MD’s Legal Muscle
By Rick Collins, Esq., NSCA-CSCS
Q: Is there a profile of the typical steroid user?
A: In 2005, I was part of a four-person research team formed to survey who was using anabolic steroids and why. We drew our nearly 2,000 male, adult, non-medical, U.S. steroid users from an international sample from 81 countries – to my knowledge, the largest sample of this population ever surveyed in-depth. The results were published in 2007 in the peer-reviewed Journal of the International Society of Sports Nutrition as a paper called “A league of their own: demographics, motivations and patterns of use of 1,955 male adult non-medical anabolic steroid users in the United States.”1 We found that the “typical” steroid user was a white, highly-educated, gainfully employed professional, approximately 30 years old, earning an above-average income, not active in organized sports, and using to increase muscle mass, strength and physical attractiveness.
However, identifying “typical” users overlooks the outliers. More recently, two researchers from Denmark suggested a theory to group steroid users into four basic types, constructed around the dimensions of risk and effectiveness. They published their theory as a chapter in a new book, Human Enhancement Drugs2, which is an awesome collection of diverse perspectives from steroid and doping experts geared toward those seeking an in-depth understanding of the scientific issues. Their four suggested types:
• The Expert-type [low risk, high effectiveness]. Motivated by scientific curiosity and fascination with using drugs to enhance the body. High degree of knowledge, including the scientific literature. Very concerned about side effects and closely monitors health.
• The Well-being-type [low risk, low effectiveness]. Motivated by improving appearance or restoring/maintaining youth. Medium knowledge. Plays it safe to limit side effects. Typically older and focused on healthy living.
• The Athlete-type [high risk, high effectiveness]. Motivated by competitive goals; focused on performance. Medium to high knowledge. Concerned about side effects but willing to sacrifice to win. Diet and training according to season.
• The YOLO-type [high risk, low effectiveness]. “You Only Live Once” mentality; typically younger; motivated by impatience, curiosity, and influence from peers and authoritative role models; wants to impress girls and peers. Low knowledge and little concern about side effects. Engages in other risk-taking behavior (recreational drugs, fights, etc.)
The authors suggest that the failure to distinguish among different types of users has impeded effective prevention, harm reduction and treatment strategies, and that type-targeted interventions would be more effective. I agree, but I also see the groupings as a way to explain the disconnects in the perception of steroid use. The responses to our survey, confirmed by other research, suggests that most steroid users exhibit the characteristics of the low-risk Expert- and Well-being-types, and that the two high-risk categories (YOLO- and Athlete-type users) are relatively tiny minorities (e.g., 89% of users were not involved in competitive sports whatsoever; average age of starting steroid use was nearly 26 years old). Nevertheless, mainstream media sources almost exclusively focus on the two high-risk groups. So, the general public continues to associate non-medical steroid use with high-risk behaviors, “cheating” athletes and reckless teenagers, while the steroid-using community remains frustrated that it is perpetually tarnished by a minority within its predominantly low-risk ranks. Obviously, the YOLO-types, who make the news for tragedies and bad behavior, are in urgent need of interventions. The authors appear to view “Athlete-types” as almost exclusively competitive bodybuilders, although that conspicuously ignores the traditional “athletes” in other amateur and elite sports whose doping scandals make headlines (maybe, then, there’s a fifth type?!). Anyway, for the vast majority of users, I agree with the authors’ conclusion that “harm reduction is a more pragmatic strategy than simply adopting a zero-tolerance stance towards drug use” – especially because their conduct is deemed low-risk.
Two other chapters in the same book intersect with the “four types” chapter. One, which I co-authored, is called “Steroid Madness: Has the dark side of anabolic-androgenic steroids (AAS) been over-stated?”3 and looks at how the “narrative of harm” has fostered bad public policies (by only considering the YOLO- and non-bodybuilder, traditional “athlete” users). The other, which I solely authored, is called “The war on anabolic-androgenic steroids: An examination of U.S. legislative and enforcement efforts” and looks at whether the criminalization of steroids has been an effective approach to abuse of the drugs and reducing their use in drug-tested sports. Spoiler alert: it hasn’t been. Putting it all together, the take-away is that most steroid users fall into the low-risk categories suggested by the Denmark researchers but that we need to do a better job of identifying and helping the minority of high-risk users.
Rick Collins, JD, CSCS [https://rickcollins.com/] is the lawyer that members of the bodybuilding community and nutritional supplement industry turn to when they need legal help or representation. [© Rick Collins, 2020. All rights reserved. For informational purposes only, not to be construed as legal or medical advice.]
References:
1. www.ncbi.nlm.nih.gov/pmc/articles/PMC2131752/
2. www.routledge.com/Human-Enhancement-Drugs-1st-Edition/Van-de-Ven-Mulrooney-McVeigh/p/book/9781138552791
3. www.sciencedirect.com/science/article/pii/S2211266918300707
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