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Factors contributing to anabolic androgenic steroid related violence ABSTRACT This paper reports on action research which investigated factors that were claimed to have contributed to anabolic androgenic steroid induced violence. The purpose of this paper is to provide descriptions and plausible explanations of how these factors could contribute to a violent episode. The factors investigated included the individuals perception of themselves, their reasons for use, the socialisation of users, the characteristics of provocation, the nature of the drug use, reported increased sensitivity to aggressive cues and other factors. The paper then examines conflicting aspects of reports of anabolic androgenic induced violence, and highlights several reasons why a person may extemalise a violent episode.

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Bruce Maycock, Research Fellow, Centre for Health Promotion Research, School of Public Health, Curtin University of Technology Peter Howat, Associate Professor, Head, Department of Health Promotion, School of Public Health , Curtin University of Technology Postal Address: Bruce Maycock, School of Public Health, Curtin University of Technology, GPO Box U 1987, Perth, Western Australia 6845. EMail: [email protected]

In 1997 an Australian body builder bludgeoned to death his ex-girlfriend and then committed suicide. The coroner found that anabolic steroid use made the body builder unstable. In 1995, two Australian males found guilty of murder used the 'steroid defence' claiming diminished responsibility due to anabolic androgenic steroid use. Though their claim was not accepted it provided incentive for the Attorney General's Department (New South Wales) to commission a review of anabolic androgenic steroid abuse and violence. The review concluded, ' ... chronic high doses of anabolic steroids are more likely to increase the risk of aggressive and/or violent behav-

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iour than leave it unaffected.' (Maycock & Beel 1997 p 6). However, while completing the review it became apparent there were factors contributing to the relationship between anabolic androgenic steroids and violent behaviour. These factors were peripherally discussed in the literature. The aim of this paper is to elaborate upon these contributing factors, to describe them, provide plausible explanations of how they could affect the relationship between anabolic androgenic steroid use and violence and present recommendations for future research.

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As such much of the research cited in the literature can be criticised as being methodologically flawed. Criticisms include not collecting base line data on aggressive behaviour, not defining what constitutes aggressive behaviour, not using measures of aggression that transfer to the real world, not validating the drugs being consumed, using levels of anabolic androgenic steroids that do not replicate real world use, not using control groups, using self reporting, inappropriate sampling and not distinguishing between classes of anabolic androgenic steroids (Bahrke et al. 1990; Ehrenkranz et al. 197 4; Kouri et al. 1995; Pope and Katz 1988; Yesalis and Bahrke 1995). Given the limitations imposed on researchers by ethics committees it is unlikely that any research will be able to account for these criticisms and provide definite answers to the complex issue of anabolic androgenic steroid consumption and violent behaviour. However, when reviewed the research does indicate trends and associations. The brief literature review that follows cites quantitative and qualitative research as well as those based in the naturalistic setting and those using clinical trials. Where there are similar findings and convergence of data has been noted. Literature review

Prior to examining the literature relating directly to anabolic androgenic steroid use and violence it is worth considering other psychological effects reported by anabolic androgenic steroid users. Anabolic androgenic steroid use has been linked to mood disorders, suicide ideation and dependency (Brower et al. 1991; Malone et al.; 1995; Pope and Katz 1990, 1994). Pope and Katz (1994) found that up to 23% of athletic subjects consuming anabolic androgenic steroids displayed affective disorders including depression and

