influencers specialized in steroids and other performance and image enhancing drugs. Int J Drug Policy 2024; 123:104246. [PMID: 37979285 DOI: 10.1016/j.drugpo.2023.104246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Like many other goods and services, performance and image enhancing drugs (PIEDs), and particularly androgenic anabolic steroids (AAS), are increasingly discussed and promoted by social media influencers. Little, however, is known about the influencers specialized in PIEDs and which drugs and services they promote and sell. AIMS Against this background, the study has been intended to identify prominent influencers specialized in PIEDs, examine the market activities they engage in, and assess the latter's legality. METHODS We first searched the clean internet to identify prominent PIED influencers. Second, we conducted a six-month-long, non-reactive digital ethnography of the social media accounts of 20 influencers and, via a content analysis, identified the market activities they engage in. Third, we assessed the latter's legality, primarily using the EU legislation as a benchmark. FINDINGS The selected influencers are all current or former bodybuilders, predominantly male and from the United States. Many of them have developed a considerable number of followers, in three cases exceeding one million. They engage in various market activities that span the whole spectrum of legality, from legal to illegal, with many activities having an uncertain, but often dubious, legal status. CONCLUSIONS Though they may promote harm reduction for some users, PIED influencers also promote the public acceptance of PIED use beyond the bodybuilding community and enhance access to PIEDs for millions of people. Multifaceted policy interventions are required, aiming at preventing influencers from becoming a major source of information on, and route of access to, PIEDs.
Collapse
Affiliation(s)
- Letizia Paoli
- Professor and Chair of the Department Criminal law and Criminology, KU Leuven Faculty of Law and Criminology, Tiensestraat 41, B3000 Leuven, Belgium.
| | - Luke Thomas Joseph Cox
- KU Leuven, Faculty of Movement and Rehabilitation Sciences, Tervuursevest 101 - box 1500, B3000 Leuven, Belgium
| |
Collapse
|
2
|
Butzke I, Iff S, Zitzmann M, Quednow BB, Claussen MC. Interdisciplinary and Psychiatric Treatment of Anabolic Androgenic Steroids Users. Praxis (Bern 1994) 2022; 111:e339-e344. [PMID: 35473322 DOI: 10.1024/1661-8157/a003868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The prevalence of anabolic androgenic steroid (AAS; anabolic steroids) use in recreational sports is underestimated. Due to the influence of social media, an increase in AAS use in recreational sports and in the general population is to be expected. AAS use is associated with significant physical and mental health consequences, and the psychiatric consequences include the risk of developing addictive behaviour. The widespread stigmatization of AAS use also by professionals often undermines users' trust in physicians and drives them into the arms of so-called "gurus." The tightening of anti-doping practices in sports and an exclusively prohibitive stance have so far failed to convincingly curb the problem in recreational sports. Harm reduction strategies could help patients to get the help they need from primary care providers.
Collapse
Affiliation(s)
- Ingo Butzke
- Clinic for Psychosis and Dependence, PZM Psychiatry Center Münsingen AG, Münsingen, Switzerland
| | - Samuel Iff
- Clinic for Psychosis and Dependence, PZM Psychiatry Center Münsingen AG, Münsingen, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Zitzmann
- Center for Reproductive Medicine and Andrology, Department of Clinical and Operative Andrology, University Hospital Münster, Westfälische Wilhelms-Universität Münster, Germany
| | - Boris B Quednow
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Malte Christian Claussen
- Clinic for Psychosis and Dependence, PZM Psychiatry Center Münsingen AG, Münsingen, Switzerland
- Private Clinic Wyss AG, Münchenbuchsee, Switzerland
- Adult Psychiatry, Psychiatric Services Grisons, Chur, Switzerland
| |
Collapse
|
3
|
Onakomaiya MM, Henderson LP. Mad men, women and steroid cocktails: a review of the impact of sex and other factors on anabolic androgenic steroids effects on affective behaviors. Psychopharmacology (Berl) 2016; 233:549-69. [PMID: 26758282 DOI: 10.1007/s00213-015-4193-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 12/11/2015] [Indexed: 12/26/2022]
Abstract
RATIONALE For several decades, elite athletes and a growing number of recreational consumers have used anabolic androgenic steroids (AAS) as performance enhancing drugs. Despite mounting evidence that illicit use of these synthetic steroids has detrimental effects on affective states, information available on sex-specific actions of these drugs is lacking. OBJECTIVES The focus of this review is to assess information to date on the importance of sex and its interaction with other environmental factors on affective behaviors, with an emphasis on data derived from non-human studies. METHODS The PubMed database was searched for relevant studies in both sexes. RESULTS Studies examining AAS use in females are limited, reflecting the lower prevalence of use in this sex. Data, however, indicate significant sex-specific differences in AAS effects on anxiety-like and aggressive behaviors, interactions with other drugs of abuse, and the interplay of AAS with other environmental factors such as diet and exercise. CONCLUSIONS Current methods for assessing AAS use have limitations that suggest biases of both under- and over-reporting, which may be amplified for females who are poorly represented in self-report studies of human subjects and are rarely used in animal studies. Data from animal literature suggest that there are significant sex-specific differences in the impact of AAS on aggression, anxiety, and concomitant use of other abused substances. These results have relevance for human females who take these drugs as performance-enhancing substances and for transgender XX individuals who may illicitly self-administer AAS as they transition to a male gender identity.
