0
Views
0
CrossRef citations to date
0
Altmetric
Review Article

“I would never go to the doctor and speak about steroids”: Anabolic androgenic steroids, stigma and harm

ORCID Icon, & ORCID Icon
Received 20 Mar 2024, Accepted 21 Jun 2024, Published online: 14 Jul 2024

References

  • Ahern, J., Stuber, J., & Galea, S. (2007). Stigma, discrimination and the health of illicit drug users. Drug and Alcohol Dependence, 88(2-3), 188–196. https://doi.org/10.1016/j.drugalcdep.2006.10.014
  • Aitken, C., Delalande, C., & Stanton, K. (2002). Pumping iron, risking infection? Exposure to hepatitis C, hepatitis B and HIV among anabolic–androgenic steroid injectors in Victoria, Australia. Drug and Alcohol Dependence, 65(3), 303–308. https://doi.org/10.1016/S0376-8716(01)00174-0
  • Albano, G. D., Amico, F., Cocimano, G., Liberto, A., Maglietta, F., Esposito, M., Rosi, G. L., Di Nunno, N., Salerno, M., & Montana, A. (2021). Adverse effects of anabolic-androgenic steroids: A literature review. Healthcare (Basel, Switzerland), 9(1), 97. https://doi.org/10.3390/healthcare9010097
  • Allen, S. T., Grieb, S. M., O’Rourke, A., Yoder, R., Planchet, E., White, R. H., & Sherman, S. G. (2019). Understanding the public health consequences of suspending a rural syringe services program: A qualitative study of the experiences of people who inject drugs. Harm Reduction Journal, 16(1), 33. https://doi.org/10.1186/s12954-019-0305-7
  • Amaral, J. M. X., Kimergård, A., & Deluca, P. (2022). Prevalence of anabolic steroid users seeking support from physicians: A systematic review and meta-analysis. BMJ Open, 12(7), e056445. https://doi.org/10.1136/bmjopen-2021-056445
  • Andreasson, J., & Henning, A. (2023). Online doping: The digital ecosystem and cyborgification of drug cultures. Springer Nature.
  • Armstrong, J. M., Avant, R. A., Charchenko, C. M., Westerman, M. E., Ziegelmann, M. J., Miest, T. S., & Trost, L. W. (2018). Impact of anabolic androgenic steroids on sexual function. Translational Andrology and Urology, 7(3), 483–489. https://doi.org/10.21037/tau.2018.04.23
  • Bartholomew, T. S., Tookes, H. E., Bullock, C., Onugha, J., Forrest, D. W., & Feaster, D. J. (2020). Examining risk behavior and syringe coverage among people who inject drugs accessing a syringe services program: A latent class analysis. The International Journal on Drug Policy, 78, 102716. https://doi.org/10.1016/j.drugpo.2020.102716
  • Bates, G., McVeigh, J., & Leavey, C. (2021). Looking beyond the provision of injecting equipment to people who use anabolic androgenic steroids: Harm reduction and behavior change goals for UK policy. Contemporary Drug Problems, 48(2), 135–150. https://doi.org/10.1177/0091450921998701
  • Bates, G., Van Hout, M. C., Teck, J. T. W., & McVeigh, J. (2019). Treatments for people who use anabolic androgenic steroids: A scoping review. Harm Reduction Journal, 16(1), 75. https://doi.org/10.1186/s12954-019-0343-1
  • Bonnecaze, A. K., O’Connor, T., & Burns, C. A. (2021). Harm reduction in male patients actively using anabolic androgenic steroids (AAS) and performance-enhancing drugs (PEDs): A review. Journal of General Internal Medicine, 36(7), 2055–2064. https://doi.org/10.1007/s11606-021-06751-3
  • Bourdieu, P. (1989). Social space and symbolic power. Sociological Theory, 7(1), 14–25. https://doi.org/10.2307/202060
  • Cama, E., Brener, L., Wilson, H., & Von Hippel, C. (2016). Internalized stigma among people who inject drugs. Substance Use & Misuse, 51(12), 1664–1668. https://doi.org/10.1080/10826084.2016.1188951
  • Chandler, M., & McVeigh, J. (2014). Steroids and image enhancing drugs 2013 survey results. LJMU Centre for public health (pp. 1–26). Public health Wales.
