Recently the journal Performance Enhancement & Health put out a call to produce a special issue on the dark side of human enhancement, including the use of legal and illegal substances, leading us to ponder whether the “dark side” of anabolic-androgenic steroids (from here on, “steroids”) has been overstated. In this commentary, we will briefly engage with this question by unpacking what we describe here as the “narrative of harm”, which tends to dominate discourses on steroid use in wider society. We then consider an alternative perspective on steroid use which focuses on the users’ experience and understanding, with particular attention to the role of pleasure. Finally, we conclude by exploring some of the negative policy consequences arising from the dominance of the “narrative of harm” and advance a regulatory approach grounded in rational and research informed discussions around both the pleasures and pains of steroid use. A more developed version of this argument can be found in the forthcoming collection Human Enhancement Drugs, published by Routledge in 2019 (Mulrooney, van de Ven, McVeigh, & Collins, 2019).

Over the past decade there has been an increase in the use of steroids and other human enhancement drugs (HEDs) (e.g., illegal weight-loss drugs, 'smart drugs') across the globe. Specifically, the Internet appears to be playing an important role in facilitating this rising global demand for HEDs: by acting both as a source of information and as a tool for obtaining these substances. Indeed, Internet based sources, such as online 'pharmacies', bodybuilding forums and steroid-selling websites, seem to increasingly be replacing the 'local (gym) vendors' by offering a wide range of HEDs at affordable prices and without a prescription.

This was a presentation made for the Drug and Alcohol Research Network at Queen's University Belfast

Anti-doping has evolved from a historically independent and un-coordinated movement to what is now a largely coherent and unified crusade, inclusive of global government, national government and sport authorities, and headed by the World Anti-Doping Agency (WADA). The growth of the anti-doping movement has not been limited to size but the scope has likewise expanded as the movement has consistently called for and successfully accrued more powerful weapons in the doping fight. While doping controls within sport have been successively ratcheted up, our attention here is with the breach of anti-doping beyond the boundaries of sport, to target social consumers and traffickers of performance and image enhancing drugs (PIEDs).

Doping in sport has become progressively viewed as a social problem and a number of actors have been successively identified as the ‘carriers of this social harm’ (Ellis, 1987; in DeKeseredy & Dragiewicz, 2012). As a result the list of ‘folk devils’ (Cohen, 1985) has grown and so too have the control mechanisms employed to combat them. Performance and Image Enhancing Drugs (PIED) are deemed morally reprehensible by the general population, and considered a practice that should be banned and criminalized (Coomber, 2013; Coakley, 2014). However, there seems to be a tendency amongst policy makers to frame steroid or PIED use outside of elite sport as an issue within sport, and to call for the same types of policies that are being used in anti-doping (Kimergard, 2014). This paper will briefly explore the PIED policies of three countries, Sweden, Belgium and Denmark, highlighting the ways in which anti-doping in elite sport is informing national drug policy and encouraging a zero tolerance approach to PIEDs as a social health issue.

Background: Cannabis policies should be relevant to communities most impacted by them. Home cultivation policies can engage people who grow cannabis and build on their motivation to supply a safe product. This paper aims to examine the laws pertaining to "home" (i.e. personal, small-scale) cannabis cultivation internationally and their different aspects, and to discuss the potential of these policies to be expanded into community-level cannabis supply models.
Methods: We reviewed relevant laws and regulations in states/countries that legalised, decriminalised or applied other non-prohibitive approaches to home cannabis cultivation.
Findings: Non-prohibitive approaches to home cannabis cultivation have been adopted in at least 27 jurisdictions. Twelve jurisdictions "de jure" legalised home cultivation (three U.S. states and Antigua and Barbuda legalised only home cultivation; six U.S. states, Uruguay and Canada legalised commercial sales as well). Eight states/countries "de facto" (Belgium, the Netherlands) or "de jure" decriminalised it (Czech Republic, Spain, Jamaica, and three Australian states). "De jure" depenalisation was in place in Chile and Brazil and recent court rulings yielded "de facto" depenalisation or "de facto" legalisation in five other jurisdictions (South Africa, Mexico, Colombia, Costa Rica and Georgia). Varying number of plants (per person and per property) and the circumstances of cultivation were in place. The key limitations of the regulations included (i) possession thresholds for the produce from home cultivations, (ii) rules about sharing the produce, and (iii) potentially disproportionate sanctions for non-authorised behaviours. Despite currently being limited, home cultivation policies might have the capacity to engage cannabis networks that already exist in the community and like that, enhance their participation in legitimate policy schemes.
Conclusions: Rules around pooled cultivation and sharing could be made fit for purpose to accommodate community supply of cannabis. Home cultivation policies could serve as a basis for community-level cannabis supply models and as such, for more inclusive cannabis policies.

