Are anabolic-androgenic steroid users polysubstance users?

Engaging in physical activity may be a protective factor against illicit substance use, with the literature suggesting a curvilinear link between illicit substance use and sports participation. Illicit substance use has been found to be one of a range of risk factors for future anabolic-androgenic steroid (AAS) use.1 What remains unclear, however, is whether past or current AAS users engage in higher levels of illicit substance use than their non-AAS using counterparts. While some studies have found no difference regarding illicit substance use among AAS users and non-users,2 others have found high rates of illicit substance use among AAS users;3 however, it has been suggested that rates of illicit substance use among AAS users may be explained by other factors such as sexual orientation.4

Men recruited from five gymnasiums in Sydney, Australia, were invited to complete an Internet-based survey between January and June 2005. Participants were asked to complete a brief survey asking about the past six-month use of both illicit substances and supplements/conditioning aids. A total of 229 men completed the survey; of these, 7.0% (n=16) reported current or past AAS use. For the purposes of comparison, a random sample of non-AAS users (n=20) was generated from the remaining non-AAS using participants. Due to ethical restraints, no individually identifiable information was collected as part of the survey. The IP address from the computer submitting information to the server hosting the survey, by normal course of operation, was collected, though this was not collected in the dataset with the survey responses and therefore could not be linked back to individual responses. The study was approved by the University of Sydney Human Research Ethics Committee.

The AAS users were slightly older than the non-AAS users (mean age 35 years vs. 31 years); however, this difference was not significant (t34=−2.0; p=0.056). AAS users were less likely to identify as heterosexual (19% vs. 55%; OR=0.2; 95% CI=0.04, 0.9; p=0.027). Few differences were found regarding substance use among the two groups. The AAS users were more likely to report past six-month use of protein supplements (100% vs. 65%; OR=1.7, 95% CI=1.5, 1.9; p=0.008), growth hormones (31% vs. 0%; OR=1.5; 95% CI=1.1, 2.0; p=0.007) and natural testosterone releasers (25% vs. 0%; OR=1.3; 95% CI=1.1, 1.8; p=0.018). No significant difference was found between the two groups regarding past six-month use of illicit substances.

The physical and psychological risks of AAS are well documented.5 While AAS use in the general population is low, sporting pursuits such as weightlifting and bodybuilding may place those who engage in these activities at risk for future AAS use. Research is needed to identify the role that substance use, in particular sporting supplements, may have in facilitating AAS use.