Exploring the Psychological and Social Dynamics of Steroid and Performance-Enhancing Drug (PED) Use Among Late Adolescents and Emerging Adults (16–22): A Thematic Analysis

Societal alternatives to anabolic steroid use.

Context: Illicit and performance-enhancing drug (PED) use is prevalent among athletes. Aims: We examine the prevalence of PED use among amateur athletes, identify the common characteristics and associated risk factors for illicit PED use and measure the perception and awareness among gym members regarding the safety and effects of illicit drug use. Settings and design: This cross-sectional study was conducted among adult male and female gym center attendees in Riyadh, Saudi Arabia. Methods and materials: Self-administered Arabic and English questionnaires were used for data collection. Statistical analysis used: SPSS version 26 was used to perform t- and chi-square tests. Results: This study included 379 participants, of whom 59.6% were male, 52.8% were between 26 and 35 years of age, and a majority of the participants had normal (47.5%) or overweight (40.9%) body mass index. Our study revealed a high prevalence (48.5%) of PED use among gym athletes in Riyadh, Saudi Arabia. Moreover, the true prevalence might have been higher due to the possibility of underreporting by some participants because of the sensitivity of the subject. Protein powder was the most commonly used type of PED. Of all the participants, 22.3% reported anabolic androgenic steroid use. Side effects of PEDs were observed in 19% of the study participants. Conclusion: The results of this study should encourage public health researchers and health advocates to design and implement behavioral interventions to educate the public on the benefits, risks, and contraindications of dietary supplements used by athletes to enhance their body performance. Key messages • Performance-enhancing drug (PED) use is prevalent among both professional and amateur athletes. • Gym athletes in Riyadh, Saudi Arabia, report increasing PED use. • Side effects and negative health impacts are associated with illicit PED use. • Misinformation on the risks and benefits of PEDs is a major public health concern. • More efforts should be implemented in public awareness about the risk of using PED targeting younger populations.

Despite the high prevalence of performance-enhancing drug (PED) use, media attention has focused almost entirely on PED use by elite athletes to illicitly gain a competitive advantage in sports, and not on the health risks of PEDs. There is a widespread misperception that PED use is safe or that adverse effects are manageable. In reality, the vast majority of PED users are not athletes but rather nonathlete weightlifters, and the adverse health effects of PED use are greatly underappreciated. This scientific statement synthesizes available information on the medical consequences of PED use, identifies gaps in knowledge, and aims to focus the attention of the medical community and policymakers on PED use as an important public health problem. PED users frequently consume highly supraphysiologic doses of PEDs, combine them with other PEDs and/or other classical drugs of abuse, and display additional associated risk factors. PED use has been linked to an increased risk of death and a wide variety of cardiovascular, psychiatric, metabolic, endocrine, neurologic, infectious, hepatic, renal, and musculoskeletal disorders. Because randomized trials cannot ethically duplicate the large doses of PEDs and the many factors associated with PED use, we need observational studies to collect valid outcome data on the health risks associated with PEDs. In addition, we need studies regarding the prevalence of PED use, the mechanisms by which PEDs exert their adverse health effects, and the interactive effects of PEDs with sports injuries and other high-risk behaviors. We also need randomized trials to assess therapeutic interventions for treating the adverse effects of PEDs, such as the anabolic-androgen steroid withdrawal syndrome. Finally, we need to raise public awareness of the serious health consequences of PEDs.

The prevalence of performance-enhancing drug (PED) use at different levels of professional sport has become an important social issue, particularly when considering recent high-profile incidents from professional sports and the Olympics. Due to the myriad of individual, team, and sociopolitical consequences that can stem from PED use, it becomes critical to study the etiology of PED involvement among athletes regarding this deviant behavior. Gottfredson and Hirschi’s general theory of crime is one such theory that may aid in explaining this phenomenon. As such, the main purpose of this study was to investigate the relationships between effective parenting, self-control, and athletes’ use of banned PEDs. Survey data from 784 professional athletes in Iran were collected, and the findings indicated that ineffective parenting, low self-control capacity, and self-control desire had significant effects on PED use. In addition, moderation effects and gender analyses were examined. Specific findings, policy implications, and study limitations are discussed.