mania. Brower et al. (1991), in a study of 49 male weight lifters found that over half (57%) were diagnosed as dependent according to DSM-111-R criteria. The depression related to discontinuation of anabolic steroids has been linked to suicide ideation and suicide attempts (Malone et al. 1995). When considering the issue of anabolic androgenic steroid use and the incidence of violent behaviour the fact that a substantial percentage of users will show signs of mood disorders and dependency must also be considered. As indicated in the introduction the issue of anabolic steroid use leading to violence is of concern in the community. The term 'roid rage' is used by anabolic steroid users to describe acts of aggression that are often over 'little things' (Beel 1996). Oft1:m it is as a result of perceived provocation (Beel 1996; Parrot, Choi and Davies 1994). Kouri et al. (1995), found there was a provocation-response relationship. That is, subjects on the anabolic androgenic steroid (testosterone cypionate) were more likely to respond aggressively to a provocation from the fictitious opponent. The finding that anabolic androgenic steroid users were more likely to respond aggressively than non-users to provocation is supported by other research (Beel 1996; Parrot, Choi and Davies 1994). Many studies reported claims by male and female athletes and non-athletes using anabolic androgenic steroids of increased aggression and irritability as a result of use (Bahrke et al. 1992; Kennedy and Lawerence 1993; Korkia and Stimson 1993; Kouri et al. 1995; Silvester 1995; Yesalis et al. 1993). Choi and Pope (1994) in a study of 24 anabolic androgenic steroid users reported that users while on a drug use cycle were more likely to report domestic verbal and physical fights compared to nonusers and those not currently using. Many case study reports

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have linked anabolic steroid use, aggressive behaviour, murder and other violent crimes ( Corrigan 1996; Dalby 1992; Pope and Katz 1990; Schulte et al. 1993). Pope and Katz (1990 p 28) in a review of three case studies concluded that; 'anabolic steroids played a necessary, if not primary, role in the etiology of the violent behaviour.'. Not all studies have found a link between anabolic steroids and increased aggression (Bahrke et al. 1992; Bjorkqvist et al. 1994; Malone et al. 1995). One notable study by Bhasin et al. (1996) placed 43 normal men into 4 groups, placebo with no exercise, testosterone with exercise, placebo with exercise and testosterone with no exercise. Testosterone subjects received 600mg of testosterone enanthate for a ten week period. This dose is six times the dose given to men with hypogonadisim. Bhasin et al. found neither mood or behaviour was altered in any group as measured by a multidimensional anger and mood inventory. The dose of 600mg is greater than some of the individual doses recommended in the black market literature (SAA research undated). However, the black market literature recommends stacking with other steroids thus creating a greater milligram consumption than the above study. Two long term studies also found no link between anabolic androgenic steroid consumption and increased aggression. A five year trial conducted by Millar (1994), found that side-effects were minimal and reversible and that subjects experienced no problems with aggression when on low to moderate doses of anabolic steroids. The World Health Organisation, reported no increases in aggression in a one year trial of testosterone enanthate as a male contraceptive (WHO 1990). These two studies have several common characteristics, the subjects were under medical supervision, on low to moderate doses and had a high compliance with

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the dose regime. There is a growing consensus amongst researchers that the higher the dose the greater the aggressive response (Choi et al. 1989; Kouri et al. 1995; Parrot et al. 1994). This dose response relationship may explain why WHO (1990) and Millar (1994) studies showed no increase in aggressive behaviour however, it does not explain the results of Bhasin et al .. It is apparent from the inconsistent results of the literature reviewed that the relationship between anabolic steroids and violence requires further investigation. There are many factors that may contribute to aggressive behaviour. Broadly they can be discussed under the headings of the drug, the individual, the socialisation process and the setting that the use is taking place in. RESEARCH DESIGN

Action research was initiated to investigate the nature of the contributing variables, to provide plausible explanations of how they could affect the anabolic androgenic steroid and violence link, and to suggest recommendations for future research. The research process involved collecting data, analysing them and then collecting more data based upon the analysis. Data were collected through interview and participant observation. Sixteen interviews were conducted with anabolic steroid users who had experienced violent episodes. A violent episode was classified as the direction or attempted direction of some unwanted physical force towards individuals or objects. This definition excluded slapping and yelling of abuse which were seen in the gym and used to heighten arousal and increase weight training performance. The selection of subjects included those who had experienced only one violent episode as well as those who had multiple violent incidents. These individuals were identified by other anabolic androgenic steroid users

