Search

In the past, research, policy and media have reported the use of anabolic androgenic steroids (AAS) primarily among younger males. However, recent studies have indicated the presence of an older cohort of men who use AAS in comparison to previous years. We carried out a scoping review of the extant literature to map and describe what is known about the use of AAS by older men (>40 years). A systematic search collected and analysed empirical research and grey literature relevant to the research question. Following application of inclusion and exclusion criteria, 44 studies were included which were subsequently charted and thematically analysed. The records included originated from the UK, USA, Canada, Australia, Slovenia, Norway, Spain, Turkey, Switzerland, Japan, and five global studies and were published between 1996 and 2021. Age ranged overall from 14 to 78 years old, however our review only discussed findings pertaining to those older than 40. Three main themes with subthemes were generated as follows: 1) Characteristics of AAS Use; Self-reported Adverse Effects from AAS Use; and Harms Diagnosed by Medical Professional. The review highlights the significant risks to hypothalamic-pituitary testicular function, cardiovascular health, and other organ systems as a result of the ageing man who is motivated to sustain masculine characteristics such as muscularity, youthfulness, sexual function, and perceived desirability and attractiveness. Future research is required to further understand the motivations of older men who use AAS. Furthermore, there is a need for age-specific research and recommendations to inform future policy and practice pertaining so that age-appropriate healthcare and policy decisions can be made in the future. [ABSTRACT FROM AUTHOR]

Harms associated with anabolic androgenic steroids (AAS) use are well-established and a public health concern. Robust estimates of the numbers using AAS are needed to inform responses, however, in the UK these are lacking. Due to the comparative rarity and associated stigma, general population surveys are problematic and data availability limits the use of indirect approaches. To address this, the Delphi method was used to refine the key parameters needed for indirect estimation from attendances at needle and syringe programmes (NSP) for AAS use. An expert panel (n = 63) was surveyed three times (n = 40, 39, and 37) to refine the parameters needed to generate a likely range from data on NSP attendances. A broad agreement was reached on: regional variations in use; the proportion of men using AAS who only use them orally; the proportion of men who inject AAS using NSP; and the proportion of the AAS population who are women. We conclude that previous general population survey-based estimates of recent AAS use appear implausible, with the likely range indicated by NSP data being up to 10-times higher. AAS use in the UK is more common than previously indicated, but further work is needed to refine population size estimation and characteristics. [ABSTRACT FROM AUTHOR]

Prevalence surveys in Ireland indicate an increased trend of youth drug use with rural areas reporting comparable drug availability and prevalence of use in urban settings (Currie, C., Nic Gabhainn, S., Godeau, E., Roberts, C., Smith, R., & Currie, D. (Eds.). (2008). "Inequalities in young people's health: HBSC international report from the 2005/2006 survey." Copenhagen: WHO Regional Office for Europe). Few studies have explored the contexts and meaning of drug use on rural youth transitions in terms of increased drug prevalence, recent influx of rural drug activity, normative tolerance of recreational drug consumption and fragmentation of traditional rural communities. Qualitative interviews were conducted with 220 young people (15-17 years), and 78 service providers in a rural area of Ireland, in order to yield contextualized narratives of their experiences of drug use and achieve a wider exploration of processes, drug transitions and realities of rural youth. The thematic analysis of the research described varied pathways, attitudes and typologies of rural youth drug use, ranging from abstinent, recreational and moderated to maturing out. The research suggests support for a "differentiated" normalization theory (Shildrick, T. (2002). Young people, illicit drug use and the question of normalisation theory. "Journal of Youth Studies, 5," 35-48) in terms of consumerist and normative rural youth drug use transitions in their negotiation of risk within integrating rural and urban dichotomies. In conclusion, it is recommended that drug education programmes need to situate localized rural drug taking behaviours within a wider understanding of rural community life.

Service user forums have the potential for improving awareness of services, empowering service users and strengthening community partnerships within an inclusive treatment and rehabilitation framework. The research aimed to investigate perspectives about service user involvement in order to inform the development of effective service user forum(s) in west Ireland. A total of 30 interviews with key service providers and 12 interviews with service users were conducted, with interview questions focusing on: (1) awareness of the Service User Support Team and (2) barriers to service user involvement and the development of service user forums in the region. An integrated data collection and thematic analysis was undertaken. Current levels of service user involvement were low, restricted by one-way communication and appeared grounded in user-provider power differentials and stigma relating to drug dependency. Service providers queried the actual terms of reference, capacity and training that would be needed for service user forums to advocate and lobby for service users. The use of existing support groups, creation of internet user forums and rotation of rural meetings were recommended to promote engagement among service users. The research underscores the need for transparency, resources and a framework for good practice that reflects a participatory approach. [ABSTRACT FROM AUTHOR]

