October 2021

ACSM Releases Consensus Statement on Anabolic-Androgenic Steroid Use

The American College of Sports Medicine has updated its 1987 consensus statement on the use of anabolic-androgenic steroid (AAS) use, synthesizing more than 30 years of research on the topic.1 The College acknowledged that lawful and ethical therapeutic use of AAS is a mainstream treatment for several clinical disorders, but also recognized that illicit use by athletes to enhance performance remains antithetical to competitive sport and called the illicit use deplorable.

In a blog2 accompanying the release, Michele Labotz, MD, one the authors, noted that the average AAS user spends 268 hours – that’s nearly 7 full-time work weeks – learning about the products and their effects before ever beginning use. While she acknowledged that the average sports medicine clinician can’t come close to this level of knowledge about these products, she did identify 4 basic patterns to understand about AAS:

  1. Most AAS users are males who are focused on increased muscle size, not improving athletic performance. “Muscle dysmorphia (aka ‘megarexia’) is a dominant risk factor for AAS misuse.”
  2. More than 99% of AAS users inject the drugs and 80% “stack” several different compounds; ancillary drugs to blunt side effects are used by 40%.
  3. Anabolic-androgenic steroids are Schedule III drugs that place users at risk for physical and psychological dependence, but their increasing clinical use (eg, testosterone therapy for aging men or as part of gender affirming treatment for transgender males) will place more households at greater risk for diversion of these drugs for non-medical uses.
  4. Long-term data regarding muscle-related effects of AAS is highly variable and needs additional work with reasoned debate about the findings.

Importantly, LaBotz reported that less than 10% of AAS users perceive physicians or pharmacists as knowledgeable about these products and explains how this statement seeks to regain credibility in this topic area.

The consensus statement is available for free at: journals.lww.com/acsm-msse/pages/articleviewer.aspx?year=2021&issue=08000&article=00026&type=Fulltext

References

  1. Bhasin S, Hatfield DL, Hoffman JR, Kraemer WJ, et al. Anabolic-androgenic steroid use in sports, health, and society. Med Sci Sports Exerc. 2021;53(8):1778-1794.
  2. LaBotz M. Anabolic-androgenic steroid use in sports, health and society | A New Consensus Statement from ACSM. Blog posted Aug. 31, 2021. Available at https://www.acsm.org/home/featured-blogs—homepage/acsm-blog/2021/08/31/anabolic-androgenic-steroid-use-sports-health-acsm-consensus-statement. Accessed Oct. 18, 2021.

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