Seeking legitimacy for broad understandings of substance use

20 Jul 2019

Seeking legitimacy for broad understandings of substance use / Niki Kiepek, Katinka Van de Ven, Matthew Dunn, Cynthia Forlini

  • International Journal of Drug Policy 73 (November 2019, p. 58-63
  • PMID: 31336295
  • DOI: 10.1016/j.drugpo.2019.07.014


Abstract

This commentary invites discussion about implicit and explicit factors that impede research about substance use from a nuanced perspective that recognises potential benefits and advantages. It is argued that explicit efforts to engage in scholarship beyond those informed by theoretical and philosophical assumptions that substance use is inherently risky and problematic can enhance genuine inquisition about substance use and transform which discourses and interpretations are legitimised. Prioritisation of scholarly funding and publication has largely been predicated on the notion that illicit substances pose an inherent risk for individual and social harm. This has implicitly and explicitly influenced what type of research has been conducted and how substance use is constructed. Researchers who engage in scholarship that suspends assumptions of risk and problems associated with substance use may become subject to judgement about their credibility, ethics, and expertise. Moving forward, we suggest that conscientiously attending to broad, nuanced experiences associated with substance use will contribute to a stronger evidence base. Equal opportunity should be given to examine the complexity of lived experiences. It may also be timely to consider what brings value to scholarly pursuit, recognising that health is but one valued social outcome. Perhaps other outcomes, such as human rights, compassion, and justice are equally commendable. To advance substance use scholarship, it is essential that decision-makers (e.g., funding bodies, editors) embrace research that does not conform to assumptions of risk or inherent problems as exclusively legitimate, advocate for scholarship that resists conforming to dominant discourses, and create spaces for critical perspectives and interpretations.

Psychosocial factors facilitating use of cognitive enhancing drugs in education: a qualitative investigation of moral disengagement and associated processes

2 Jul 2919

Psychosocial factors facilitating use of cognitive enhancing drugs in education : a qualitative investigation of moral disengagement and associated processes / Andrew Robert Heyes, Ian David Boardley

  • Drugs: Education, Prevention and Policy 26 (2019) 4, p. 329-338
  • DOI:10.1080/09687637.2019.1586831
  • Special Issue: Pharmaceutical Cognitive Enhancement


Abstract

Illicit use of prescription drugs (e.g. modafinil) to enhance academic performance – termed cognitive enhancement (CE) – is a legal, health, and ethical issue. Guided by Bandura’s social cognitive theory of moral thought and action, this study investigated whether student users of CE evidenced specific psychosocial mechanisms (i.e. mechanisms of moral disengagement) when explaining their reasons for CE. Following ethical approval from the lead author’s institution, in-depth-semi-structured interviews were conducted with nine students with experience of CE. Data were content analysed deductively, using definitions for the eight mechanisms of moral disengagement; six of the eight mechanisms were identified through data analysis: diffusion of responsibility (DR), advantageous comparison (AC), distortion of consequences (DCs), displacement of responsibility, moral justification, and euphemistic labelling. In addition, inductive data analysis identified three further themes; self-medication, family and friends, and institutional position. Overall, the study findings suggest students may morally disengage to justify and rationalise use of CE to minimise negative emotional responses (e.g. guilt) that may be expected to result given the potential legal-, health-, and ethics-based deterrents to CE.

Perceptions of legitimacy, attitudes and buy-in among athlete groups: a cross-national qualitative investigation providing practical solutions

15 Jun 2018

Perceptions of legitimacy, attitudes and buy-in among athlete groups : a cross-national qualitative investigation providing practical solutions / April Henning, Paul Dimeo. - University of Stirling, 2018

  • Report compiled for the World Anti-Doping Agency Social Science Research Scheme


Abstract

First paragraph: In order to achieve its stated purpose, anti-doping relies on athlete buy-in to its overall goals and methods and their compliance with anti-doping policies. Previous research on athlete behavior focused on ways to induce athletes into compliance. However, the authors of the Sport Drug Control Model hypothesized that athletes views of anti-doping and their resultant behaviors resulted from their first hand experiences with anti-doping (Donovan et al, 2002). These and similar findings supported the hypothesis that the greater the levels of perceived legitimacy of antidoping organizations among athletes, the greater the likelihood athletes would comply with anti-doping policies. A better understanding of which experiences at the policy, agency, and individual levels are viewed positively or negatively can provide a path for improving perceptions of legitimacy among athletes. The purpose of this study is to investigate perceived legitimacy, athletes' attitudes, and buy-in towards anti-doping policies in a selection of national contexts and sports. The overall objective is to provide clear, practical guidance as to how to improve the athlete experience to increase levels of perceived legitimacy of anti-doping organizations and regulations among athletes.

