Tijs Verdegaal1, Diederik Smit2, Willem de Ronde3
(1) Spaarne Gasthuis/endocrinology, Haarlem, Netherlands. (2) Elisabeth-Tweesteden ziekenhuis/endrocrinology, Tilburg, Netherlands. (3) Spaarne Gasthuis/endocrinology, Haarlem, Netherlands.
The abuse of anabolic androgenic steroids, or androgens, for performance or image enhancement has become increasingly widespread in the general population, posing substantial health risks such as cardiovascular- and endocrinological disorders. Despite these risks, evidence on the efficacy of harm reduction strategies tailored to androgen users remains scarce. Therefore, effective interventions are needed to mitigate the adverse effects of androgen use. This historically controlled trial investigates the efficacy of a multifaceted harm reduction intervention in reducing androgen exposure among amateur athletes. The study includes 100 male amateur athletes aged 18 and older who are planning to initiate an androgen cycle imminently. The intervention involved structured counseling to reduce androgen exposure during the follow-up period. Outcomes were compared with a historical control group. Fourteen participants (14%) renounced their plans to use androgens after the initial counseling session (T0), whilst three participants (3%) did not conduct an androgen cycle for other reasons. The androgen cycle duration of the 83 participants in the intervention group was significantly shorter than in the control group (11,5 vs. 18,9 weeks, P<.001). Weekly androgen dosage (613 vs. 1,014 mg, P<.001) and cumulative androgen exposure (7,086 vs. 19,347 mg, P<.001) were also markedly reduced. Importantly, no inadvertent enabling effects of the intervention were observed. This study demonstrates that a harm reduction intervention can effectively reduce androgen abuse, potentially mitigating long-term health risks associated with these substances. Further research into the development and validation of harm reduction interventions for androgen users is required, remaining mindful of possible enabling effects.