  • Cheetham, A., Picco, L., Barnett, A., Lubman, D. I., & Nielsen, S. (2022). The impact of stigma on people with opioid use disorder, opioid treatment, and policy. Substance Abuse and Rehabilitation, 13, 1–12. https://doi.org/10.2147/SAR.S304566
  • Chegeni, R., Pallesen, S., McVeigh, J., & Sagoe, D. (2021). Anabolic-androgenic steroid administration increases self-reported aggression in healthy males: A systematic review and meta-analysis of experimental studies. Psychopharmacology, 238(7), 1911–1922. https://doi.org/10.1007/s00213-021-05818-7
  • Christiansen, A. V. (2015). Drug use in gyms. In Routledge handbook of drugs and sport (pp. 421–438). Routledge.
  • Christiansen, A. V. (2020). Gym culture, identity and performance-enhancing drugs: Tracing a typology of steroid use. Routledge.
  • Cornford, C. S., Kean, J., & Nash, A. (2014). Anabolic-androgenic steroids and heroin use: A qualitative study exploring the connection. The International Journal on Drug Policy, 25(5), 928–930. https://doi.org/10.1016/j.drugpo.2014.06.002
  • Corrigan, P. W., Druss, B. G., & Perlick, D. A. (2014). The impact of mental illness stigma on seeking and participating in mental health care. Psychological Science in the Public Interest: a Journal of the American Psychological Society, 15(2), 37–70. https://doi.org/10.1177/1529100614531398
  • Cox, L. T. J., & Paoli, L. (2023). Social media influencers, YouTube & performance and image enhancing drugs: A narrative-typology. Performance Enhancement & Health, 11(4), 100266. https://doi.org/10.1016/j.peh.2023.100266
  • Cox, L., Gibbs, N., & Turnock, L. A. (2023). Emerging anabolic androgenic steroid markets; the prominence of social media. Drugs: Education, Prevention and Policy, 31(2), 257–270. https://doi.org/10.1080/09687637.2023.2176286
  • Department of Health. (2017). Drug misuse and dependence. UK guidelines and clinical management. Retrieved from https://assets.publishing.service.gov.uk/media/5a821e3340f0b62305b92945/clinical_guidelines_2017.pdf
  • Dunn, M., Mulrooney, K. J., Forlini, C., van de Ven, K., & Underwood, M. (2021). The pharmaceuticalisation of ‘healthy’ageing: Testosterone enhancement for longevity. The International Journal on Drug Policy, 95, 103159. https://doi.org/10.1016/j.drugpo.2021.103159
  • Dunn, M., Piatkowski, T., Whiteside, B., & Eu, B. (2023). Exploring the experiences of general practitioners working with patients who use performance and image enhancing drugs. Performance Enhancement & Health, 11(2), 100247. https://doi.org/10.1016/j.peh.2023.100247
  • El Wakeel, H., Abou Arab, M. H., & Kholosy, H. M. (2021). Bodybuilder gynecomastia: Etiology, characteristics, and management. The Egyptian Journal of Plastic and Reconstructive Surgery, 45(3), 133–139. https://doi.org/10.21608/ejprs.2021.183853
  • Fomiatti, R., Latham, J. R., Fraser, S., Moore, D., Seear, K., & Aitken, C. (2019). A ‘messenger of sex’? Making testosterone matter in motivations for anabolic-androgenic steroid injecting. Health Sociology Review, 28(3), 323–338. https://doi.org/10.1080/14461242.2019.1678398
  • Fomiatti, R., Lenton, E., Latham, J. R., Fraser, S., Moore, D., Seear, K., & Aitken, C. (2020). Maintaining the healthy body: Blood management and hepatitis C prevention among men who inject performance and image-enhancing drugs. The International Journal on Drug Policy, 75, 102592. https://doi.org/10.1016/j.drugpo.2019.10.016