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and by employers. Additional interviews (42) were conducted with doctors, anabolic androgenic steroid users who had not experienced violent episodes, security company managers, trainers associated with the security companies and witnesses of violent acts attributed to anabolic androgenic steroid consumption. Subjects were selected of their practical knowledge and placement within the anabolic androgenic steroid network. Participant observation included mixing with the subjects in recreational, occupational and training (gym and martial arts) settings. It should be noted that anabolic androgenic using subjects differentiated between recreation and training. Training was seen as more than recreation. For the user, training defined who they were and was more important, it was seen as part of their job. Participant observation was conducted as both covert and overt observation. Subjects were observed unobtrusively while they worked and recreated. Once an observational period was completed contact was made with selected subjects and interviews conducted. Observational data continued to be collected during this period. Interview data were transcribed in full while observational data were selectively transcribed. All data were managed by the non-numerical unstructured data indexing searching and theorizing software (NUD.IST). The NUD.IST software assisted in the management and organisation of the analytical categories. Data were analysed for common themes, language, common meanings, common processes, characteristics of socialisation and images of self that individuals held. This analytical perspective was grounded in symbolic interactionism (Blumer 1969). Two typologies of violent types were developed as an aid to theoretical understanding.

DISCUSSION

The anabolic androgenic steroid users who experienced violent episodes identified a number of factors that they believed contributed to the incident/s. These factors are illustrated in figure one and are discussed in the following section. FIGURE ONE. FACTORS CONTRIBUTING TO ANABOLIC STEROID RELATED VIOLENCE.

Type/s of anabolic steroid and consumption patterns

Socialisation

The drug

During interviews anabolic androgenic steroid users identified differences in the effects of anabolic androgenic steroids. Claims varied from user to user with some claiming that anabolic androgenic consumption was responsible for the user becoming reclusive, ·moody, being unable to control their libido, responsible for broken relationships, lost jobs, criminal records, and violent behaviour. The users tended to use themselves as guinea pigs on whom they experimented with different doses and stacks. Through this method they determined when a dose was excessive or when a particular anabolic androgenic steroid produced an adverse effect. Some drugs were seen as benign, the one most frequently mentioned was Deca 50 (Nandrolone Decanoate 50mg/ml). Deca 50 is a veterinary steroid with little androgenic effect and is one of the most commonly used illegal anabolic steroids. It is most used by


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body builders and non-athletes. Its' oil base makes it inappropriate for athletes due to the potential for detection. The anabolic androgenic steroids most frequently mentioned as increasing feelings of aggression were those with a high androgenic component. The two most frequently mentioned were Anapolon and Halotestin, though occasionally Sustanon 250 was mentioned and Primoteston depo. Both the Anapolon and Halotestin have been removed from distribution in Australia as they had little medical use. According to the subjects interviewed they both have reputations of producing problems, such as increased aggression and mood swings. Their reputation may be based upon a pharmacological effect and/or there may be an expectancy effect. That is, the user may expect to feel more aggressive on these drugs. This concept is supported by Bjorkqvist et al. (1994). They found increased aggression in placebo taking subjects, which they suggested this could have been due to an expectancy effect. An increase in testosterone has been linked to increased aggression in animal studies (Bouissou 1983) however, in primates there appears to be some socialisation effect related to social status (Rejeski et al. 1988). Benton (1992) believed that there was little relationship between aggression related to testosterone consumption in humans and that social and cognitive factors played a greater role. Anabolic androgenic steroid users consistently identified a subcultural hierarchy that was partially based upon size. It is possible that these individuals are affected by a biological drive that identifies with bigger being better. Two subjects mentioned that they experienced large increases in aggression while on Stanazol. Both subjects experienced large gains in strength and body weight

