PMID- 33948794
OWN - NLM
STAT- MEDLINE
DCOM- 20210805
LR  - 20220716
IS  - 1525-1497 (Electronic)
IS  - 0884-8734 (Print)
IS  - 0884-8734 (Linking)
VI  - 36
IP  - 7
DP  - 2021 Jul
TI  - Harm Reduction in Male Patients Actively Using Anabolic Androgenic Steroids (AAS) 
      and Performance-Enhancing Drugs (PEDs): a Review.
PG  - 2055-2064
LID - 10.1007/s11606-021-06751-3 [doi]
AB  - Anabolic androgenic steroid (AAS) and performance-enhancing drug (PED) use is a 
      prevalent medical issue, especially among men, with an estimated 2.9-4 million 
      Americans using AAS in their lifetime. Prior studies of AAS use reveal an 
      association with polycythemia, dyslipidemia, infertility, hypertension, left 
      ventricular hypertrophy, and multiple behavioral disorders. AAS withdrawal 
      syndrome, a state of depression, anhedonia, and sexual dysfunction after 
      discontinuing AAS use, is a common barrier to successful cessation. Clinical 
      resources for these patients and training of physicians on management of the 
      patient using AAS are limited. Many men are hesitant to seek traditional medical 
      care due to fear of judgment and lack of confidence in physician knowledge base 
      regarding AAS. While proposed approaches to weaning patients off AAS are 
      published, guidance on harm reduction for actively using patients remains sparse. 
      Medical education regarding the management of AAS use disorder is paramount to 
      improving care of this currently underserved patient population. Management of 
      these patients must be non-judgmental and focus on patient education, harm 
      reduction, and support for cessation. The approach to harm reduction should be 
      guided by the specific AAS/PEDs used.
CI  - (c) 2021. Society of General Internal Medicine.
FAU - Bonnecaze, Alex K
AU  - Bonnecaze AK
AUID- ORCID: 0000-0002-9642-7222
AD  - Dept of Internal Medicine, Section on Endocrinology and Metabolism, Wake Forest 
      University School of Medicine, Winston-Salem, NC, USA. Abonneca@wakehealth.edu.
FAU - O'Connor, Thomas
AU  - O'Connor T
AD  - Dept of Internal Medicine, University of Connecticut School of Medicine, 
      Farmington, CT, USA.
FAU - Burns, Cynthia A
AU  - Burns CA
AD  - Dept of Internal Medicine, Section on Endocrinology and Metabolism, Wake Forest 
      University School of Medicine, Winston-Salem, NC, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210504
PL  - United States
TA  - J Gen Intern Med
JT  - Journal of general internal medicine
JID - 8605834
RN  - 0 (Anabolic Agents)
RN  - 0 (Performance-Enhancing Substances)
RN  - 0 (Steroids)
RN  - 0 (Testosterone Congeners)
SB  - IM
MH  - *Anabolic Agents/adverse effects
MH  - Harm Reduction
MH  - Humans
MH  - Male
MH  - *Performance-Enhancing Substances/adverse effects
MH  - Steroids
MH  - *Substance-Related Disorders
MH  - Testosterone Congeners/adverse effects
PMC - PMC8298654
COIS- Thomas O'Connor owns and operates a private practice internal medicine clinic 
      based out of Essex, CT, and has written a book on the adverse effects of AAS 
      misuse. The authors have no other disclosures to declare.
EDAT- 2021/05/06 06:00
MHDA- 2021/08/06 06:00
PMCR- 2022/07/01
CRDT- 2021/05/05 06:36
PHST- 2020/05/12 00:00 [received]
PHST- 2021/03/21 00:00 [accepted]
PHST- 2021/05/06 06:00 [pubmed]
PHST- 2021/08/06 06:00 [medline]
PHST- 2021/05/05 06:36 [entrez]
PHST- 2022/07/01 00:00 [pmc-release]
AID - 10.1007/s11606-021-06751-3 [pii]
AID - 6751 [pii]
AID - 10.1007/s11606-021-06751-3 [doi]
PST - ppublish
SO  - J Gen Intern Med. 2021 Jul;36(7):2055-2064. doi: 10.1007/s11606-021-06751-3. Epub 
      2021 May 4.