Beyond the law: Exploring the impact of criminalising anabolic–androgenic steroid use on help-seeking and health outcomes in Australia

Abstract

This study aimed to investigate how Anabolic–Androgenic Steroid (AAS) users and healthcare professionals perceive the criminalisation of AAS on users’ ability to seek help and, ultimately, what effect this has on the health outcomes for these consumers. This study triangulated the views ( N = 24) of male ( n = 8) and female ( n = 7) AAS users ( Mage = 35.4, SD = 9.1), as well as healthcare providers ( n = 9), regarding how the criminalisation of AAS had an impact on consumers’ health behaviours and help-seeking. Data were analysed thematically. An overarching narrative was developed regarding the “politicogenic drug effects” which emerge from the illegality of AAS with three overarching themes. First, participants expressed challenges in seeking help and support due to the stigma and fear associated with the illegal nature of AAS use. This fear stemmed from the criminalisation of AAS and the potential legal consequences. Participants also highlighted the social challenges and the need for secrecy surrounding AAS use, which further hindered open discussions and engagement with healthcare providers. The cohort emphasised the close-knit social networks among AAS users, offering support and shared experiences but also entangled in the criminality associated with AAS use. Moreover, participants acknowledged the difficulties in promoting harm reduction initiatives due to the need for secrecy and the potential social and economic disadvantages. The escalation of AAS criminalisation that has impacted both consumers and healthcare professionals has exacerbated the challenges associated with their interaction, further impeding a relationship already fraught with obstacles. Consequently, users remain entrenched within the illicit market, with few options for harm reduction intervention. The study advocates for a rethinking of AAS policies, considering a potential reclassification aligned with the United Kingdom's Class C framework to destigmatise use and promote harm reduction. This shift would require comprehensive research to assess its impact on public health, user behaviour, and harm reduction outcomes.

Exploring the role of community pharmacies as a harm reduction environment for anabolic–androgenic steroid consumers: triangulating the perspectives of consumers and pharmacists

“…The hesitancy to discuss AAS use creates a barrier to effective communication and potential for rapport-building. These perspectives likely indicate broader systemic barriers faced by AAS consumers in seeking support and guidance from healthcare professionals [ 56 ]. CP 7: The big barrier is probably the [AAS] consumer being hesitant to talk about it.…”

Exploring Anabolic Androgenic Steroid Use Among Cisgender Gay, Bisexual, and Queer Men

“…Finally, illegality around AAS use complicates the ability for patients to obtain medical care, as similarly demonstrated by Piatkowski et al 51 To optimize health care outcomes, future work should revisit the risks and benefits of the scheduling of AAS, as well as test methods to prevent AAS use disclosure from the electronic medical record to life and disability insurance companies.…”

The Uses of Anabolic Androgenic Steroids Among Athletes; Its Positive and Negative Aspects- A Literature Review

“… 59 Furthermore, it’s important to note that while AAS has legitimate medical uses as mentioned, its potential for misuse and abuse, along with the associated health risks, underscores the critical necessity for responsible medical supervision and comprehensive patient education regarding the proper and safe use of these substances. 60 …”