In the bodybuilding and fitness communities, anecdotal evidence suggests that some take 'steroid holidays', traveling to and living in foreign countries so as to have greater access to performance and image enhancing drugs (PIEDs). This study aimed to explore this phenomenon. Discussions in bodybuilding, fitness, and PIED forums formed the basis of this study. Several websites were identified and keyword searches were used to identify potential 'threads', which were downloaded and thematically analyzed. Twenty-two threads consisting of 254 posts from 188 individual forum members were included. Two themes were identified: (1) Product purchasing and (2) Logistics. In the first theme, the purchase of the products for individual use was a key feature, with their motivations centered on perceptions of legality, purity, and risk. In the second theme, discussions focused those members who sought to use the PIEDs they sourced in a foreign country within that country versus using foreign-sourced PIEDs in Australia. The perception that steroids may be cheaper, more readily accessible, or of better quality in countries in close proximity to Australia may lead some to travel to low- or middle-income countries to use or access PIEDs which could lead to legal and health risks.

The United Nations estimates that the world’s population will reach 8.5 billion by 2030, and the populations of most countries are expected to grow older. This is case for many developed countries, including Australia, the United Kingdom, Canada, the United States of America, and member states of the European Union. Older cohorts will comprise a larger proportion of overall populations, driven in part by our increases in life expectancy. An ageing population poses challenges for governments; notably, older people tend to have multiple, chronic health conditions which can place a burden of health budgets. At the same time, we are witnessing a shift in how we respond to the health needs of our populations, with global drug policy acknowledging that some substances are contributing to increased morbidity and mortality (e.g. opioids) while others may have beneficial therapeutic effects (e.g. psylocibin, cannabis). There is general agreement that as men age their levels of testosterone decrease, and there is some evidence to suggest that there have been population-level declines in testosterone which are not associated with age. Anecdotally, testosterone is accessed by men seeking to self-medicate in the belief that they are experiencing low testosterone levels. There has also been a rise in anti-ageing clinics in the United States, providing access to testosterone replacement therapy (TRT). The non-medical use of testosterone can result in a number of adverse health events, including complications from the use of black market or underground products. Placing testosterone under a new prescribing regime may address some of these concerns, but is society ready for this change, and if so, what would this regime look like? This paper will explore the issue of how society responds to enhancement for longevity, or how we increasingly use pharmaceuticals to address and prevent illness, with a specific focus on testosterone and testosterone deficiency.