Introduction Performance-enhancing drug (PED) use—particularly anabolic–androgenic steroids (AAS)—has expanded from competitive sport into mainstream fitness settings. Although PED use is associated with emotional, cognitive, and social difficulties, less is known about how duration of use or psychosocial factors shape these outcomes. Understanding these dynamics is essential for identifying individuals at greater risk for psychological impairment. Methods A total of 285 adult gym-goers (87 long-term users, 95 short-term users, 103 non-users) completed validated measures of depression (BDI-II), anxiety (BAI), muscle dysmorphia (MDDI), self-efficacy (GSE), social support (MSPSS), and social functioning (SASS), along with the Stroop test assessing executive function. Group comparisons, multiple regressions, and PROCESS-based mediation and moderation analyses were conducted, controlling for demographic covariates. Results Long-term PED users reported significantly higher depression, anxiety, and muscle dysmorphia than short-term users and non-users, and showed poorer Stroop interference performance. Mediation analysis revealed that depression and anxiety partially explained the link between PED use and poorer social functioning. Moderation results indicated that stronger self-efficacy and higher perceived social support buffered depressive and anxious symptoms among users. Discussion Chronic PED use is associated with heightened emotional distress and reduced executive functioning, which in turn contribute to impaired social functioning. However, psychosocial resources such as self-efficacy and social support may mitigate these adverse effects. These findings underscore the need for routine psychological assessment and the development of supportive, prevention-oriented interventions for individuals engaged in PED use.

As national anti-doping organizations (NADOs) adopt preventative measures to complement detection-based deterrence methods, understanding coaches’ attitudes toward drugs in sport will take on a new importance. This study was conducted to measure coaches’ attitudes in the sport of track and field toward performance enhancing drug (PED) use and drug testing. A total of 254 track and field coaches (Age: 33.4 yrs ±9.7) completed a 51-item survey. Coaches who were certified reported they felt more knowledgeable about PED use (rs = .168, p = .004) and that they had learned about PED use and testing through the USA Track and Field (USATF) coaches education program (rs = .220, p < .001). USATF certified coaches also reported a stronger perception that the coach plays a key role in PED deterrence (rs = .158, p = .006). These findings suggest that national sport governing bodies (NGBs) like USATF have taken significant steps to educate prospective coaches on the topic of PED’s and drug testing and these measures have positively impacted coaches.

Drawing from participant observation and interviews, I examine the attitudes and beliefs of elite and former professional cyclists and team personnel regarding performance-enhancing drug (PED) use and the neutralization techniques they employed to excuse and justify PED consumption. Participants most frequently adopted accounts in which they condemned the condemners, viewing as hypocrites those labeling PED use as deviant, and arguing that all manner of PED use is commonplace throughout society. Participants further expressed distrust of sporting federations, law enforcement, and medical professionals, whom they viewed as exaggerating and distorting information about the dangers of PED use. Riders also appealed to higher loyalties and defense of necessity, claiming that PED use was for many professional cyclists nearly an occupational necessity. Members viewed PED use as a rational means to an end while also embodying fundamental tenets of professional cycling culture which prizes risk taking and commitment.

The attitudes and perceptions of adolescent track and field athletes toward PED use

Performance-enhancing drug (PED) use is a known and increasingly recognized maladaptive behavior among athletes of all ages and levels of competition. The underlying reasons for use are diverse and may include attempting to gain a selective advantage, to recover from injury, or to optimize cosmetic appearance. The veil of secrecy and stigma regarding PED use challenges the careful study of use behavior patterns, but there is an emerging body of evidence linking PED use to the presence and development of mental health disorders. In order to counteract PED use in the interest of athlete safety and fair play, most governing sports bodies have imposed escalating penalties, including performance bans, for multiple-time PED offenders. It is important for the treating provider to become familiar with PED use and use patterns in order to have an educated discussion with the at-risk athlete.