Mephedrone (4-methylmethcathinone) is a synthetic 'amphetamine-type stimulant' (ATS) derived from the Khat plant and collectively known as 'M-Cats'. Research has indicated the presence of strong displacement patterns in post-legislative timeframes with mephedrone incurred positive effects stimulating user preferences over amphetamine, MDMA and cocaine. The aim of this research was to investigate post-legislative mephedrone consumerist patterns and the presence of (any) incurred displacement patterns, as follow-up to an earlier study on pre-legislative mephedrone use in the Republic of Ireland (Van Hout & Brennan, 2011c. Plantfood for thought: A qualitative study of mephedrone use in Ireland. Drugs Education Prevention and Policy. 1-11. Advance online publication.). A total of 22 in-depth interviews were undertaken with findings indicative of the relative influence of macro- and micro-level club drug markets in determining the continuation of mephedrone use. 'Temporary displacement' patterns between mephedrone and club stimulant drugs were observed with 10 users reporting continued use and the remainder reverting back to 'old favourites'. This was based on user emergent negative psychostimulant experiences with mephedrone, concerns for product contamination and improved quality of club stimulants at that time. The synthetic drug market remains of concern, given the recent evidence for 'blended' club drugs using mephedrone, and with the need for continued monitoring on the impact of legislation on drug consumptive patterns and outcomes. [ABSTRACT FROM AUTHOR]

The synthetic cathinone derivative club drug 'mephedrone' [4-methylmethcathinone (4MMC)] has been recognized in the EMCDDA early warning system since 2008 [EMCDDA (2010a). 'Article 5 of the Council Decision' council decision 2005/387/JHA of 10 May 2005 on the information exchange, risk assessment and control of new psychoactive substances. Official Journal, L 127. Retrieved from ] and is currently under legislative control in Ireland. Research on this drug remains scant, and primarily UK based. This exploratory research aimed to present a 'consumptive snapshot' of this emerging drug in the Irish drug scene, with specific focus on mephedrone user experiences, social situatedness of use and risk discourses. Twenty two in-depth interviews were undertaken with young Irish people aged 18-35 years, who had used mephedrone in the 6 months prior to fieldwork. The resulting narratives were phenomenologically and thematically analysed; and identified unique mephedrone user decision-making processes, particular drug effects and outcomes, socially contextualized mephedrone use and user harm reducing strategies grounded in prior illicit and poly drug taking careers. The research supports UK-based findings, which suggested the presence of drug displacement patterns between licit and illicit, with Irish mephedrone user preferences centralized in mephedrone availability, competitive pricing and general lack of quality illicit stimulants in the street trade. Policy makers and drug educational specialists are dealing with rapid metamorphoses and re-branding of cathinone derivatives circumventing legislation amid widespread internet availability. [ABSTRACT FROM AUTHOR]

The Traveller community was traditionally protected from drug use by distinct traditional anti-drug norms and potent family networks within their 'separateness' from the 'settled' community. Estimations of Traveller substance use remain clouded due to lack of ethnic monitoring in drug reporting systems, and poor service utilization by Travellers. This article draws on a Traveller and substance use regional needs analysis in Ireland, comprising 12 Traveller focus groups and 45 interviews with key stakeholders. Drug activity in terms of both drug dealing and drug use among Travellers is increasing in recent years [Van Hout, M.C. (2009a). Substance misuse in the traveller community: A regional needs assessment. Western Regional Drug Task Force. Series 2. ISBN 978-0-9561479-2-9]. Traditional resiliency factors are dissipating in strength due to increased Traveller housing within marginalized areas experiencing drug activity and increased levels of young Travellers encountering youth drug use within school settings, by way of their attempts 'to fit in' and integrate with their 'settled peers' [Van Hout, M.C. (2009b). Irish travellers and drug use - An exploratory study. Ethnicity and Inequalities in Health and Social Care, 2(1), 42-49]. Fragmentation of Traveller culture is occurring as Travellers strive to retain their identity within the assimilation process into modern sedentarist Irish society. Treatment and outreach policies need to protect Traveller identity by reducing discriminatory experiences, promoting cultural acceptance with service staff and addressing literacy, implementing peer led approaches and offering flexible therapy modalities. [ABSTRACT FROM AUTHOR]