Polypharmacy among anabolic-androgenic steroid users: a descriptive metasynthesis
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Polypharmacy among anabolic-androgenic steroid users: a descriptive metasynthesis Dominic Sagoe1*, Jim McVeigh2, Astrid Bjørnebekk3, Marie-Stella Essilfie4, Cecilie Schou Andreassen1,5 and Ståle Pallesen1
Abstract Background: As far as we are aware, no previous systematic review and synthesis of the qualitative/descriptive literature on polypharmacy in anabolic-androgenic steroid(s) (AAS) users has been published. Method: We systematically reviewed and synthesized qualitative/descriptive literature gathered from searches in electronic databases and by inspecting reference lists of relevant literature to investigate AAS users’ polypharmacy. We adhered to the recommendations of the UK Economic and Social Research Council’s qualitative research synthesis manual and the PRISMA guidelines. Results: A total of 50 studies published between 1985 and 2014 were included in the analysis. Studies originated from 10 countries although most originated from United States (n = 22), followed by Sweden (n = 7), England only (n = 5), and the United Kingdom (n = 4). It was evident that prior to their debut, AAS users often used other licit and illicit substances. The main ancillary/supplementary substances used were alcohol, and cannabis/cannabinoids followed by cocaine, growth hormone, and human chorionic gonadotropin (hCG), amphetamine/meth, clenbuterol, ephedra/ephedrine, insulin, and thyroxine. Other popular substance classes were analgesics/opioids, dietary/nutritional supplements, and diuretics. Our classification of the various substances used by AAS users resulted in 13 main groups. These non-AAS substances were used mainly to enhance the effects of AAS, combat the side effects of AAS, and for recreational or relaxation purposes, as well as sexual enhancement. Conclusions: Our findings corroborate previous suggestions of associations between AAS use and the use of other licit and illicit substances. Efforts must be intensified to combat the debilitating effects of AAS-associated polypharmacy. Keywords: Anabolic-androgenic steroids, Ergogenic aids, Doping, Human enhancement drugs, IPEDs, Polypharmacy, Stacking, Metasynthesis, Qualitative research
Introduction Anabolic-androgenic steroid(s) (AAS) refer to testosterone and its synthetic derivatives mainly used nonmedically for enhancing muscle growth and strength, boosting physical activity or sports performance, and for aesthetic purposes as well as for enhancing psychological well-being [1]. AAS are typically used in phases referred to as ‘cycles’: ‘on cycles’ referring to specific periods when the users administer AAS and ‘off cycles’ referring to an AAS-free phase intended to prevent tolerance towards AAS, lessen the possibility of side * Correspondence: [email protected] 1 Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5015 Bergen, Norway Full list of author information is available at the end of the article
effects, and allow recovery of natural hormonal functioning. During ‘on cycles’ users sometimes combine dif
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