Outline of a typology of men s use of anabolic androgenic steroids in fitness and strength training environments

Transcription

1 Outline of a typology of men s use of anabolic androgenic steroids in fitness and strength training environments Ask Vest Christiansen Section for Sport Science, Department of Public Health Aarhus University avc@ph.au.dk International Conference on Doping and Public Health Oslo 7 9 June 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

2 Quantitative survey studies Qualiative interview studies The use of anabolic androgenic steroids (AAS) in fitness environments So, if you are a politician or a professional working with interventions, what do you learn about users of AAS from these studies? 3 4 2

3 What characterises AAS users? Cohen et al. (2007): Internet survey of 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. Pallesen et al. (2006). Survey high school students. Use of AAS were strongly related to use of other drugs such as alcohol, nicotine, and narcotics. Use is 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, million Americans may have used AAS. EHFA (2012). Survey, +8,000 fitness customers. 2.5% had used AAS; The peak age group was 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

4 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 Numerous qualitative studies, for example Barland & Tangen, 2009; Bilard, Ninot, & Hauw, 2011; Christiansen & Bojsen Møller, 2012; Cohen et al., 2007; Grogan, Shepherd, Evans, Wright, & Hunter, 2006; Ip, Barnett, 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

5 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

6 Max Weber s ideal typology as a way forward A typology is concerned with general or idealtypical 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 necessarily describe real world people but is a way of learning about the real world. Max Weber Multifaceted individual voices and lifestyles I went from listening to other [steroid] users to study it myself. How does it work? Why does it work? What should be taken into account and so on? It s been a process where I over the course of 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. Well, it was the steroids that had our focus on weekdays. It was Saturdays we went downtown. We gathered after our training sessions. Then we began to drink, and eventually amphetamine was put on the table Sometimes one of us would take some Winstrol before leaving, just, 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 wise I can see that I want to be in the big class, because I can get up there. I ve got the talent, the genetics and the mentality. It is not a question of being a hugely muscular giant. Now I just want to have a feeling of wellbeing. 6

7 Typology on the use of anabolic androgenic steroids YOLO type Well, it was the steroids that had our focus on weekdays. It was Saturdays we went downtown. We gathered after our training sessions. Then we began to drink, and eventually amphetamine was put on the table Sometimes one of us would take some Winstrol before leaving, just, you know, to feel a bit more ripped and all that. Risk Athlete type 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 wise I can see that I want to be in the big class, because I can get up there. I ve got the talent, the genetics and the mentality. Effectiveness Wellbeing type It is not a question of being a hugely muscular giant. Now I just want to have a feeling of wellbeing. Expert type I went from listening to other [steroid] users to study it myself. How does it work? Why does it work? What should be taken into account and so on? It s been a process where I over the course of 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 I went from listening to other users to study it myself. How does it work? Why does it work? What should be taken into account and so on? It s been a process where I over the course of 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. Most people know that you shouldn t just take a steroid and then you grow. It actually does something to your body. There are adverse effects. No matter what people say: steroids are bad for your body. I m not trying to hide that. But there are ways to protect yourself, so you can move beyond the side effects promoted by the media. 14 7

8 Expert type I measure my blood pressure at home every other day, and then I make a note simply to see if it s going up or down. Everyone should do that. At least if you re on a cycle [of steroids]. And you should also be doing it when you reach a certain age in life. Because you cannot really feel elevated blood pressure. I find the medical science behind it fascinating, and I can come up with many excuses for how I justified using gear [AAS], but I like the idea of putting theory into practice and see if you have learned enough by reading online if you can put that into practice. And I could. So, I think it s nice that you can learn such things 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

9 Typology on the use of AAS in gyms Risk Expert type Effectiveness 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 injuryprone body, and I ve had all kinds of injuries throughout my life. But since I started training and taking steroids, I ve had nothing. My general well being has improved a lot, so the training and the steroids really made a difference. I feel much better than I did before. The pain in my back is completely gone. I had chronic back pain before, that s just gone now because I spend so much time in the gym. I think it helps you to stay young, right? You feel a little better, and you feel more rested in the morning. Your skin becomes more youthful to look at, and your energy level is generally higher. I see it as a supplement for well being, so I m not using it [hgh] to gain size but mostly to improve my own wellbeing. 18 9