  • Fook, J. (1999). Reflexivity as method. Annual Review of Health Social Science, 9(1), 11–20. https://doi.org/10.5172/hesr.1999.9.1.11
  • Gibbs, N., Cox, L., & Turnock, L. (2022). Anabolics coaching: Emic harm reduction or a public health concern? Performance Enhancement & Health, 10(3), 100227. https://doi.org/10.1016/j.peh.2022.100227
  • Gibson, K., & Hutton, F. (2021). Women who inject drugs (WWID): Stigma, gender and barriers to needle exchange programmes (NEPs). Contemporary Drug Problems, 48(3), 276–296. https://doi.org/10.1177/00914509211035242
  • Gikas, P., & Mokbel, K. (2007). Management of gynaecomastia: An update. International Journal of Clinical Practice, 61(7), 1209–1215. https://doi.org/10.1111/j.1742-1241.2006.01095.x
  • Goffman, E. (1963). Embarrassment and social organization. In N. J. Smelser & W. T. Smelser (Eds.), Personality and social systems (pp. 541–548). John Wiley & Sons, Inc. https://doi.org/10.1037/11302-050
  • Goodyear, T., Brown, H., Browne, A. J., Hoong, P., Ti, L., & Knight, R. (2021). “Stigma is where the harm comes from”: Exploring expectations and lived experiences of hepatitis C virus post-treatment trajectories among people who inject drugs. The International Journal on Drug Policy, 96, 103238. https://doi.org/10.1016/j.drugpo.2021.103238
  • Grant, B., Kean, J., Vali, N., Campbell, J., Maden, L., Bijral, P., Dhillo, W. S., McVeigh, J., Quinton, R., & Jayasena, C. N. (2023). The use of post-cycle therapy is associated with reduced withdrawal symptoms from anabolic-androgenic steroid use: A survey of 470 men. Substance Abuse Treatment, Prevention, and Policy, 18(1), 66. https://doi.org/10.1186/s13011-023-00573-8
  • Grealish, S. (2022). SICK LEADER. Putin ‘has “roid rage” from CANCER treatment’ as Western spies say bloated face & lust for violence down to medical care. Retrieved from https://www.thesun.co.uk/news/17931327/putin-roid-rage-cancer-treatment/
  • Griffiths, S., Murray, S. B., & Mond, J. M. (2016). The stigma of anabolic steroid use. Journal of Drug Issues, 46(4), 446–456. https://doi.org/10.1177/0022042616661837
  • Hanavadi, S., Banerjee, D., Monypenny, I. J., & Mansel, R. E. (2006). The role of tamoxifen in the management of gynaecomastia. Breast (Edinburgh, Scotland), 15(2), 276–280. https://doi.org/10.1016/j.breast.2005.04.007
  • Harvey, O., Parrish, M., van Teijlingen, E., & Trenoweth, S. (2022). Libido as a motivator for starting and restarting non-prescribed anabolic androgenic steroid use among men: A mixed-methods study. Drugs: Education, Prevention and Policy, 29(3), 276–288. https://doi.org/10.1080/09687637.2021.1882940
  • Harvey, O., Parrish, M., van Teijlingen, E., & Trenoweth, S. (2020). Support for non-prescribed anabolic androgenic steroids users: A qualitative exploration of their needs. Drugs: Education, Prevention and Policy, 27(5), 377–386. https://doi.org/10.1080/09687637.2019.1705763
  • Hatzenbuehler, M. L., & Link, B. G. (2014). Introduction to the special issue on structural stigma and health. Social Science & Medicine, 103, 1–6. https://doi.org/10.1016/j.socscimed.2013.12.017
  • Hatzenbuehler, M. L. (2016). Structural stigma: Research evidence and implications for psychological science. The American Psychologist, 71(8), 742–751. https://doi.org/10.1037/amp0000068
