Exploring user narratives of self-medicated black market IPED use for therapeutic & wellbeing purposes
Section snippets
Background
Enhancement drugs are an increasingly important topic for public health research, with data indicating they are used by a growing portion of the population (Bates, McVeigh & Leavey, 2021). With these drugs associated with a number of harms (Pope et al., 2014), contemporary research has sought to understand how and why they are accessed and used, in order to formulate effective harm reduction policies (Kimergård & McVeigh, 2014; McVeigh & Begley, 2016). Existing explorations of enhancement drugs
Approach
Findings are drawn from a multi-year, multi-sited ethnography of IPED user cultures, exploring both offline and online sites, forming a ‘connective ethnography’ (Gibbs & Hall, 2021) of UK gyms and international digital contexts. This multi-sited approach to work spanning both digital and gym fieldsites has been adopted by a number of IPED researchers in recent years, and reflects the increasing significance of overlap between these spaces in the lives of cultural participants, both as part of
Injury repair/rehabilitation
The most commonly-cited form of therapeutic use identified in participant interviews related to injury repair and rehabilitation. With several participants belonging to sporting cultures, where remaining injury-free and minimizing time out of training was important, repair-focussed use was commonplace among those already using IPEDs for more conventional purposes:
‘[my IPED use] was mainly for strength gains, but I would use something every now and then [therapeutically], like I used some Anavar
Contributions of the research
This article builds on existing literature examining the heterogeneous behavior profiles of IPED users, and exploring the ways in which greater understanding of their motivations may help in formulating effective harm reduction policy for this population. Building on prior explorations which have developed typologies to understand IPED consumption, and how behaviours and motives correlate within user populations (Christiansen et al., 2017; Zahnow et al., 2018), this article has pointed to a
Declaration of Competing Interest
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
References (76)
- et al.
Performance and image enhancing drug interventions aimed at increasing knowledge among healthcare professionals (HCP): reflections on the implementation of the Dopinglinkki e-module in Europe and Australia in the HCP workforce
International Journal of Drug Policy
(2021) - et al.
Raw juicing” – an online study of the home manufacture of anabolic androgenic steroids (AAS) for injection in contemporary performance and image enhancement (PIED) culture
Performance Enhancement & Health
(2018) - et al.
Blood letting”—Self-phlebotomy in injecting anabolic-androgenic steroids within performance and image enhancing drug (PIED) culture
International Journal of Drug Policy
(2018) - et al.
The supply of steroids and other performance and image enhancing drugs (PIEDs) in one English city: fakes, counterfeits, supplier trust, common beliefs and access
Performance Enhancement & Health
(2014) - et al.
The pharmaceuticalisation of ‘healthy’ ageing: testosterone enhancement for longevity
International Journal of Drug Policy
(2021) - et al.
The value of unsolicited online data in drug policy research
International Journal of Drug Policy
(2019) - et al.
Medical cannabis access, use, and substitution for prescription opioids and other substances: a survey of authorized medical cannabis patients
International Journal of Drug Policy
(2017) - et al.
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
(2019) - et al.
Polydrug use and polydrug markets amongst image and performance enhancing drug users: implications for harm reduction interventions and drug policy
International Journal of Drug Policy
(2019) - et al.
Testosterone replacement therapy for hypogonadal men with SSRI-refractory depression
Journal of Affective Disorders
(1998)
Polydrug use and drug market intersections within powerlifting cultures in remote South-West England
Performance Enhancement & Health
Exploring the social lives of image and performance enhancing drugs: an online ethnography of the Zyzz fandom of recreational bodybuilders
International Journal of Drug Policy
Human enhancement drugs and new (?) research directions
Performance Enhancement & Health
Exploring the relationship between online buyers and sellers of image and performance enhancing drugs (IPEDs): quality issues, trust and self-regulation
International Journal of Drug Policy
Social suppliers: exploring the cultural contours of the performance and image enhancing drug (PIED) market among bodybuilders in the Netherlands and Belgium
International Journal of Drug Policy
Identifying a typology of men who use anabolic androgenic steroids (AAS)
International Journal of Drug Policy
Gain with no pain’: anabolic-androgenic steroids trafficking in the UK
European Journal of Criminology
Rethinking enhancement substance use: a critical discourse studies approach
International Journal of Drug Policy
Nutritional supplement and doping use in sport: possible underlying social cognitive processes
Scandinavian Journal of Medicine & Science in Sports
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
Image and Performance Enhancing Drugs 2016 National Survey Results
The Emotional Imagination: Exploring critical ventriloquy and emotional edgework in reflexive sociological ethnography with young people
Licit forms of Performance enhancement and possible links with IPED use: current knowledge and future directions
Harm reduction in male patients actively using anabolic androgenic steroids (aas) and performance-enhancing drugs (PEDs): a review
Journal of General Internal Medicine
Constructing Grounded Theory: A Practical Guide through Qualitative Analysis
Outline of a typology of men's use of anabolic androgenic steroids in fitness and strength training environments
Drugs: Education, Prevention and Policy
The supply of image and performance enhancing drugs (IPED) to local non-elite users in England: Resilient traditional and newly emergent methods
Cannabis as a substitute for prescription drugs–a cross-sectional study
Journal of Pain Research
The high price of low testosterone
Men's Health
Underground Steroid Handbook II
Do performance and image enhancing drug users in regional Queensland experience difficulty accessing health services?
