The Formation and Development of Illicit Performance and Image Enhancing Drug Markets: Exploring Supply and Demand, and Control Policies in Belgium and the Netherlands

This research explores the understudied phenomenon of performance and image enhancing drug (PIED) markets by examining the structure and formation of the market for PIEDs in the Netherlands and Belgium. Furthermore, this study aims to understand and analyse the actors that operate in the PIED dealing environment. In particular bodybuilding is adopted as a case study. Finally, this thesis examines how the PIED control system and its application influence these respective markets. Chapter one introduces the global PIED problem, the policy options currently available to deal with it, and its connection to anti-doping and sport. Chapter two begins by reviewing the literature on PIED use and its supply, and reflects on the anti-doping and PIED policies that seek to regulate this market. In chapter three the theoretical contours of this dissertation are developed. Chapter four describes the research methods which form the empirical bases of the findings chapters. Chapter five focuses on the general characteristics of PIED suppliers, and the ways in which the actions of PIED dealers are influenced by the market cultures in which they operate. Chapter six examines the importance of socio-cultural factors in the formation and development of PIED dealing networks within bodybuilding subcultures. Chapter seven analyses and describes the characteristics of the Belgian and Dutch PIED markets, and unravels the complex relationship between the two. Chapter eight explores the illegal production of steroids in the Netherlands and the flourishing Internet trade in Belgium. Chapter nine assesses the harms related to the production and distribution of PIEDs, and accounts for the effects that Belgian and Dutch PIED policies may have on this illicit market. Finally, in chapter ten, the main findings of this dissertation are summarized, future research endeavours are considered and policy implications are drawn from the analysis. This thesis illustrates that social systems of rules and values, and in particular the embeddedness of culture, are important factors in our efforts to comprehend illicit PIED markets. Specifically, ‘the beliefs, norms, ‘tools’, rules and behaviours appropriate to a cultural setting are key factors for understanding the structure of PIED markets and greater attention must be given to the role played by socio-cultural factors in influencing the market behaviour of criminal groups and individuals. Nevertheless, this thesis also demonstrates that it is imperative to examine the production, distribution and use of PIEDs, as embedded within a diverse combination of social, economic and cultural processes. Indeed, the structure and formation of illicit PIED markets are shaped by a variety of factors including the types of PIEDs dealt within them, the characteristics of the users, the social structures which sustain them, the cultural and economic context in which the markets exist, and market forces (e.g. technical innovations, drug policies)

'Counting your steps': The use of wearable technology to promote employees’ health and wellbeing

The intersection between workplace productivity and health is complex, often leaving the worker to balance the seesaw of simultaneously trying to improve performance and health. Digital platforms, email, smartphones and laptops, and increased connectivity have made it increasingly easy to work from anywhere, especially in white-collar industries. Yet it seems many still work from the same analog spot: their desk chair. But clocking hours in the chair seems to be doing workers' health no favors. Sedentary behaviors are an important risk factor for poor health and mortality and office work significantly contributes to the overall sedentary exposure of office workers (Parry & Straker, 2013). All the technologies that make working easier and more productive also seem to contribute to increasingly sedentary lifestyles (Borodulin, Laatikainen, Juolevi, & Jousilahti, 2007; Matthews et al., 2008). Paradoxically, technology may also be a solution to improve the health and wellbeing of employees.Output Type: Editoria

Do you plan your life around your fitness schedule? You could be addicted to exercise

Physical activity feels good and it's great for your health. It can reduce your risk of developing chronic conditions like type 2 diabetes, strengthen your bones, muscles and joints, and can even help with certain mental health conditions, such as depression. While exercise has clear benefits, it can cause problems if your love of working out crosses over into an addiction. If you constantly cancel activities with friends or family in favour of exercise – so you plan your life around your gym workouts – you might have a problem. If you exercise in spite of pain or injury, and feel obsessively guilty when you miss a session, it could be that you're addicted to exercise

Australia should stop beefing up its steroid laws - that won't help users

The use of image and performance enhancing drugs – in particular steroids – is a growing area of concern globally. The use of these drugs has traditionally been limited to elite athletes and professional bodybuilders. But now their use is becoming normalised as part of a fitness and beauty regime for people who want to gain muscle, become leaner, and improve their appearance. Several population studies have shown the use of image and performance enhancing drugs in Australia is relatively low. However, the dramatic increase of steroids detected at the country's borders, and the number of users accessing needle and syringe programs, seem to indicate otherwise

The emergence of Exercise Addiction, Body Dysmorphic Disorder, and other image-related psychopathological correlates in fitness settings: A cross sectional study.