Collapse
|
4
|
Busardò FP, Frati P, Sanzo MD, Napoletano S, Pinchi E, Zaami S, Fineschi V. The impact of nandrolone decanoate on the central nervous system. Curr Neuropharmacol 2016; 13:122-31. [PMID: 26074747 PMCID: PMC4462037 DOI: 10.2174/1570159x13666141210225822] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 10/10/2014] [Accepted: 10/25/2014] [Indexed: 01/31/2023] Open
Abstract
Nandrolone is included in the class II of anabolic androgenic steroids (AAS) which is
composed of 19-nor-testosterone-derivates. In general, AAS is a broad and rapidly increasing group
of synthetic androgens used both clinically and illicitly. AAS in general and nandrolone decanoate
(ND) in particular have been associated with several behavioral disorders. The purpose of this review
is to summarize the literature concerning studies dealing with ND exposure on animal models, mostly
rats that mimic human abuse systems (i.e. supraphysiological doses). We have focused in particular
on researches that have investigated how ND alters the function and expression of neuronal signaling molecules that
underlie behavior, anxiety, aggression, learning and memory, reproductive behaviors, locomotion and reward.
Collapse
Affiliation(s)
- Francesco P Busardò
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy; ; Neuromed, Istituto Mediterraneo Neurologico (IRCCS), Via Atinense 18, Pozzilli, 86077 Isernia, Italy
| | - Mariantonia Di Sanzo
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy
| | - Simona Napoletano
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy
| | - Enrica Pinchi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy
| |
Collapse
|
5
|
Frati P, Kyriakou C, Del Rio A, Marinelli E, Vergallo GM, Zaami S, Busardò FP. Smart drugs and synthetic androgens for cognitive and physical enhancement: revolving doors of cosmetic neurology. Curr Neuropharmacol 2016; 13:5-11. [PMID: 26074739 PMCID: PMC4462043 DOI: 10.2174/1570159x13666141210221750] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 11/22/2022] Open
Abstract
Cognitive enhancement can be defined as the use of drugs and/or other means with the
aim to improve the cognitive functions of healthy subjects in particular memory, attention, creativity
and intelligence in the absence of any medical indication. Currently, it represents one of the most
debated topics in the neuroscience community. Human beings always wanted to use substances to
improve their cognitive functions, from the use of hallucinogens in ancient civilizations in an attempt
to allow them to better communicate with their gods, to the widespread use of caffeine under various
forms (energy drinks, tablets, etc.), to the more recent development of drugs such as stimulants and glutamate activators.
In the last ten years, increasing attention has been given to the use of cognitive enhancers, but up to now there is still only
a limited amount of information concerning the use, effect and functioning of cognitive enhancement in daily life on
healthy subjects. The first aim of this paper was to review current trends in the misuse of smart drugs (also known as
Nootropics) presently available on the market focusing in detail on methylphenidate, trying to evaluate the potential risk
in healthy individuals, especially teenagers and young adults. Moreover, the authors have explored the issue of cognitive
enhancement compared to the use of Anabolic Androgenic Steroids (AAS) in sports. Finally, a brief overview of the
ethical considerations surrounding human enhancement has been examined.
Collapse
Affiliation(s)
- Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy; ; Neuromed, Istituto Mediterraneo Neurologico (IRCCS), Via Atinense 18, Pozzilli, 86077 Isernia, Italy
| | - Chrystalla Kyriakou
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy
| | - Alessandro Del Rio
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy
| | - Enrico Marinelli
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy
| | - Gianluca Montanari Vergallo
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy
| | - Francesco P Busardò
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161, Rome, Italy
| |
Collapse
|
6
|
Abstract
Since the 1970s anabolic androgenic steroids (AAS) have been abused at ever increasing rates in competitive athletics, in recreational sports and in bodybuilding. Exceedingly high doses are often consumed over long periods, in particular by bodybuilders, causing acute or chronic adverse side effects frequently complicated by additional polypharmacy. This review summarizes side effects on non-reproductive organs and functions; effects on male and female reproduction have been recently reviewed in a parallel paper. Among the most striking AAS side effects are increases in haematocrit and coagulation causing thromboembolism, intracardiac thrombosis and stroke as well as other cardiac disturbances including arrhythmias, cardiomyopathies and possibly sudden death. 17α-alkylated AAS are liver toxic leading to cholestasis, peliosis, adenomas and carcinomas. Hyperbilirubinaemia can cause cholemic nephrosis and kidney failure. AAS abuse may induce exaggerated self-confidence, reckless behavior, aggressiveness and psychotic symptoms. AAS withdrawal may be accompanied by depression and suicidal intentions. Since AAS abuse is not or only reluctantly admitted physicians should be aware of the multitude of serious side effects when confronted with unclear symptoms.
Collapse
Affiliation(s)
- Eberhard Nieschlag
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany.
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Elena Vorona
- Centre of Endocrinology, Diabetology and Rheumatology, Dortmund, Germany
| |
Collapse
|