Drug & Alcohol Review
Current concepts in anabolic-androgenic steroids
The American Journal of Sports Medicine
Human Enhancement: The Emerging Challenges to Public Health
Can conditions of skeletal muscle loss be improved by combining exercise with anabolic–androgenic steroids? A systematic review and meta-analysis of testosterone-based interventions
Reviews in Endocrine and Metabolic Disorders
Pharma in the bedroom... and the kitchen.... The pharmaceuticalisation of daily life
Sociology of Health & Illness
2, 4 dinitrophenol: it's not just for men
International Journal of Drug Policy
Digital ethnography in criminology: Some notes from the virtual field
Researching Cybercrimes: Methodologies, Ethics, and Critical Approaches
The Discovery of Grounded Theory: Strategies for Qualitative Research
Cited by (10)
Big business: The private sector market for image and performance enhancing drug harm reduction in the UK
2023, International Journal of Drug PolicyClick, click, buy: The market for novel synthetic peptide hormones on mainstream e-commerce platforms in the UK
2023, Performance Enhancement and HealthThe Liver King Lie: Misrepresentation, justification, and public health implications
2023, International Journal of Drug PolicySystems mapping to understand complexity in the association between image and performance enhancing drugs (IPEDs) and harm
2022, International Journal of Drug PolicyCitation Excerpt :This debate highlights that harm reduction approaches need to be appropriate to those that they are targeting and we must recognise the substantial diversity in IPED communities such as relating to types of IPEDs used (Begley et al., 2017), methods of administration (van de Ven et al., 2020), attitudes towards risk (Christiansen et al., 2016; Zahnow et al., 2018), and motivations for use (Brennan et al., 2016; Greenway & Price, 2018). While studies of IPED use in the UK have commonly focused on young white males, studies highlight IPED use amongst other demographic groups including women (Begley et al., 2017), men who have sex with men (Hibbert et al., 2021), older men (Harvey et al., 2021; Turnock, 2021), and South Asian communities (Van Hout & Kean, 2015), which adds to this diversity. There is therefore great variation in needs and preferences for healthcare, services, and interventions.
Continuing the conversation: Anabolics coaching: Emic harm reduction or a public health concern?
2022, Performance Enhancement and HealthAnabolics coaching: Emic harm reduction or a public health concern?
2022, Performance Enhancement and HealthCitation Excerpt :Demographically, the anabolics coaches explored here mostly operated in the high-end, professional and semi-professional athlete market, typically targeting clients in sports where IPED consumption is highly normalised, like bodybuilding, powerlifting and strongman (Monaghan, 2001; Turnock, 2021a). Whilst this is unsurprising, Simon, along with numerous anabolics coaches that we found advertising on social media and the surface web, also worked with older men seeking medicalised testosterone therapy (TRT) who sought out IPEDs on account of their anti-aging properties (see Underwood et al., 2021; Turnock, 2022), therefore tying into the broader discourses of medicalisation of declining testosterone and lifestyle enhancement (Evans-Brown et al., 2012). Interestingly, Simon exhibited a number of moral boundaries in his anabolics coaching, as he refused to work with athletes in drugs-tested sports – citing their attempt to ‘cheat the system’ – as well as female users due to his limited knowledge of the female anatomy and IPED use and the long-term negative side effects.