  • Havnes, I. A., Jørstad, M. L., Innerdal, I., & Bjørnebekk, A. (2021). Anabolic-androgenic steroid use among women–A qualitative study on experiences of masculinizing, gonadal and sexual effects. The International Journal on Drug Policy, 95, 102876. https://doi.org/10.1016/j.drugpo.2020.102876
  • Havnes, I. A., Jørstad, M. L., & Wisløff, C. (2019). Anabolic-androgenic steroid users receiving health-related information; health problems, motivations to quit and treatment desires. Substance Abuse Treatment, Prevention, and Policy, 14(1), 20. https://doi.org/10.1186/s13011-019-0206-5
  • Hearne, E., Atkinson, A., Boardley, I., McVeigh, J., & Van Hout, M. C. (2024). ‘Sustaining masculinity’: A scoping review of anabolic androgenic steroid use by older males. Drugs: Education, Prevention and Policy, 31(1), 27–53. https://doi.org/10.1080/09687637.2022.2132135
  • Henderson, C., Noblett, J., Parke, H., Clement, S., Caffrey, A., Gale-Grant, O., Schulze, B., Druss, B., & Thornicroft, G. (2014). Mental health-related stigma in health care and mental health-care settings. The Lancet. Psychiatry, 1(6), 467–482. https://doi.org/10.1016/S2215-0366(14)00023-6
  • Henning, A., & Andreasson, J. (2022). Preventing, producing, or reducing harm? Fitness doping risk and enabling environments. Drugs: Education, Prevention and Policy, 29(1), 95–104. https://doi.org/10.1080/09687637.2020.1865273
  • Hilkens, L., Cruyff, M., Woertman, L., Benjamins, J., & Evers, C. (2021). Social media, body image and resistance training: Creating the perfect ‘me’ with dietary supplements, anabolic steroids and SARM’s. Sports Medicine - Open, 7(1), 1–13. https://doi.org/10.1186/s40798-021-00371-1
  • Hill, S. A., & Waring, W. S. (2019). Pharmacological effects and safety monitoring of anabolic androgenic steroid use: Differing perceptions between users and healthcare professionals. Therapeutic Advances in Drug Safety, 10, 2042098619855291. https://doi.org/10.1177/2042098619855291
  • Hope, V. D., Harris, R., McVeigh, J., Cullen, K. J., Smith, J., Parry, J. V., DeAngelis, D., & Ncube, F. (2016). Risk of HIV and hepatitis B and C over time among men who inject image and performance enhancing drugs in England and Wales: Results from cross-sectional prevalence surveys, 1992-2013. Journal of Acquired Immune Deficiency Syndromes (1999), 71(3), 331–337. https://doi.org/10.1097/QAI.0000000000000835
  • Hope, V. D., McVeigh, J., Smith, J., Glass, R., Njoroge, J., Tanner, C., Parry, J. V., Ncube, F., & Desai, M. (2017). Low levels of hepatitis C diagnosis and testing uptake among people who inject image and performance enhancing drugs in England and Wales, 2012-15. Drug and Alcohol Dependence, 179, 83–86. https://doi.org/10.1016/j.drugalcdep.2017.06.018
  • Hope, V. D., Walker Bond, V., Boardley, I., Smith, J., Campbell, J., Bates, G., Ralphs, R., Van Hout, M.-C., & McVeigh, J. (2023). Anabolic androgenic steroid use population size estimation: A first stage study utilising a Delphi exercise. Drugs: Education, Prevention and Policy, 30(5), 461–473. https://doi.org/10.1080/09687637.2022.2070058
  • Hope, V., & Iversen, J. (2019). Infections and risk among people who use image and performance enhancing drugs. In Human enhancement drugs (pp. 85–100). Taylor & Francis. Routledge.
  • Hope, V., Leavey, C., Morgan, G., Acreman, D., Turner, D., & Smith, J. (2020). Facilitators and barriers to health care access amongst people using image and performance enhancing drugs in Wales. Findings & Outcomes Report. Public Health Wales.