INTRODUCTION: In a society that perpetuates the strive for a perfect appearance, a fit body has become synonymous with success, but simultaneously hard to achieve. This represents a fertile ground for the development of Exercise Addiction (EA) alongside other disorders, such as Body Dysmorphic Disorder (BDD). This study aims to explore the diffusion of EA in fitness settings in the United Kingdom, Italy, Netherlands, Hungary and the previously unexplored association with appearance anxiety, BDD, self-esteem and the use of fitness supplements. METHODS: A large cross-sectional sample (N = 1711) was surveyed in fitness settings using the Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI) and Rosenberg's Self Esteem Scale (RSE) in addition to questions surrounding the use of fitness supplements. RESULTS: Compulsive exercise, appearance anxiety and low self-esteem were present in this sample according to the psychometric measures used (EAI, AAI, RSE). 11.7% scored over the cut off for EA, with alarming peaks in the Netherlands (20.9%) and the United Kingdom (16.1%). 38.5% were found at risk of BDD, mainly female (47.2%). 39.8% used fitness enhancing supplements without medical consultation (95.5%). This cohort of supplement users scored higher in both EAI and AAI. The logistic regression model revealed a strong association between the consumption of sport products and the level of EA across the sample with an odds ratio (OR) of 3.03. Other co-variable factors among female were appearance anxiety (AAI; OR 1.59) and to a lesser extent self-esteem (RSE) (OR 1.08). CONCLUSIONS: This study identified a high risk of EA, appearance anxiety and BDD amongst a cohort of gym users internationally. The previously-unexplored association between these disorders and the unsupervised use of a variety of fitness products, including illicit drugs, highlights the need for informed and integrated responses targeting such vulnerable individuals

Treatments for people who use anabolic androgenic steroids: a scoping review.

BACKGROUND: A growing body of evidence suggests that anabolic androgenic steroids (AAS) are used globally by a diverse population with varying motivations. Evidence has increased greatly in recent years to support understanding of this form of substance use and the associated health harms, but there remains little evidence regarding interventions to support cessation and treat the consequences of use. In this scoping review, we identify and describe what is known about interventions that aim to support and achieve cessation of AAS, and treat and prevent associated health problems. METHODS: A comprehensive search strategy was developed in four bibliographic databases, supported by an iterative citation searching process to identify eligible studies. Studies of any psychological or medical treatment interventions delivered in response to non-prescribed use of AAS or an associated harm in any setting were eligible. RESULTS: In total, 109 eligible studies were identified, which included case reports representing a diverse range of disciplines and sources. Studies predominantly focussed on treatments for harms associated with AAS use, with scant evidence on interventions to support cessation of AAS use or responding to dependence. The types of conditions requiring treatment included psychiatric, neuroendocrine, hepatic, kidney, cardiovascular, musculoskeletal and infectious. There was limited evidence of engagement with users or delivery of psychosocial interventions as part of treatment for any condition, and of harm reduction interventions initiated alongside, or following, treatment. Findings were limited throughout by the case report study designs and limited information was provided. CONCLUSION: This scoping review indicates that while a range of case reports describe treatments provided to AAS users, there is scarce evidence on treating dependence, managing withdrawal, or initiating behaviour change in users in any settings. Evidence is urgently required to support the development of effective services for users and of evidence-based guidance and interventions to respond to users in a range of healthcare settings. More consistent reporting in articles of whether engagement or assessment relating to AAS was initiated, and publication within broader health- or drug-related journals, will support development of the evidence base

'Blurred lines': Anti-doping, national policies, and the performance and image enhancing drug (PIED) market in Belgium and The Netherlands

Background Due to a growing awareness of the consumption of performance and image enhancing drugs (PIEDs), and the perceived associated adverse health effects, PIEDs have increasingly come to be viewed as a serious public health problem. However, there seems to be a tendency amongst policymakers to frame recreational PIED use as an issue within sport, and to call for the same types of policies that are being used in anti-doping. This paper explores the ways in which national PIED policies in The Netherlands and Belgium and anti-doping measures are intertwined, and how the different approaches adopted in each nation are impacting on the illicit PIED market. Methods This article draws on two years of fieldwork in various bodybuilding settings, 47 semi-structured interviews with individuals who are directly or indirectly involved in the PIED market, and a content analysis of 64 PIED-dealing cases initiated by criminal justice agencies in The Netherlands and Belgium. Findings The data indicates that both countries do not appear to be successful in disrupting the illicit PIED market. In Belgium the demand for PIEDs seems to be unaffected by the threat of criminal penalties or disciplinary measures and continued enforcement may worsen present health risks. However, due to the limited priority of controlling PIED production and/or distribution in The Netherlands, a large underground culture has developed, stimulated by the Internet, in which individuals and groups manufacture and distribute their own PIEDs. In both countries, the intertwinement of national efforts to address recreational PIED use, with sport policy, hinders the exploration of alternative measures and/or the inclusion of other substances and using populations in prevention and harm reduction initiatives. Conclusion Both the regulation and law enforcement practices around PIEDs in Belgium and the limited priority in The Netherlands may be contributing to increasing and exacerbating existing harms

A critical analysis of the diverging anti-doping policies of Belgium and the Netherlands and their effect on performance and image enhancing drugs markets

In the mid 2000's sport authorities (i.e. WADA) began to blame the high amount of consumption of performance and image enhancing drugs (PIEDs) on (mafia type) organised crime. According to the officials these alleged mafia-like groups are not only a threat to sport but also to society as a whole. Subsequently, a picture is painted which suggests that highly organised and well-financed individuals and groups are preying on the success of athletes and luring youngsters into using PIEDs to serve their own economic interests