“Will steroids kill me if I use them once?” A qualitative analysis of inquiries submitted to the Danish anti-doping authorities

BackgroundThe Danish strategy for fighting the use of anabolic androgenic steroids in fitness centres is likely the most comprehensive of its sort in the world. It is instituted in the national anti doping organisation, Anti Doping Denmark (ADD), and consists of doping controls, educational campaigns, and anonymous counselling through a web-based email service.Aim and methodInquiries that were submitted to ADD's web-based counselling service over an 18-month period were explored with the aim to identify and analyse differences in concerns and approach to the counselling service. Two categories of inquiries were the focus of attention: (1) those addressing side effects of anabolic steroids and (2) those addressing concerns for receiving a positive doping test after the use of supplements.Results and discussionIn the first category four different types of approaches were identified and inquirers’ concerns analysed: (a) those that lacked knowledge on anabolic steroids, (b) those that had experienced side effects, (c) those that expressed knowledge of anabolic steroids, and (d) those that presented potential harm reduction dilemmas for the service. The second category revealed noteworthy concerns as a result of the legislation on the issue.ConclusionThe approach to the counselling service and the knowledge of health consequences of the drugs consumed differed substantially between the two categories and groups of inquiries.ImplicationsIn order to educate the target group about anabolic steroids there is a need for the involved organisations to consider harm reduction policies in adjunct with the often applied zero tolerance approach.

► Anti Doping Denmark offers web-based counselling to inquirers on anabolic steroids (AS).
► The article examines content and meaning for two categories of inquiries.
► There is great variance in the distribution of knowledge of AS between inquirers.
► Inquirers determined to use AS pose a separate challenge for anti-doping education.
► Harm reduction policies could be considered as an alternative to the present policy.