  • Islam, M. M., & Conigrave, K. M. (2007). Assessing the role of syringe dispensing machines and mobile van outlets in reaching hard-to-reach and high-risk groups of injecting drug users (IDUs): A review. Harm Reduction Journal, 4(1), 14. https://doi.org/10.1186/1477-7517-4-14
  • James, E., & Wynn, L. L. (2022). Testosterone vs. steroids: Comparing the disciplined bodywork projects of performance and image enhancing drug users in Australia. The International Journal on Drug Policy, 107, 103776. https://doi.org/10.1016/j.drugpo.2022.103776
  • Jepson, K. (2010). Gunman violence could be linked to steroid abuse. Retrieved from https://www.channel4.com/news/articles/uk/moataposs%2Bviolence%2Bcould%2Bbe%2Blinked%2Bto%2Bsteroid%2Babuse/3700487.html
  • Johnson, R. E., & Murad, M. H. (2009). Gynecomastia: Pathophysiology, evaluation, and management. Mayo Clinic Proceedings, 84(11), 1010–1015. (Elsevier https://doi.org/10.4065/84.11.1010
  • Kimergård, A., & McVeigh, J. (2014). Environments, risk and health harms: A qualitative investigation into the illicit use of anabolic steroids among people using harm reduction services in the UK. BMJ Open, 4(6), e005275. https://doi.org/10.1136/bmjopen-2014-005275
  • Kimergård, A., & McVeigh, J. (2014). Variability and dilemmas in harm reduction for anabolic steroid users in the UK: A multi-area interview study. Harm Reduction Journal, 11(1), 19. https://doi.org/10.1186/1477-7517-11-19
  • Kindred, A. (2021). ‘Self-obsessed’ steroid addict stabbed girlfriend to death at Holiday Inn. Retrieved from https://www.mirror.co.uk/news/uk-news/self-obsessed-steroid-addict-stabbed-25427210
  • Kotzé, J., Richardson, A., & Antonopoulos, G. A. (2023). Getting big but not hard: A retrospective case-study of a male powerlifter’s experience of steroid-induced erectile dysfunction. The International Journal on Drug Policy, 121, 104195. https://doi.org/10.1016/j.drugpo.2023.104195
  • Latkin, C. A., Gicquelais, R. E., Clyde, C., Dayton, L., Davey-Rothwell, M., German, D., Falade-Nwulia, S., Saleem, H., Fingerhood, M., & Tobin, K. (2019). Stigma and drug use settings as correlates of self-reported, non-fatal overdose among people who use drugs in Baltimore, Maryland. The International Journal on Drug Policy, 68, 86–92. https://doi.org/10.1016/j.drugpo.2019.03.012
  • Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27(1), 363–385. https://doi.org/10.1146/annurev.soc.27.1.363
  • Link, B. G., & Phelan, J. (2014). Stigma power. Social Science & Medicine (1982), 103, 24–32. https://doi.org/10.1016/j.socscimed.2013.07.035
  • Lloyd, C. (2013). The stigmatization of problem drug users: A narrative literature review. Drugs: education, Prevention and Policy, 20(2), 85–95. https://doi.org/10.3109/09687637.2012.743506
  • Maycock, B., & Howat, P. (2005). The barriers to illegal anabolic steroid use. Drugs: education, Prevention and Policy, 12(4), 317–325. https://doi.org/10.1080/09687630500103622
  • McVeigh, J., & Bates, G. (2022). Stigma and the use of anabolic androgenic steroids by men in the United Kingdom. In Drugs, Identity and Stigma. (pp. 121–146). Springer International Publishing.
  • McVeigh, J., & Begley, E. (2017). Anabolic steroids in the UK: An increasing issue for public health. Drugs: Education, Prevention and Policy, 24(3), 278–285. https://doi.org/10.1080/09687637.2016.1245713
  • McVeigh, J., Kimergård, A., Bates, G., Hope, V. D., & Ncube, F. (2016). Harm reduction interventions should encompass people who inject image and performance enhancing drugs. BMJ (Clinical Research ed.), 353, i1889. https://doi.org/10.1136/bmj.i1889
  • McVeigh, J. (2019). Engaging with people who use image and performance enhancing drugs: One size does not fit all. The International Journal on Drug Policy, 71, 1–2. https://doi.org/10.1016/j.drugpo.2019.05.016
  • Merton, R. K. (1968). Social theory and social structure. Simon and Schuster.