The Health Threat Posed by the Hidden Epidemic of Anabolic Steroid Use and Body Image Disorders Among Young Men

17 Sep 2018

The Health Threat Posed by the Hidden Epidemic of Anabolic Steroid Use and Body Image Disorders Among Young Men / Anna L. Goldman, Harrison G. Pope, Shalender Bhasin

  • Journal of Clinical Endocrinology & Metabolism 104 (2019 4 (April), p. 1069-1074
  • PMID: 30239802
  • DOI: 10.1210/jc.2018-01706


Abstract

Context: The prevalence of body image disorders and anabolic-androgenic steroid (AAS) use is increasing, despite the evidence of their serious adverse health effects and despite the passage of laws regulating their sales. Here we review the evolution of the dual emerging epidemics of body image disorders and AAS use, adverse health effects of AASs, and the need for an integrated health policy and regulatory response.

Evidence acquisition: We searched for studies published prior to June 2018. Quality of evidence was low to moderate because of its observational nature; heterogeneity of eligibility criteria; variable doses; reliance on retrospective self-reported data in many studies; and variable quality of outcome ascertainment.

Evidence synthesis: Most AAS users are nonathlete young men, who use these substances to look lean and more muscular. Some of these men suffer from "muscle dysmorphia," a form of body dysmorphic disorder. AASs has been associated with cardiovascular disorders, psychiatric disorders, AAS-withdrawal hypogonadism, infertility, neurotoxic effects, musculoskeletal injuries, liver toxicity, and needle-borne infections. Potential adverse effects may be compounded by the use of other substances (e.g., opioids) and high-risk behaviors. Unregulated Internet sales of AASs and selective androgen receptor modulators, which are easily purchased without a prescription, are of concern because of their potential to fuel the epidemic among adolescents and the military.

Conclusions: Integrated nationwide efforts are necessary to raise public awareness of this epidemic, to study long-term health effects of AASs and treatment strategies, and to reform regulations to stem the epidemics of AAS use and body image disorders.

Engaging with people who use image and performance enhancing drugs: One size does not fit all

27 May 2019

Engaging with people who use image and performance enhancing drugs: One size does not fit all / Jim McVeigh

  • International Journal of Drug Policy 71 (September 2019), p. 1-2
  • PMID: 31146199
  • DOI: 10.1016/j.drugpo.2019.05.016


Commentary on:

The unintended consequences of emphasising blood-borne virus in research on, and services for, people who inject image and performance enhancing drugs: A commentary based on enhanced bodybuilder perspectives / Mair Underwood

    • International Journal of Drug Policy  67 (May 2019), p. 19-23
    • PMID: 30844641
    • DOI: 10.1016/j.drugpo.2018.11.005

Use of substances among professionals and students of professional programs: a review of the literature

15 Sep 2017

Use of substances among professionals and students of professional programs : a review of the literature / Niki Kiepek, Jonnie-Lyn Baron

  • Drugs: Education, Prevention and Policy 26 (2019) 1, p. 6-31)
  • DOI: 10.1080/09687637.2017.1375080


Abstract

Background and aims: This literature review investigates the scope of information regarding self-reported substance use by professionals and students in professional programs, with a focus on anticipated and actual effects of substances.

Methods: A review of English, peer-reviewed journals and professional journals was conducted. Articles were included if they reported empirical findings of original research and specifically described an aspect of substance use (e.g. type of substance used, patterns of use, reasons for use) by professionals or students.

Results: Of the 130 articles ultimately included, 105 involved anonymous self-administered survey methodology. Self-reported data about the effects of substance use or reasons for use were reported in 35 articles. Reasons for use included positive impact on performance and experience, such as fun, pleasure, sleep, enhanced work performance, improved attention and concentration, and relaxation. Predictive associations were analysed regarding demographic factors, mental health, type of profession, and area of specialisation.

Conclusions: Little is known about the effects of substance use on the performance or experience of professionals or students in professional programs. Research is required that incorporates qualitative methodologies, elicits anticipated and actual effects of substance use, including controlled and beneficial patterns of use. Minimisation of research bias is key to future study of the effects of substance use by professionals or students in professional programs.

‘Shades of Grey’ : The Ethics of Social Work Practice in Relation to Un-prescribed Anabolic Androgenic Steroid Use

23 Dec 2018

‘Shades of Grey’: The Ethics of Social Work Practice in Relation to Un-prescribed Anabolic Androgenic Steroid Use / Orlanda Harvey

  • Practice : Social Work in Action 30 (2019) 4, p. 239-258
  • DOI: 10.1080/09503153.2018.1510480


Abstract

This paper reflects on some of the ethical dilemmas that social workers face when assessing risk in relation to those using substances. It explores how legislation and societal factors can impact not just on people’s choices and decisions but also on their ‘vulnerability’ and access to services. Vulnerability, a contested term, is linked, in this paper, to assessment of risk. There are ethical issues that arise when assessing risk with people who use Anabolic Androgenic Steroids (AAS) from both service user and professional perspectives. These ethical issues concern a person’s right to choose and make potentially harmful decisions. The paper argues that using substances such as AAS in and of itself does not suffice to make a person vulnerable but this does not mean that people using AAS are not in need of support. It suggests that there may be some groups of people who are more at risk to starting AAS use and that social workers should be aware of these. It also recommends the need for further qualitative research to understand the reasons for starting use and support to help people stop using AAS.

