ISSUES
: Drugs
Chapter 1: Drug issues
14
Anabolic steroids a serious global health
problem amid boom in cosmetic use
An article from
The Conversation
.
By Dominic Sagoe, PhD Research Fellow in
Social Psychology, University of Bergen
A
competitive spirit is an
indispensable aspect of
human life, where it could
be argued that a failure to compete
only results in participating in a
competition to fail. Over a very long
period of time, humans have relied
on various kinds of performance-
enhancing substances. It has been
suggested, for example, that the
ancient Greeks turned to potions to
improve performance.
Today, these substances range
from ‘soft’ or legal substances
such as energy drinks to ‘hard’
substances such as steroids and
amphetamines, and other more
‘natural’ methods, including blood
doping to increase the number
of rich red blood cells in the
bloodstream.
In the exercise or athletic world,
anabolic-androgenic steroids or
anabolic steroids are a very popular
performance-enhancing substance.
But over the past 40 years they have
increasingly been used for aesthetic
or ‘beauty’ reasons. This is what we
found in a recent study, published
in
Annals of Epidemiology
, that
suggested that 3.3% of the world’s
population have used anabolic
steroids at least once, most of whom
were male (around 6.4% of males
and 1.6% of females).
The biggest users were in the Middle
East, followed by South America,
Europe, North America, Oceania,
Africa and Asia. Use was highest
among recreational sportspeople
followed by athletes, prisoners and
arrestees, drug users, high school
students and non-athletes.
Our finding suggests that use of
anabolic steroids is now a serious
global public health problem. Not
confined to athletes, the spread of
their use into the general population
means millions of individuals across
the world, many of whom have no
athletic ambitions, are using them to
increase and improve their physical
strength and appearance.
A recent Australian survey suggested
that two-thirds of young men who
began injecting drugs in the past three
years were using steroids (rather than
methamphetamine or heroin).
Previous work
Anabolic steroids are a group of
hormones that include thenaturalmale
sex hormone testosterone and a set
of synthetic versions. Early scientific
forays into the effects of testosterone
included one Harvard professor
injecting himself with a “rejuvenating
elixir” that included extract from dog
and guinea pig testicles in 1889. It
wasn’t until the mid-1930s, however,
that human testosterone was first
‘discovered’ and then synthesised by
Adolf Butenandt and Leopold Ruzicka
(independently of each other) in 1939.
Both were awarded the Nobel Prize
for their work.
All anabolic steroids – natural and
synthetic – have two essential results:
a ‘muscle-building’ effect that results
in muscle growth, and an androgenic
or virilising effect that results in
masculinising characteristics such
as deepening of the voice. Anabolic
steroids increase the production of
protein within cells, which decreases
body fat as well as increasing muscle
growth beyond natural limits.
Steroids are used in medicine for
several purposes including the
treatment of male hypogonadism,
a condition where the body doesn’t
produce enough testosterone and
which can limit the production of
sperm. It is also used to treat delayed
puberty, enhance appetite and
stimulate growth.
Many ‘steroids’ prescribed by medics
are not anabolic, but corticosteroids
which have neither anabolic nor
addictive potential. But other people
who use these steroids for fitness
or aesthetic purposes clearly do it
outside of these health reasons.
Spread to general
population
Around the 1960s and 1970s,
anabolic steroids were mainly used
by elite athletes and bodybuilders
motivated by the desire to develop
bigger muscles and enhance their
athletic performance. In the past
three or four decades however,
millions of non-competitive athletes
such as recreational sportspeople
and adolescents have been using
them, motivated by the desire to
look more attractive. This means
their use has spread from the
athletic community into the general
population. While it has been
suggested that athletes comprise
the smallest group of anabolic
users, in our study they were the
second biggest.
Until recently, several questions
over the global use estimates were
largely unanswered. The aim of our
study was to estimate the global
prevalence of use. Putting together
findings from 187 studies (and
subject to some limitations such
as the paucity of anabolic steroid
prevalence research in especially
Africa and Asia), we estimate the
problem is gradually increasing.
Between 1990 and 1999 prevalence
was about 2.9% but post 2000,
this has risen to 3.2%.
Harmful effects
These findings should attract the
attention of global public health
officials because of the associated
serious harmful effects of long-
term use. These include high blood
pressure, heart attack, stroke, acne
and skin infections, liver damage,
tendon rupture, premature baldness,
stunted bone growth in adolescents,