  • Monaghan, L. (1999). Challenging medicine? Bodybuilding, drugs and risk. Sociology of Health & Illness, 21(6), 707–734. https://doi.org/10.1111/1467-9566.00180
  • Mullen, C., Whalley, B. J., Schifano, F., & Baker, J. S. (2020). Anabolic androgenic steroid abuse in the United Kingdom: An update. British Journal of Pharmacology, 177(10), 2180–2198. https://doi.org/10.1111/bph.14995
  • Mulrooney, K. J., van de Ven, K., McVeigh, J., & Collins, R. (2019). Commentary: Steroid Madness- has the dark side of anabolic-androgenic steroids (AAS) been over-stated? Performance Enhancement & Health, 6(3-4), 98–102. https://doi.org/10.1016/j.peh.2019.03.001
  • Muncan, B., Walters, S. M., Ezell, J., & Ompad, D. C. (2020). “They look at us like junkies”: Influences of drug use stigma on the healthcare engagement of people who inject drugs in New York City. Harm Reduction Journal, 17(1), 53. https://doi.org/10.1186/10.1186/s12954-020-00399-8
  • Musolino, E. A., O’Connor, B. P., & Cioe, J. D. (2022). Bigger isn’t always better: An exploration of social perception bias against high levels of muscularity in women. The Journal of Social Psychology, 162(5), 523–539. https://doi.org/10.1080/00224545.2021.1927943
  • National Institute for Health and Care Excellence (NICE). (2014). Needle and syringe programmes NICE public health guidance. Retrieved from https://www.nice.org.uk/guidance/ph52
  • Noone, J. H., & Stephens, C. (2008). Men, masculine identities, and health care utilisation. Sociology of Health & Illness, 30(5), 711–725. https://doi.org/10.1111/j.1467-9566.2008.01095.x
  • Paoli, L., & Cox, L. T. J. (2024). Across the spectrum of legality: The market activities of influencers specialized in steroids and other performance and image enhancing drugs. The International Journal on Drug Policy, 123, 104246. https://doi.org/10.1016/j.drugpo.2023.104246
  • Pescosolido, B. A., Martin, J. K., Lang, A., & Olafsdottir, S. (2008). Rethinking theoretical approaches to stigma: A framework integrating normative influences on stigma (FINIS). Social Science & Medicine (1982), 67(3), 431–440. https://doi.org/10.1016/j.socscimed.2008.03.018
  • Piatkowski, T. M., Hides, L. M., White, K. M., Obst, P. L., & Dunn, M. (2022). Understanding perspectives on harm reduction from performance and image enhancing drug consumers and health care providers. Performance Enhancement & Health 10(3), 100223. https://doi.org/10.1016/j.peh.2022.100223
  • Piatkowski, T. M., Neumann, D. L., Keane, C., & Dunn, M. (2023). “More drugs means more stress on my body”: Exploring enhancement and health among elite strength athletes who use performance and image enhancing drugs. Addiction Research & Theory, 0(0), 1–6. https://doi.org/10.1080/16066359.2023.2271839
  • Piatkowski, T. M., White, K. M., Hides, L. M., & Obst, P. L. (2020). Australia’s Adonis: Understanding what motivates young men’s lifestyle choices for enhancing their appearance. Australian Psychologist, 55(2), 156–168. https://doi.org/10.1111/ap.12451
  • Piatkowski, T., & Cox, L. T. J. (2024). ‘Insulin is super dangerous if you don’t know what you’re doing’: Situating the risks of insulin within the image and performance enhancing drug community. Drug and Alcohol Review, 2024, 857. https://doi.org/10.1111/dar.13857
  • Piatkowski, T., Gibbs, N., & Dunn, M. (2023). Beyond the law: Exploring the impact of criminalising anabolic-androgenic steroid use on help-seeking and health outcomes in Australia. Journal of Criminology, 57(1), 62–82. https://doi.org/10.1177/26338076231209044