Keywords:

Anabolic Androgenic Steroids (AAS) Image and Performance Enhancing Drugs (IPED) social work substance use ethics vulnerability body imageme dialegislation risk

A ‘messenger of sex’? Making testosterone matter in motivations for anabolic-androgenic steroid injecting

20 Oct 2019

A ‘messenger of sex’? Making testosterone matter in motivations for anabolic-androgenic steroid injecting / Renae Fomiatti, J.R. Latham, Suzanne Fraser, David Moore, Kate Seear, Campbell Aitken

  • Health Sociology 3 (2019) 3, p. 323-338
  • DOI: 10.1080/14461242.2019.1678398


ABSTRACT

Anabolic-androgenic steroids are synthetic derivatives of testosterone. They are thought to be the most commonly used performance and image-enhancing drugs (PIEDs) in Australia. However, the motivations for men’s use of steroids and other PIEDs are poorly understood. Established ways of understanding these motivations highlight men’s performance and/or image-related concerns, in the context of contemporary masculinities and gender norms. Researchers have paid little attention to how the social and political features of testosterone shape and transform steroid use. Instead, testosterone tends to be taken for granted as a ‘messenger of sex’ that acts on the body in predictable and routinised ways. This article takes a different approach. Drawing on feminist science studies and interviews conducted for an Australian research project, we investigate how the cultural and symbolic meanings assigned to testosterone shape the ontological politics of men’s steroid consumption. Approaching testosterone as an emergent social and biopolitical gathering rather than as a stable sex hormone allows us to better understand how men’s PIED consumption is mediated, particularly by pervasive ideas about sexual difference and the biology of gender. In concluding, we consider ways of better engaging men who consume steroids in health initiatives, in keeping with their concerns and perspectives.

The availability and acquisition of modafinil on the internet

16 Aug 2019

The availability and acquisition of modafinil on the internet / Suat Dursun, Matthew Dunn, Fiona H. McKay

  • Drug and Alcohol Review 38 (2019) 6 (September), p. 699-702
  • PMID: 31418943
  • DOI: 10.1111/dar.12977


Abstract

Introduction and aims: Prescription medications are readily accessible on both the dark and surface web. This study focuses specifically on modafinil. Modafinal is a medication that is used to treat sleepiness due to a range of sleep disorders, but is also used off-label as a cognitive enhancer. This study aimed to evaluate surface websites which sold modafinil to Australia to provide an overview of and to document the characteristics of surface web retailers.

Design and methods: An online search to identify online retailers selling modafinil was performed using three search engines. Retailers were included if they sold modafinil to Australia, as verified through the purchasing process. Thirteen retailers were included in the final sample.

Results: Most retailers sold more than one product, with products being sold in tablet form the most common (88%). Retailers offered products of multiple strength, with the 200 mg product most common (51%). Most retailers included information on the side effects of the substances (77%), few listed any supporting evidence. Few listed information regarding legal status (24%). Most retailers used a number of features to indicate legitimacy.

Discussion and conclusion: This is the first study to document the characteristics of surface web retailers purporting to sell modafinil to Australia. Future studies may analyse purchased samples to identify potential counterfeit or poor-quality medications.

“Athlete suspended for presence of banned substance”: A storied approach to protecting student-athletes from doping in sport

5 Aug 2019

“Athlete suspended for presence of banned substance” : A storied approach to protecting student-athletes from doping in sport / Kelsey Erickson

  • Journal for the Study of Sports and Athletes in Education 13 (2019) 3,  p. 214-234
  • DOI: 10.1080/19357397.2019.1648149


ABSTRACT

Banned substance use is a growing issue among student-athlete populations but limited research has addressed this concern. The aim of this research was therefore to explore the lived experience of a sanctioned student-athlete in order to expose the contexts and experiences surrounding their sanction and illuminate student-athlete specific doping risk factors. A narrative approach was adopted and one male student-athlete (“Tyler”) serving a doping sanction was interviewed. Data is presented in the form of a creative non-fiction story. The story demonstrates the interplay between multiple risk factors that ultimately combined and led to Tyler’s doping sanction. Injury and supplementation emerged as particularly significant, as did Tyler’s family life. Informed by the story presented, practical implications are offered for supporting student-athletes in avoiding banned substance use. It is hoped that the story will trigger a critical conversation and collective effort towards proactively protecting student-athletes from their doping susceptibility.

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