Citation

Smith A, Claussen MC, Liebrenz M. Sports Psychiatry 2023; 2(2): 73-76.

Copyright

(Copyright © 2023, Hogrefe)

DOI

10.1024/2674-0052/a000036

PMID

unavailable

Abstract

Image and Performance Enhancing Drugs (IPEDs) have become a worldwide public health concern, spanning high professional competitive environments and affecting recreational and non-elite sports [1]. Anabolic-androgenic steroids (AAS) tend to be the most common IPEDs, with Sagoe et al. estimating a global lifetime prevalence use rate of 3.3% (6.4% in males and 1.6% in females) [2]. Given these trends, researchers have portrayed AAS consumption as an international "epidemic" [3, 4, 5]. In part, usage rates may be driven by sociocultural factors, technological advancements, and the widening accessibility of these substances for athletes and the general public [3, 6]. Enduring stigmatisation surrounds AAS use, which can undermine trust in physicians, impair therapeutic programmes and educational initiatives, and amplify the role of non-medical experts [7, 8]. Studies suggest that people who use AAS believe that physicians have limited understanding about these substances, with perceived knowledge levels comparable to that of internet resources and even those who illicitly sell them [8]. Additionally, AAS consumption may occur for several years, leading to dependence and withdrawal symptoms that can prevent successful discontinuation [9].

Although the World Anti-Doping Federation and national anti-doping bodies have outlawed AAS use because of performance enhancing effects [6], elite-level athletes still engage in harmful consumption. As anti-doping testing regimes have become more rigorous, use patterns of AAS in elite-level sport have increasingly centred around novel substances that are harder to identify [10]. Nevertheless, high-profile transgressions continue to be detected and often engender widespread press coverage. Anti-doping violations in elite-level competitions can carry lengthy sporting bans, and, in certain circumstances, may entail criminal or civil charges depending on the jurisdiction. However, in practice, the requisite burden of proof and the intricacies of anti-doping scenarios mean that formal judicial proceedings for AAS usage in elite-level sports seldom occur [11], and the legality of providing self-incriminating evidence through voluntary drug tests has been questioned [12].

Language: en