Abstract
BackgroundAnabolic-androgenic steroid (AAS) use is associated with health problems and substance use. Substance use is common among inmates. This study aims to estimate lifetime and prison use of AAS and other substances, compare characteristics of groups of inmates, and describe factors associated with AAS use in a national prison population. MethodsData from the Norwegian Offender Mental Health and Addiction (NorMA) Study, a cross-sectional survey of people in prisons, included sociodemographic variables and lifetime and prison use of AAS and other substances. Altogether 1,499 inmates, including 96 (6.4%) women, were divided into three mutually exclusive groups according to lifetime AAS use, non-AAS substance use and no substance use. ResultsLifetime AAS use was reported by 427 (28.5%) inmates; 6 women and 421 men. Non-AAS substance use was reported by 593 (39.6%) and 479 (31.9%) had never used AAS or non-AAS substances.Compared to the non-AAS substance group, the AAS group reported younger debut ages for nearly all non-AAS substances, higher mean number of non-AAS substances used in their lifetime (8.9, 6.6, p < 0.001), during the six months prior to incarceration (5.2, 3.1, p < 0.001), and during (2.3, 1.3, p < 0.001) imprisonment. Although 120 (8.0%) inmates used AAS during the six months prior to incarceration, only ten continued during imprisonment. ConclusionsLifetime AAS use is common among inmates and may be an indicator of more severe substance use problems. Screening for previous and present AAS use at incarceration and increased staff awareness are needed to tailor treatment approaches appropriately.
Highlights
Lifetime Anabolic-androgenic steroid (AAS) use is found to be higher in some subpopulations such as illicit substance users (Hope et al, 2013; Lundholm et al, 2015), pa tients in substance use disorder (SUD) treatment (Havnes et al, 2020b; Kanayama et al, 2003; Nøkleby, 2013), and inmates in prison (Keene, 1997; Klötz et al, 2010; Korte et al, 1998; Lundholm et al, 2010; Pope et al, 1996)
In Sweden, 25.6% of 3597 remand prisoners with illicit substance use (Lundholm et al, 2010) and 55.9% of 59 prisoners diagnosed with SUDs reported lifetime AAS use (Klötz et al, 2010)
1,499 inmates participated in the study, of which 96 (6.4%) were women
Summary
Use of anabolic-androgenic steroids (AAS) is associated with illicit substance use (Dodge and Hoagland, 2011; Garevik and Rane, 2010; Hakansson et al, 2012; Ip et al, 2011; Kanayama et al, 2003; Lundholm et al, 2015), and with an increased risk of developing a wide range of mental (Hall et al, 2005; Piacentino et al, 2015) and physical health problems (Baggish et al, 2017; Bjørnebekk et al, 2017; Horwitz et al, 2019; Pope et al, 2014), suicide (Thiblin et al, 1999), and mortality (Ljungdahl et al, 2019; Petersson et al, 2006a; Petersson et al, 2006b; Thiblin et al, 2015).A meta-analysis of mainly selected samples suggests that the global lifetime prevalence of AAS use is 3.3 % (Sagoe et al, 2014). In Sweden, 25.6% of 3597 remand prisoners with illicit substance use (Lundholm et al, 2010) and 55.9% of 59 prisoners diagnosed with SUDs reported lifetime AAS use (Klötz et al, 2010). This study aims to estimate lifetime and prison use of AAS and other substances, compare characteristics of groups of inmates, and describe factors associated with AAS use in a national prison population. Methods: Data from the Norwegian Offender Mental Health and Addiction (NorMA) Study, a cross-sectional survey of people in prisons, included sociodemographic variables and lifetime and prison use of AAS and other substances. Non-AAS substance use was reported by 593 (39.6%) and 479 (31.9%) had never used AAS or non-AAS substances
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