Anabolik Androjenik Steroid Kötüye Kullanımı
Özet
Anabolik Androjenik Steroidler (AAS), performans ve kas kütlesini artırmak amacıyla özellikle 15-30 yaş arası genç erkekler tarafından kötüye kullanılan sentetik testosteron türevleridir. Batı kültüründe öne çıkan kaslı erkek imajı ve beden dismorfik bozukluğu, bireyleri bu maddelere yönlendiren temel etkenler arasındadır. DSM-5'e göre "Diğer madde bağımlılıkları" ve "Kas Dismorfisi" altında sınıflandırılan AAS'lerin suprafizyolojik dozlarda ve kontrolsüzce kullanımı; jinekomasti, hipogonadizm, erektil disfonksiyon, kardiyak problemler, kognitif bozukluklar, saldırganlık ve ciddi depresyon gibi ağır fiziksel ve mental yan etkilere yol açmaktadır. Kullanıcılar bu yan etkileri yönetebilmek adına polifarmasiye başvurarak tıbbi riskleri daha da artırmakta, ayrıca enjektör paylaşımı nedeniyle Hepatit ve HIV gibi bulaşıcı hastalıklara maruz kalmaktadır. AAS'lerin tedavi amaçlı yasal endikasyonları bulunsa da suistimal edilen dozlar çok yüksektir. Bu halk sağlığı sorununu önlemek için internet satışlarına mevzuatsal düzenlemeler getirilmesi, medya üzerinden sağlıklı beden algısının desteklenmesi, farkındalık çalışmaları yapılması ve riskli bireylere bilişsel davranışçı terapi ile ilaç kombinasyonlarının uygulanması gerekmektedir.
Anabolic Androgenic Steroids (AAS) are synthetic testosterone derivatives misused by young men aged 15-30 to enhance performance and muscle mass. The muscular male image promoted in Western culture and body dysmorphic disorder are key factors driving individuals toward these substances. Classified under "Other substance use disorders" and "Muscle Dysmorphia" in DSM-5, supraphysiological and uncontrolled use of AAS causes severe physical and mental side effects, including gynecomastia, hypogonadism, erectile dysfunction, cardiac problems, cognitive impairments, aggression, and major depression. Users resort to polypharmacy to manage these side effects, increasing medical risks, and face infectious diseases like Hepatitis and HIV due to needle sharing. Although AAS have legitimate therapeutic uses, the doses abused are substantially higher. To address this public health issue, regulatory adjustments on internet sales are required, along with media campaigns supporting healthy body image, awareness studies, and implementing a combination of cognitive behavioral therapy and medication for vulnerable individuals.
Referanslar
El-Guebaly N, Carrà G, Galanter M, Baldacchino AM. Textbook of Addiction Treatment. Second. Textbook of Addiction Treatment. Switzerland: Springer; 2021. 307–320 p.
Miller S. The ASAM Principles of Addiction Medicine [Internet]. The ASAM Principles of Addiction Medicine. 2018. 704–35 p.
Pope HG, Kanayama G. Body Image Disorders and Anabolic Steroid Withdrawal Hypogonadism in Men. Endocrinol Metab Clin North Am [Internet]. 2022;51(1):205–16.
Kanayama G, Hudson JI, Pope HG. Anabolic-Androgenic Steroid Use and Body Image in Men: A Growing Concern for Clinicians. Psychother Psychosom. 2020;89(2):65–73.
Casagrande Tango R. Psychiatric side effects of medications prescribed in internal medicine. Dialogues Clin Neurosci. 2003;5(2):155–65.
Claussen MC. Sports Psychiatry in "Praxis". Praxis (Bern 1994). 2022;110(4):e177-e178. doi:10.1024/1661-8157/a003842
Scarth M, Havnes IA, Jørstad ML, McVeigh J, Van Hout MC, Westlye LT, et al. Severity of anabolic steroid dependence, executive function, and personality traits in substance use disorder patients in Norway. Drug Alcohol Depend. 2022;231(January).
Nelson BS, Hildebrandt T, Wallisch P. Anabolic-androgenic steroid use is associated with psychopathy, risk-taking, anger, and physical problems. Sci Rep. 2022;12(1):9133. Published 2022 Jun 1. doi:10.1038/s41598-022-13048-w
Rabin O, Corazza O. Emerging Drugs in Sport. Emerging Drugs in Sport. Switzerland: Springer; 2022.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. 2013.
Mhillaj E, Morgese MG, Tucci P, Bove M, Schiavone S, Trabace L. Effects of anabolic-androgens on brain reward function. Front Neurosci. 2015;9:1–13.
Börjesson A. Side Effects and Experiences of Doping With Anabolic Androgenic. [Stockholm]: Karolinska Institutet; 2021.
Börjesson A, Ekebergh M, Dahl ML, Ekström L, Lehtihet M, Vicente V. Men´s experiences of using anabolic androgenic steroids. Int J Qual Stud Health Well-being [Internet]. 2021;16(1).
Yazdan MMS, Kumar R, Leung SW. The Environmental and Health Impacts of Steroids and Hormones in Wastewater Effluent, as Well as Existing Removal Technologies: A Review. Ecologies. 2022;3(2):206–24.
Smith ACT, Stewart B, Westberg K, Stavros C. Performance and Image Enhancing Drugs and Substances. Performance and Image Enhancing Drugs and Substances. 2018.
Svedsäter G, Svennberg L, Westfelt L, Qvarfordt A, Lilja M. Performance and image enhancing substance use among young people in Sweden. Perform Enhanc Heal. 2021;9(2):0–3.
Davani-Davari D, Karimzadeh I, Khalili H. The potential effects of anabolic-androgenic steroids and growth hormone as commonly used sport supplements on the kidney: A systematic review. BMC Nephrol. 2019;20(1):1–13.
Patanè FG, Liberto A, Maglitto ANM, Malandrino P, Esposito M, Amico F, et al. Nandrolone decanoate: Use, abuse and side effects. Medicina (B Aires). 2020;56(11):1–24.
Ip EJ, Silva MD. Unsafe Behaviors and Anabolic Steroid Use. Handb Subst Misuse Addict. 2022;1–19.
Albaker W, Alkhars A, Elamin Y, Jatoi N, Boumarah D, Al-Hariri M. Anabolic–androgenic steroid abuse among gym users, eastern province, saudi arabia. Med. 2021;57(7):1–8.
Chegeni R, Pallesen S, McVeigh J, Sagoe D. Anabolic-androgenic steroid administration increases self-reported aggression in healthy males: a systematic review and meta-analysis of experimental studies. Psychopharmacology (Berl). 2021;238(7):1911–22.
Pope HG, Kanayama G, Hudson JI, Kaufman MJ. Review Article: Anabolic-Androgenic Steroids, Violence, and Crime: Two Cases and Literature Review. Am J Addict. 2021;30(5):423–32.
Talih F, Fattal O, Malone D. Anabolic steroid abuse: Psychiatric and physical costs. Cleve Clin J Med. 2007;74(5):341–52.