  • Piatkowski, T., Puljevic, C., Ferris, J., Francis, C., & Dunn, M. (2023). “They sent it away for testing and it was all bunk”: Exploring perspectives on drug checking among steroid consumers in Queensland, Australia. The International Journal on Drug Policy, 119, 104139. https://doi.org/10.1016/j.drugpo.2023.104139
  • Piatkowski, T., Whiteside, B., Lamon, S., Robertson, J., & Dunn, M. (2024). Performance and image enhancing drug use among Australian women: The role of interpersonal relationships in facilitating use. Contemporary Drug Problems, 51(2), 142–159. https://doi.org/10.1177/00914509241256002
  • Piatkowski, T., Cox, L., Gibbs, N., Turnock, L., & Dunn, M. (2024a). ‘The general concept is a safer use approach’: How image and performance enhancing drug coaches negotiate safety through community care. Drugs: Education, Prevention and Policy, 2024, 1–9. https://doi.org/10.1080/09687637.2024.2352442
  • Piatkowski, T., Vigorous, S., Cox, L., & McVeigh, J. (2024b). “You could try this compound, but it might send you nuts”: How steroid suppliers perceive the underground market and their ‘hybrid’role within It. Deviant Behavior, 2024, 1–12. https://doi.org/10.1080/01639625.2024.2375014
  • Pinfold, V., Thornicroft, G., Huxley, P., & Farmer, P. (2005). Active ingredients in anti-stigma programmes in mental health. International Review of Psychiatry, 17(2), 123–131. https://doi.org/10.1080/09540260500073638
  • Pope, H. G., Jr., & Kanayama, G. (2012). Anabolic–androgenic steroids. In Drug abuse and addiction in medical illness: Causes, consequences and treatment (pp. 251–264). Springer New York.
  • Pope, H. G., Jr., Kanayama, G., Athey, A., Ryan, E., Hudson, J. I., & Baggish, A. (2014). The lifetime prevalence of anabolic-androgenic steroid use and dependence in Americans: current best estimates. The American Journal on Addictions, 23(4), 371–377. https://doi.org/10.1111/j.1521-0391.2013.12118.x
  • Pope, H. G., Kanayama, G., Ionescu-Pioggia, M., & Hudson, J. I. (2004). Anabolic steroid users’ attitudes towards physicians. Addiction (Abingdon, England), 99(9), 1189–1194. https://doi.org/10.1111/j.1360-0443.2004.00781.x
  • Rahnema, C. D., Lipshultz, L. I., Crosnoe, L. E., Kovac, J. R., & Kim, E. D. (2014). Anabolic steroid–induced hypogonadism: Diagnosis and treatment. Fertility and Sterility, 101(5), 1271–1279. https://doi.org/10.1016/j.fertnstert.2014.02.002
  • Richardson, A., & Antonopoulos, G. A. (2019). Anabolic-androgenic steroids (AAS) users on AAS use: Negative effects, “code of silence”, and implications for forensic and medical professionals. Journal of Forensic and Legal Medicine, 68, 101871. https://doi.org/10.1016/j.jflm.2019.101871
  • Room, R. (2005). Stigma, social inequality and alcohol and drug use. Drug and Alcohol Review, 24(2), 143–155. https://doi.org/10.1080/09595230500102434
  • Rops, M. A., Smit, D. L., & de Ronde, W. (2022). Bias among health care professionals: How prejudice leads to diagnostic delay in patients using anabolic–androgenic steroids. Androgens: Clinical Research and Therapeutics, 3(1), 203–207. https://doi.org/10.1089/andro.2022.0016
  • Sagoe, D., & Pallesen, S. (2018). Androgen abuse epidemiology. Current Opinion in Endocrinology, Diabetes, and Obesity, 25(3), 185–194. https://doi.org/10.1007/s00213-021-05818-7
  • Sagoe, D., Molde, H., Andreassen, C. S., Torsheim, T., & Pallesen, S. (2014). The global epidemiology of anabolic-androgenic steroid use: A meta-analysis and meta-regression analysis. Annals of Epidemiology, 24(5), 383–398. https://doi.org/10.1016/j.annepidem.2014.01.009