10 Wellbeing type It is not a question of being a hugely muscular giant. Now I just want to have a feeling of wellbeing. I ll most likely be using it [AAS and hgh] for the rest of my life. At least as long as I m able to take care of myself and to continue training. But 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 wellbeing 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. Motivated by 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

11 Typology on the use of AAS in gyms Risk Effectiveness Wellbeing type 1. Motivated by 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 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 YOLO type My buddy was introduced to a slightly older guy, who was much bigger than us. He was a man of the world, we thought. Someone who had been around. And he took steroids and we wanted to be like him, so when my buddy found out, he also wanted to try this miracle drug. I ate a can of tuna a day. There were no vegetables in my diet and we had no knowledge on how much protein you can absorb. We thought of vegetables as something reserved for rabbits and fitness girls. And I didn t mind eating pizza immediately after training. Our approach lacked as much seriousness as it possibly could.[ ] Rather than cooking, it was easier to just jab something [steroids] in the thigh 22 11

12 YOLO type then we started going out on the town, and people started saying: Hell, you ve been working out! And I was like: Yeah man! suddenly people could see that you lifted weights. That was fantastic. People saw it. And we thought our build was something any woman would fall for. So, now we always wore a tight T shirt or shirt. We were mostly concerned what other people thought. Well, it was the steroids that had our focus on weekdays. But on Saturdays we often gathered together after training. Then we began to drink, and eventually amphetamine was put on the table or, mostly amphetamine. But sometimes cocaine was also brought to the table. And, of course, we drank like alcoholics. You can drink much more than usual when you take amphetamine, so I guess we ended up each drinking a whole bottle of booze before going downtown. Sometimes one of us would take some Winstrol before leaving, just, you know, to feel a bit more ripped and all that. 23 YOLO type Summary 1. Motivated by impatience, curiosity and influence from peers and authoritative role models 2. Focus on asserting his masculinity, impressing girls, and advancing upwards in the male hierarchy 3. Little to no concern about side effects 4. Aims at immediate benefits 5. Low level of knowledge based on lore and advice from gym rats 6. Hedonistic and flying blind attitude towards health combines AAS with recreational drugs and is more likely to end up in fights than the other types 7. Little concern about diet and recovery has an experimenting life style which includes various kinds of risk taking 24 12

13 YOLO type 1. Motivated by impatience, curiosity and influence from peers and authoritative role models 2. Focus on asserting his masculinity, impressing girls, and advancing upwards in the male hierarchy 3. Little to no concern about side effects 4. Aims at immediate benefits 5. Low level of knowledge based on lore and advice from gym rats 6. Hedonistic and flying blind attitude towards health combines AAS with recreational drugs and is more likely to end up in fights than the other types 7. Little concern about diet and recovery has an experimenting life style which includes various kinds of risk taking Typology on the use of AAS in gyms Risk Effectiveness Wellbeing type 1. Motivated by vanity and/or wishes for restoration or rejuvenation 2. Focus on well being, moderation and peer recognition (e.g. during the summer) 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 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 Athlete type I get fascinated by this muscle thing It s the aesthetics in it that I m caught by. The controlling of my life down to the minute. That s necessary but it s the aesthetics I m fascinated by. The designing of my body. It awakens something in me. 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 wise I can see that I want to be in the big class, because I can get up there. I ve got the talent, the genetics and the mentality

14 Athlete type I ve had a couple of incidents where I was about to go into sugar shock. But I ve always been able to feel that now I m about to shut down! And then I ve just taken whatever and stuffed myself. Fast carbohydrates like honey on a rice cake for instance or sugar water or something. Then, two minutes pass and you feel stable again. And that s just something you need to understand and accept before you start playing with this [combining insulin with steroids]. You need to have something sugary at hand if things go wrong. Actually, I don t think about it [health risks]. Because, if I began worrying too much about risks I would probably realize that I couldn t fulfil my dream [on competing]. Then I would have to be realistic and say this has to stop. Indeed, there are risks that may materialize in the future. It can have consequences. You just have to keep your fingers crossed. 27 Athlete type Summary 1. Motivated by competitive aspirations 2. Focus on performance (e.g. skills, size, and definition) 3. Concerned with side effects but willing to run health risks in order to fulfil sporting ambitions 4. Aims at maximising benefits by combining different steroids (stacking) with other performance and image enhancing drugs (polypharmacy) 5. Medium to high level of knowledge based on medical assistance and experience from his sporting community 6. Plans training and diet according to season avoids recreational drugs 7. Dedicated to the athlete life style 28 14