The effects of the COVID-19 pandemic on the use of the performance-enhancing drugs.

BackgroundSeveral reports have implied progressive increase of performance-enhancing drug (PED) use among Iranian athletes. More importantly, most of the previous research in the Iranian population had mainly focused on the anabolic steroid abuse, and ignored other agents.ObjectivesThe aim of this study was to investigate the prevalence and characteristics of PED use among bodybuilding athletes in Bushehr, south of Iran.MethodsFour hundred and fifty three male bodybuilding athletes were recruited from Bushehr gyms between February and May of 2015. Men were eligible to participate in the survey if they had regularly participated in the strength-training exercise (minimum of 1 year and 4 hour/week). Data were collected via a face-to-face interview. The survey consisted of three separate parts including demographic data, exercise pattern and PED use.ResultsAccording to this study, 234 (51.7%) of bodybuilding athletes had used PEDs. The PED users reported an average of 3.80 ± 4.52 agents’ use in their programs and they had used PEDs for the average of 3.24 ± 3.99 years. The most prevalent agents which had been abused by the athletes were anabolic steroids (used by 185 athletes (79.4% of athletes). Furthermore, 110 (47%) of athletes reported stimulant agents’ use during their routines. The most prevalent motivation for using PEDs was increasing muscle mass that was reported by 164 (70.1%) of PED users. In addition, sexual and dermatologic effects were the most prevalent adverse effects reported by the PED user athletes (114 (49.4%) and 103 (44.2%), respectively).ConclusionsThis study showed the high rate of PED use among recreational and professional Iranian bodybuilding athletes that can expose them to the serious side effects of these agents.

Nation Ford CEO gains $7.9 M for “blowing the whistle” on Toyo Ink's import declarations

“I don't know if I would report them”: Student-athletes' thoughts, feelings and anticipated behaviours on blowing the whistle on doping in sport

Performance-enhancing drugs (PEDs) are commonly consumed in the United States with high prevalence of use in athlete populations and increased use by deployed service members. Many PEDs may contain anabolic-androgenic steroids (AAS), which are legally restricted and prohibited by many agencies due to their health risk. A unique case of acute pancreatitis associated with the use of the PED "Guerilla Warfare," a labeled AAS-containing supplement, is presented. The patient is a healthy 20-year-old male Marine who presented with multiple episodes of abdominal cramps each day for a month with decreased appetite and nonbilious vomiting. He reported a 6-week history of "Guerilla Warfare" PED use and review of systems identified fatigue and 12 lb reported weight loss. He presented with normal vital signs, tenderness in upper abdominal quadrants, elevated lipase (909 units/L), lactate dehydrogenase (193 units/L), and an enlarged pancreas with surrounding inflammation on computed tomography. This constitutes the first report of acute pancreatitis with the use of "Guerilla Warfare," and the second reported case with the use of any AAS-containing PED. Increased awareness of significant PED-associated adverse effects by both the civilian and military communities is needed to better characterize these risks moving forward.

The use of physical performance-enhancing drugs is not limited to professional sports only, but has also been reported as common practice in recreational sports. A significant amount of epidemiological studies have highlighted the collective of fitness center visitors to be a high-risk group for using performance-enhancing drugs. From a sociological perspective, however, the decision to use performance-enhancing drugs (e.g., doping in the context of high-performance sport) is not an individual phenomenon only, but rather a result of social opportunity structures. This research article gives insight into enhancing-related Internet forums, in which the expertise of using and applying substances is passed on step by step. Using selected criminological learning theories, the “doping talk” in these social networks is hermeneutically reanalyzed and the Internet is exposed as a previously under-analyzed option for acquiring knowledge on the use of performance-enhancing drugs. This article shows that users of “doping platforms” are highly informed about doping and this offer of information acts like a knock-on effect to athletes who have so far abstained from doping. Consequently, future prevention models against the abuse of performance-enhancing drugs should consider the subcultural background of the milieu in which the athletes act.