A sentinel population: The public health benefits of monitoring enhanced body builders

Abstract

There is heightened recognition of the public health implications of anabolic androgenic steroids (AAS) for the use of image and performance enhancement; with increasing evidence of their long-term negative health impacts, the hazards associated with their administration (often via injection), and the variability and unpredictability of their contents. In order to optimise the effects of these drugs, together with strict dietary and training regimes, AAS users typically supplement their use with an expansive and continually evolving range of ancillary drugs. The discovery and subsequent adoption of these drugs by the broader AAS user population is largely dependent upon a minority of social influencers within the bodybuilding community.Pioneering enhanced bodybuilders who self-experiment with a diverse range of image and performance enhancing drugs (IPEDs) and ancillary drugs have been the forerunners in the development of an underground user-led literature, online discussion forums, and were early adopters of internet-facilitated drug markets. Yet the impact of their self-experimentations

Exploring the Impacts of Rurality on Service Access and Harm Among Image and Performance Enhancing Drug (IPED) Users in a Remote English Region

“…While academic discourse around IPEDs increasingly acknowledges the importance of harm reduction for users (Bates et al, 2022), it is clear there remain gaps in our understanding regarding how best to serve specific populations (Hope et al, 2022; McVeigh, Hearne, et al, 2021). With IPED use being highly heterogenous (van de Ven et al, 2019), much work has acknowledged the extent to which interventions must be tailored to the different practices, motivations and harm profiles of users (Christiansen et al, 2017; Harvey et al, 2021; Vinther & Christiansen, 2019).…”

“…These trends in contemporary IPED use are important to understand, since these drugs come with a range of potential health risks, from cardiovascular strain and hepatotoxicity, to psychological harms such as depression (Kanayama et al, 2018;McVeigh, Hearne, et al, 2021;McVeigh, Salinas, & Ralphs, 2021). Additionally, with many of the most popular IPEDs being injected, these further carry associated risks of infection, and potential exposure to blood borne viruses (BBV; Bates & McVeigh, 2016;Hope et al, 2013), even if BBV risk is lower for those injecting steroids (via intramuscular (IM) injections) than for intravenous (IV) drug users (see Underwood, 2019).…”

The Use of Anabolic Androgenic Steroids as a Public Health Issue

“…dinitrophenol, clenbuterol). Over the years, many different substances have entered the repertoire of drugs used for muscular enhancement (McVeigh, Salinas, & Ralphs, 2020). For instance, human growth hormone has steadily increased in popularity, from use by competitive athletes and elite bodybuilders in the 1980s, to become easily available and commonly used within gyms around the world (Brennan, Wells, & Van Hout, 2017;Holt & Ho, 2019).…”

“…For instance, human growth hormone has steadily increased in popularity, from use by competitive athletes and elite bodybuilders in the 1980s, to become easily available and commonly used within gyms around the world (Brennan, Wells, & Van Hout, 2017;Holt & Ho, 2019). Some drugs have maintained a level of use despite scant evidence of effectiveness, for example gamma hyroxybutyrate (GHB) (Takahara et al, 1977), taken to enhance the release of human growth hormone (Assael, 2007;McVeigh et al, 2020). While for other drugs, use has been transient, for instance, nalbuphine hydrochloride (Nubain©) gained popularity for a relatively short period in the 1990s based on an unfounded reputation for having anti-catabolic properties (Duchaine, 1988;Wines, Gruber, Pope, & Lukas, 1999) and is now rarely reported as being used (Begley et al, 2017;McBride, Williamson, & Petersen, 1996;McElrath & Connolly, 2006) However, while various drugs have gained popularity with those looking to enhance musculature, the AAS have remained a constant feature and the basis of drug regimens for muscular enhancement around the world (Bonnecaze, O'Connor, & Aloi, 2020;Cohen, Collins, Darkes, & Gwartney, 2007).…”

Human enhancement drugs: Emerging issues and responses

“…The use of drugs for muscular enhancement has typically centred on the use of AAS and associated drugs, however the use of a range of other substances has also emerged amongst the enhanced bodybuilding population over the last 35 years. McVeigh, Salinas and Ralphs (2021) in their commentary explore the emergence of a number of substances and how they have then diffused to become more widely established in other groups. They argue that the collaborative monitoring of this influential population could be key to recognising, interpreting and responding to emerging patterns of drug use before their diffusion to wider, sometimes vulnerable populations.…”