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while on Stanazol. Stanazol is a veterinary anabolic steroid containing 50mg/ml of Stanozolol. It is used for horses dogs and cats and is identified as being highly anabolic with a low androgenic effect. It is a popular anabolic steroid, especially with athletes as it is water based and clears the system reasonably quickly. One of the subjects claimed he experienced severe mood swings, bad acne and was very violent while consuming 50 ml of Stanazol in an 8 week course. This course was 25 ml greater than he usually consumed. The phenomenon of increased aggression while on Stanazol has been observed by a medical practitioner involved in the monitoring of several hundred anabolic androgenic users. The medical practitioner explained that a small group of people (approximately 5% of Stanazol users) got enhanced effect from Stanazol. Typically they experienced large increases in strength and body weight as well as increased side effects. The males got a lot of gynaecomastia, females a lot of acne and increased sex drive and both experienced mood swings and aggression. Medical monitoring indicated that they often had impaired liver function and elevated cholesterol. The medical practitioner speculated that it seemed to act as an androgenic agent in that small group of people, though he was unable to explain why. One subject who experienced multiple violent episodes identified he was more likely to respond violently when on a cycle and also in the first 10 days after ceasing a cycle. During the withdrawal phase he claimed to experience severe depression and mood swings which resulted in violence if provoked. The individual Reasons for use can be subsumed under two categories: improved performance (strength, athletic performance) and/or improved appearance (size, shape, defini-

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tion, muscle tone). Improved appearance is the most frequently reported reason for use among gym based weight trainers (Gridley and Hanrahan 1994; Korkia and Stimson 1993; Taylor and Black 1987). Amongst competitive athletes, improved physical appearance ranked fourth after reasons related to athletic performance, prevention or treatment of injuries and perception that other competitors were using anabolic steroids (Wagman et al. 1995; Yesalis et al. 1988). All of the anabolic androgenic using subjects interviewed in this study gave similar reasons for their use. However, further analysis of their responses indicated that all of the reasons for use could be subsumed under the heading of compensation. Whether this be for a perceived lack of size, strength, respect, belonging, security, or the need to change body shape. All reasons could be categorised as a need to compensate for some perceived inadequacy. The headings of improved performance and/or improved appearance were only superficial excuses, given in place of underlying reasons. The use of weight training and anabolic androgenic steroids was part of a transformation process designed to eliminate the perceived inadequacy. As one long term user of anabolic androgenic steroids said ... "Inside every body builder is the little kid or the fat kid, they are still there years afterwards." (Body builder, aged 41) ·

As mentioned previously the hierarchy in the anabolic steroid using subculture is partially based upon size. The following statement by a 35 year old body builder illustrates this. "To the young guys the bigger you are the higher you are. But then it is like a pack , we are like animals. ... There is a pecking order. ... As the younger ones get bigger they get

their own following. The bigger the individual the more respect.". (Body builder aged 35)

This quote illustrates how the increase in size can address several requirements of the user, including the need to belong and be respected. Those who were most violent were employed or had been employed as doormen. They identified themselves as doormen first and as body builders second. Many of them made condescending remarks towards body builders. Remarking that their size had no functional use, while they on the other hand could handle themselves. They often gave the need for respect and the need to protect themselves as reason for starting anabolic androgenic steroid use and weight training. Their responses indicated they viewed the world as violent and threatening. Many of them identified a tendency for aggression prior to using anabolic androgenic steroids. One user who had experienced multiple violent episodes while on anabolic androgenic steroids described how he used to get nose bleeds as a child when he flew into rages. At the time of interview he weighed 105 kilograms and was over 6 feet tall with martial arts training. Typologies of violent users When describing the violent incidents the anabolic steroid users described how their violence was often directed towards someone who they perceived as being threatening, arrogant or not respectful. The violent users tended to display one of two images which can be represented by two typologies, the bad-man-hard-man typology or the white knight typology, though in reality there was significant over lap between the two. The bad-man-hard-man image was typified by short or shaven hair, glaring at individuals and a 'bad' attitude. They displayed the attitude by barging through people, daring people to


