Anabolic androgenic steroid use population size estimation: a first stage study utilising a Delphi exercise

Vivian Hope, Vincent Bond, Ian Boardley, Josie Smith, John Campbell, Geoff Bates, Rob Ralphs, Marie-Claire Van Hout, James McVeigh

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8 Citations (SciVal)


Harms associated with anabolic androgenic steroids (AAS) use are well-established and a public health concern. Robust estimates of the numbers using AAS are needed to inform responses, however, in the UK these are lacking. Due to the comparative rarity and associated stigma, general population surveys are problematic and data availability limits the use of indirect approaches. To address this, the Delphi method was used to refine the key parameters needed for indirect estimation from attendances at needle and syringe programmes (NSP) for AAS use. An expert panel (n = 63) was surveyed three times (n = 40, 39, and 37) to refine the parameters needed to generate a likely range from data on NSP attendances. A broad agreement was reached on: regional variations in use; the proportion of men using AAS who only use them orally; the proportion of men who inject AAS using NSP; and the proportion of the AAS population who are women. We conclude that previous general population survey-based estimates of recent AAS use appear implausible, with the likely range indicated by NSP data being up to 10-times higher. AAS use in the UK is more common than previously indicated, but further work is needed to refine population size estimation and characteristics.

Original languageEnglish
Pages (from-to)461-473
JournalDrugs: Education, Prevention and Policy
Issue number5
Early online date15 May 2022
Publication statusPublished - 31 Dec 2023


  • Anabolic androgenic steroids
  • Delphi method
  • needle & syringe programmes
  • prevalence estimation

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health(social science)


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