15 YOLO type 1. Motivated by impatience, curiosity and influence from peers and authoritative role models 2. Focus on asserting his masculinity, impressing girls, and advancing upwards in the male hierarchy 3. Little to no concern about side effects 4. Aims at immediate benefits 5. Low level of knowledge based on lore and advice from gym rats 6. Hedonistic and flying blind attitude towards health combines AAS with recreational drugs and is more likely to end up in fights than the other types 7. Little concern about diet and recovery has an experimenting life style which includes various kinds of risk taking Typology on the use of AAS in gyms Risk Athlete type 1. Motivated by competitive aspirations 2. Focus on performance (e.g. skills, size, and definition) 3. Concerned with side effects but willing to run health risks in order to fulfil sporting ambitions 4. Aims at maximising benefits by combining different steroids (stacking) with other performance and image enhancing drugs (polypharmacy) 5. Medium to high level of knowledge based on medical assistance and experience from his sporting community 6. Plans training and diet according to season avoids recreational drugs 7. Dedicated to the athlete life style Effectiveness Wellbeing type 1. Motivated by vanity and/or wishes for restoration or rejuvenation 2. Focus on well being, moderation and peer recognition (e.g. during the summer) 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 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 Expert type, Wellbeing type, YOLO type, Athlete type Abuse / Dependence Periods off steroids become shorter than periods on. Dosages are increased. Fear of loosing mass, manliness or masculinity One long, continuous cycle Loss of control! Health situation that requires treatment 30 15

16 Risk High The YOLO type The Athlete type The Well being type The Expert type Low Low Effectiveness High Risk High The YOLO type The Athlete type Younger group. Larger group in absolute numbers. More The susceptible Well being to input. type Hard to reach group. Often got a fixed agenda. Small in The absolute Expert numbers type Low Low Effectiveness High 16

17 YOLO type 1. Motivated by impatience, curiosity and influence from peers and authoritative role models 2. Focus on asserting his masculinity, impressing girls, and advancing upwards in the male hierarchy 3. Little to no concern about side effects 4. Aims at immediate benefits 5. Low level of knowledge based on lore and advice from gym rats 6. Hedonistic and flying blind attitude towards health combines AAS with recreational drugs and is more likely to end up in fights than the other types 7. Little concern about diet and recovery has an experimenting life style which includes various kinds of risk taking Wellbeing type 1. Motivated by vanity and/or wishes for restoration or rejuvenation 2. Focus on well being, moderation and peer recognition (e.g. during the summer) 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 Typology on the use of AAS in gyms Risk Provide different users with tailored risk related information, safer alternatives for reaching their goals, and appropriately prioritised and delivered health messages Expert type Athlete type 1. Motivated by competitive aspirations 2. Focus on performance (e.g. skills, size, and definition) 3. Concerned with side effects but willing to run health risks in order to fulfil sporting ambitions 4. Aims at maximising benefits by combining different steroids (stacking) with other performance and image enhancing drugs (polypharmacy) 5. Medium to high level of knowledge based on medical assistance and experience from his sporting community 6. Plans training and diet according to season avoids recreational drugs 7. Dedicated to the athlete life style Effectiveness 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 34 17

18 Thank you! Thanks to my coworkers: Outline of a typology of men s use of anabolic androgenic steroids in fitness and strength training environments Anders Vinther Dimitris Liokaftos Ask Vest Christiansen Section for Sport Science, Department of Public Health Aarhus University avc@ph.au.dk International Conference on Doping and Public Health Oslo 7 9 June 35 18