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say something and being overtly aggressive. Two quotes from a violent doorman help illustrate the bad man-hard man type. "You get instant respect from having no hair." ".. .respect comes from fear. doesn't it!". (Doorman aged 24) When asked about their violent episodes they typically responded, "This one is a beauty. .. . ". The white knight typology is best represented by Jason a character in the book Sex, Drugs and Knuckle-dusters (Dunk 1997). The book is loosely based upon events that happened in the doorman network in Western Australia. The white knight is the anabolic androgenic steroid user who adopts a less severe countenance and portray themselves as the friendly good guy. They related stories of violent episodes where the others deserved it, where the others broke the rules, bad mouthed the women, were criminal and undesirable. Invariably their stories ended up with them bashing the bad guy and getting the woman. These individuals projected the image of being physically competent, fair, rule abiding. Their self representations were similar to comic book hero projections. When covertly observed they regaled one another with violent war stories, in which they justify their aggressive responses and highlight their physical competence. Individuals who fitted into the badman-hard-man typology often displayed overt aggression to members of the general public. These overt displays seemed to serve several purposes. During the aggressive display the individual gained confirmation from the general public that their transformation was completed. For example, if he barged through or scowled at some one and they cowered then it was confirmation that he generated fear and hence respect. It was also confirmation that he was safe and that he was

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in a higher hierarchical position than the cowering person. The reaction from the public provided a source of confirmation that the transformation was complete. It also provides some insight into why these individuals became aggressive with others. Others who did not show the appropriate response were often described as arrogant and lacking respect. Their lack of appropriate response could be seen to be endangering the individuals perception of transformation, and hence they needed to be dealt with. As one bouncer said, "it is fine once the person had submitted". Bouncer aged 35.

Socialisation The issue of socialisation is intimately bound with the individuals perception of themselves. Individuals initiated use in attempts to transform some aspect of themselves. During their using period they mixed with others with similar aspirations. The socialisation process for body builders is well documented in books such as Muscle: Confessions of an unlikely body builder (Fussell 1991) and Little big men (Klein 1993). Typically during this time the serious body builder is taught how to walk, talk, dress, eat, train and have the correct attitude. This socialisation process extends a lot further than just the gym, for many it becomes a life style. The overt expression of aggression is common in the weight training subculture and is represented in both language and behaviour (Ardito et al. 1994; Klein 1993; Rada et al. 1976; Yesalis and Bahrke 1995). In the gym the weight trainer learnt that social sanctions that normally inhibit overt displays of aggression are relaxed. There was positive reinforcement for aggressive acts such as yelling, slapping the face of their training partner.

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This process of socialisation is replicated in the subgroups of anabolic androgenic steroid users. It is important to note that the anabolic steroid using subculture is made up of various sub groups, and that though there is enough in common to define a subculture sub group differences exist. The socialisation of doormen, involved significant reductions in the social sanctions restricting violence. The men interviewed who identified themselves as doormen fitted into one of the two typologies discussed previously. These individuals described numerous violent episodes, some of which they believed were contributed to by anabolic androgenic steroid consumption. The people in this subgroup were required to become violent if the situation demanded. They described a basic credo that required them to take responsibility for their own safety, the safety of their colleagues and the safety of the venue. It was typical that after violent incidents they would sit around and discuss various aspects. Telling and retelling moves they made, or highlighting aspects of the encounter. Being tough and known as competent in a violent situation also established a place in the subcultural hierarchy. It should be noted that the portrayals of the incidents were not consistent. When the researcher was covertly observing, as part of the subgroup, the skill and violence were emphasised. When the individuals involved were interviewed about the same incident the emphasis often changed and they would often play down the violence or emphasis the provocation. This response was expected, and was one of the reasons why a covert and overt observational mode was adopted. To paraphrase Bogdan and Taylor there is only perception and deception, and both are data. Responding to aggressive cues Experienced doormen identified a number of cues which indicated a

person was about to become violent. The cues were viewed as being so basic that that everyone should know them, though they acknowledged that the ability to detect them was based upon experience. The doormen identified a number of physical cues they used to gauge whether some one was about to become violent. These cues included dropping the shoulder, moving back or moving forward depending upon the original body spacing and moving the hands into their personal space. The doormen regarded these actions as provocation and adopted a variety of ways of dealing with them. Some hit the individual making the provocative move, others applied a choke or a lock. One bouncer claimed that applying a choke until the person was unconscious was a more gentle and kind technique. Doormen also identified that they did an assessment of some individuals which included whether they were more likely to press legal charges.

