Kimergård Andreas, McVeigh Jim
Addictions Department, National Addiction Centre, Institute of Psychiatry, King's College London, London, UK Centre for Public Health, Liverpool John Moores University, Liverpool, UK.
Centre for Public Health, Liverpool John Moores University, Liverpool, UK.
BMJ Open. 2014 Jun 4;4(6):e005275. doi: 10.1136/bmjopen-2014-005275.
The illicit use of anabolic steroids among the gym population continues to rise, along with the number of steroid using clients attending harm reduction services in the UK. This presents serious challenges to public health. Study objectives were to account for the experiences of anabolic steroid users and investigate how 'risk environments' produce harm.
Qualitative face-to-face interviews with 24 users of anabolic steroids engaged with harm reduction services in the UK.
Body satisfaction was an important factor when deciding to start the use of anabolic steroids. Many users were unaware of the potential dangers of using drugs from the illicit market, whereas some had adopted a range of strategies to negotiate the hazards relating to the use of adulterated products, including self-experimentation to gauge the perceived efficacy and unwanted effects of these drugs. Viewpoints, first-hand anecdotes, norms and practices among groups of steroid users created boundaries of 'sensible' drug use, but also promoted practices that may increase the chance of harms occurring. Established users encouraged young users to go to harm reduction services but, at the same time, promoted risky injecting practices in the belief that this would enhance the efficacy of anabolic steroids.
Current steroid-related viewpoints and practices contribute to the risk environment surrounding the use of these drugs and may undermine the goal of current public health strategies including harm reduction interventions. The level of harms among anabolic steroid users are determined by multiple and intertwining factors, in addition to the harms caused by the pharmacological action or injury and illness associated with incorrect injecting techniques.
在健身人群中，合成代谢类固醇的非法使用呈上升趋势，同时在英国，使用类固醇并寻求减少伤害服务的客户数量也在增加。这给公共卫生带来了严峻挑战。研究目标是了解合成代谢类固醇使用者的经历，并调查“风险环境”是如何造成伤害的。
对24名在英国接受减少伤害服务的合成代谢类固醇使用者进行了定性面对面访谈。
身体满意度是决定开始使用合成代谢类固醇的一个重要因素。许多使用者并未意识到从非法市场获取药物的潜在危险，而有些人则采取了一系列策略来应对使用掺假产品带来的风险，包括自我试验以评估这些药物的预期功效和不良影响。类固醇使用者群体中的观点、第一手轶事、规范和做法划定了“合理”用药的界限，但也助长了一些可能增加伤害发生几率的行为。有经验的使用者鼓励年轻使用者去接受减少伤害服务，但同时又宣扬危险的注射行为，认为这样能提高合成代谢类固醇的功效。
当前与类固醇相关的观点和做法加剧了围绕这些药物使用的风险环境，可能会破坏包括减少伤害干预措施在内的当前公共卫生战略目标。合成代谢类固醇使用者所遭受伤害的程度是由多种相互交织的因素决定的，除了药物作用、不正确注射技术导致的伤害和疾病所造成的危害之外。
