Misuse of anabolic steroids in youth. Trends, attitudes and evaluation of an intervention programme

Sammanfattning: Background: Misuse of androgenic anabolic steroids in US is well known. Less is known about the situation in Sweden and Europe. If there does exist a problem of misuse, it is important to investigate prevalence, risk-factors and attitudes towards anabolics. This knowledge is vital in order to design intervention.Aim:. The aims of this thesis were to investigate the prevalence in a Swedish county, rural and urban areas as well as different points in time; analyse attitudes among users and non-users of androgenic anabolic steroids; assess the importance of self-esteem, appearance and peer pressure among male youths; design And evaluate an intervention programme.Methods: Prevalence studies by questionnaires were performed regularly 1993-2000 to follow trends of the misuse and to study attitudes towards androgenic anabolic steroids. Based on background factors for the drug misuse an intervention programme was designed, implemented and evaluated. To add further to our understanding of youths attitudes and lifestyles a quantitative study with individual and focus-groups interviews were performed. The material was analysed in phenomenological tradition. Results: The first prevalence study verified misuse of anabolics with the prevalence rate of 5.8% among male adolescents. Sports activities were protecting factors. An appearance programme, including group discussions catalysed by specially educated health-workers, was implemented. The programme was well received and the misuse figures remain stable with a possible tendency to decline. The prevalence rates were 3.0% 1995 and 1.2% 2000 among male adolescents. The attitudes among misusers and non-misusers differed risk factors for misuse were immigrant status, smoking, drinking more alcohol including home-distilled alcohol, other drug-misuse and muscular training at gyms. Thewell-trained body was reported as an important factor for self-confidence, respect from other boys and girls, for security in nightlife and in the beach culture.Conclusions: Misuse of anabolics among male adolescents is a threatening problem in the community. This intervention programme based on appearance discussions and self-confidence strengthening seems to be a possible way to prevent misuse of anabolics. These findings would be interesting to implement and evaluate in different settings, with possible modifications, in order to find effective ways to reduce the misuse of androgenic anabolic steroids.