The recreational use of steroids and other image enhancing drugs (SIEDs) to enhance image and/or performance has been firmly recognized as a public health concern (McVeigh, et al. 2016). In a meta-analysis of 187 studies exploring the recreational use of SIEDs, an overall global lifetime prevalence of 3.3 percent, and a lifetime prevalence of 2.3 percent for high school students who use SIEDs, was found (Sagoe, et al. 2014). In addition, looking at fitness training-related groups, such as bodybuilders, we see much higher numbers, with prevalence rates in gyms as high as almost half of all members. While most countries focus on prevention and education to deal with this growing issue, a handful have taken the drastic step of introducing dope-testing programs in gyms (only EU countries) and high schools (mainly the United States).

Background: It is now commonly accepted that there exists a form of drug supply, that involves the non-commercial supply of drugs to friends and acquaintances for little or no profit, which is qualitatively different from profit motivated 'drug dealing proper'. 'Social supply', as it has become known, has a strong conceptual footprint in the United Kingdom, shaped by empirical research, policy discussion and its accommodation in legal frameworks. Though scholarship has emerged in a number of contexts outside the UK, the extent to which social supply has developed as an internationally recognised concept in criminal justice contexts is still unclear.
Methods: Drawing on an established international social supply research network across eleven nations, this paper provides the first assessment of social supply as an internationally relevant concept. Data derives from individual and team research stemming from Australia, Belgium, Canada, Czech Republic, Finland, Germany, Hong Kong, the Netherlands, England and Wales, and the United States, supported by expert reflection on research evidence and analysis of sentencing and media reporting in each context. In situ social supply experts addressed a common set of questions regarding the nature of social supply for their particular context including: an overview of social supply research activity, reflection on the extent that differentiation is accommodated in drug supply sentencing frameworks; evaluating the extent to which social supply is recognised in legal discourse and in sentencing practices and more broadly by e.g. criminal justice professionals in the public sphere. A thematic analysis of these scripts was undertaken and emergent themes were developed. Whilst having an absence of local research, New Zealand is also included in the analysis as there exists a genuine discursive presence of social supply in the drug control and sentencing policy contexts in that country.
Results: Findings suggest that while social supply has been found to exist as a real and distinct behaviour, its acceptance and application in criminal justice systems ranges from explicit through to implicit. In the absence of dedicated guiding frameworks, strong use is made of discretion and mitigating circumstances in attempts to acknowledge supply differentiation. In some jurisdictions, there is no accommodation of social supply, and while aggravating factors can be applied to differentiate more serious offences, social suppliers remain subject to arbitrary deterrent sentencing apparatus.
Conclusion: Due to the shifting sands of politics, mood, or geographical disparity, reliance on judicial discretion and the use of mitigating circumstances to implement commensurate sentences for social suppliers is no longer sufficient. Further research is required to strengthen the conceptual presence of social supply in policy and practice as a behaviour that extends beyond cannabis and is relevant to users of all drugs. Research informed guidelines and/or specific sentencing provisions for social suppliers would provide fewer possibilities for inconsistency and promote more proportionate outcomes for this fast-growing group.

This commentary invites discussion about implicit and explicit factors that impede research about substance use from a nuanced perspective that recognises potential benefits and advantages. It is argued that explicit efforts to engage in scholarship beyond those informed by theoretical and philosophical assumptions that substance use is inherently risky and problematic can enhance genuine inquisition about substance use and transform which discourses and interpretations are legitimised. Prioritisation of scholarly funding and publication has largely been predicated on the notion that illicit substances pose an inherent risk for individual and social harm. This has implicitly and explicitly influenced what type of research has been conducted and how substance use is constructed. Researchers who engage in scholarship that suspends assumptions of risk and problems associated with substance use may become subject to judgement about their credibility, ethics, and expertise. Moving forward, we suggest that conscientiously attending to broad, nuanced experiences associated with substance use will contribute to a stronger evidence base. Equal opportunity should be given to examine the complexity of lived experiences. It may also be timely to consider what brings value to scholarly pursuit, recognising that health is but one valued social outcome. Perhaps other outcomes, such as human rights, compassion, and justice are equally commendable. To advance substance use scholarship, it is essential that decision-makers (e.g., funding bodies, editors) embrace research that does not conform to assumptions of risk or inherent problems as exclusively legitimate, advocate for scholarship that resists conforming to dominant discourses, and create spaces for critical perspectives and interpretations.