  • Sampogna, G., Bakolis, I., Evans-Lacko, S., Robinson, E., Thornicroft, G., & Henderson, C. (2017). The impact of social marketing campaigns on reducing mental health stigma: Results from the 2009–2014 Time to Change programme. European Psychiatry, 40, 116–122. https://doi.org/10.1016/j.eurpsy.2016.08.008
  • Santos, G. H., & Coomber, R. (2017). The risk environment of anabolic–androgenic steroid users in the UK: Examining motivations, practices and accounts of use. The International Journal on Drug Policy, 40, 35–43. https://doi.org/10.1016/j.drugpo.2016.11.005
  • Simmonds, L., & Coomber, R. (2009). Injecting drug users: A stigmatised and stigmatising population. The International Journal on Drug Policy, 20(2), 121–130. https://doi.org/10.1016/j.drugpo.2007.09.002
  • Stangl, A. L., Earnshaw, V. A., Logie, C. H., Van Brakel, W., Simbayi, L. C., Barré, I., & Dovidio, J. F. (2019). The Health Stigma and Discrimination Framework: A global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas. BMC Medicine, 17(1), 31. https://doi.org/10.1186/s12916-019-1271-3
  • Treloar, C., Rance, J., Yates, K., & Mao, L. (2016). Trust and people who inject drugs: The perspectives of clients and staff of Needle Syringe Programs. The International Journal on Drug Policy, 27, 138–145. https://doi.org/10.1016/j.drugpo.2015.08.018
  • Turnock, L. A., & Mulrooney, K. J. (2023). Exploring the impacts of rurality on service access and harm among image and performance enhancing drug (IPED) users in a remote English region. Contemporary Drug Problems, 50(2), 232–253. https://doi.org/10.1177/00914509231155487
  • Turnock, L., Gibbs, N., Cox, L., & Piatkowski, T. (2023). Big business: The private sector market for image and performance enhancing drug harm reduction in the UK. The International Journal on Drug Policy, 122, 104254. https://doi.org/10.1016/j.drugpo.2023.104254
  • Underwood, M. (2019). The unintended consequences of emphasising blood-borne virus in research on, and services for, people who inject image and performance enhancing drugs: A commentary based on enhanced bodybuilder perspectives. The International Journal on Drug Policy, 67, 19–23. https://doi.org/10.1016/j.drugpo.2018.11.005
  • van de Ven, K., Malouff, J., & McVeigh, J. (2023). The association between the nonmedical use of anabolic-androgenic steroids and interpersonal violence: A meta-analysis. Trauma, Violence & Abuse, 25(2), 1484–1495. https://doi.org/10.1177/15248380231186150
  • van de Ven, K., Zahnow, R., McVeigh, J., & Winstock, A. (2020). The modes of administration of anabolic-androgenic steroid (AAS) users: Are non-injecting people who use steroids overlooked? Drugs: Education, Prevention and Policy, 27(2), 131–135. https://doi.org/10.1080/09687637.2019.1608910
  • Vojvodic, M., Xu, F. Z., Cai, R., Roy, M., & Fielding, J. C. (2019). Anabolic-androgenic steroid use among gynecomastia patients: Prevalence and relevance to surgical management. Annals of Plastic Surgery, 83(3), 258–263. https://doi.org/10.1097/SAP.0000000000001850
  • Wassersug, R. J., & Oliffe, J. L. (2009). The social context for psychological distress from iatrogenic gynecomastia with suggestions for its management. The Journal of Sexual Medicine, 6(4), 989–1000. https://doi.org/10.1111/j.1743-6109.2008.01053.x
  • Yu, J., Hildebrandt, T., & Lanzieri, N. (2015). Healthcare professionals’ stigmatization of men with anabolic androgenic steroid use and eating disorders. Body Image, 15, 49–53. https://doi.org/10.1016/j.bodyim.2015.06.001
  • Zahnow, R., McVeigh, J., Ferris, J., & Winstock, A. (2017). Adverse effects, health service engagement, and service satisfaction among anabolic androgenic steroid users. Contemporary Drug Problems, 44(1), 69–83. https://doi.org/10.1177/0091450917694268