Other factors Anabolic androgenic steroid users who had experienced violent incidents identified other factors which they believed contributed to violent response. These included lack of sleep, diet, temperature and the consumption of other drugs.

Doormen described how they were more likely to respond to provocation at the end of a twelve hour shift. Other users identified that they suffered from insomnia when on anabolic androgenic steroids which made them more aggressive. Body builders identify that during the dieting process prior to a competition they were more likely to respond aggressively. This behaviour was a recognised part of gym culture and allowances were made towards body builder, training for competition.


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A small number reported that amphetamine consumption increased feelings of aggression. Alcohol was frequently mentioned as a major contributing factor to violence. Doormen and other steroid users noted that when they consumed alcohol and were on a cycle they were more likely to respond violently. Two men in separate incidents described how they verbally abused and had pushed or thrown woman after being told how ugly they were. Both men believed that they would not have normally responded to this provocation and blamed the fact they had consumed alcohol for their response. Provocation

The anabolic androgenic users in this study identified a very wide range of things which they considered provocation. They ranged from others being arrogant, or showing them a lack of respect, breaking the unwritten rules, to food being late. "Being ten minutes late for a meal, .... you get so aggressive and so angry, ... I remember I was at home and once I got so angry, I head butted a wall, that hard I collapsed. " (Doorman aged 34). When questioned further it became evident that a single look, or the way a person walked could be enough to label them as arrogant or lacking respect and hence provoke a violent reaction from the doorman. The breaking of unwritten rules referred to the rules of the street, which when questioned about the users had difficulty defining. Other factors such as giving off aggressive cues through body movements were also seen as provocation. It is difficult to clarify what would be provocation apart to confirm that it may be a very little action that educes the violent response. Reports of 'roid' induced violence The users who experienced violent episodes while on anabolic andro-


genic steroids presented different accounts of the effect they believed anabolic steroids had on them. Some individuals claimed that not only did it increase their tendency to react aggressively, but it also contributed to this by making them more reclusive, and less caring. A number of doormen reported an amplified aggressive response when on anabolic steroids. One doorman claimed that he did not have more fights while on anabolic androgenic steroids but when he did fight the consequences were worse. "It is like a trigger, something would trigger you off, and it was like a bad temper, but like ten times more than anything I had experienced before. When I was fighting it was more severe... there was no remorse, there was no thinking, all you wanted to do was fucking bash them." (Doorman, aged 30)

Analysis of collected case histories of violent episodes provided evidence that some subjects did seem to lose all sense of their surroundings and what they were doing, while other who claimed to be totally out of control actually showed signs that they were aware of their surroundings, what they were doing and the potential consequences of their actions. There may be several reasons why a person who has acted in a violent manner would claim it to be a 'roid' induced rage. If the case went to court the defence of diminished responsibility could be used. Further, as violence is seen as a socially undesirable act by the majority of the population, a claim of diminished responsibility could be used to counter negative comments. The following account was reported to the researcher as a roid rage. Prior to describing the event the individual emphasised he was not in control. It is clear that during this, even the person was still aware of his environment, the potential consequences of his

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actions and that he had some control. The sequence of this event were corroborated by witnesses. "It was the end of a 12 hour shift... he was pretty arrogant... I told them to leave, he said I am not going ... and it was on. .. . He tried to run off, ... another doorman stopped him. I was in such a rage, I tore the doorman off saying he is mine, I was going to destroy him. There were cameras and witnesses everywhere. 1was focused on one thing. I was going to destroy this guy. I dragged him into the female toilets where there were no cameras ... I would not have stopped not until my hands were broken or something. He would have been finished. " (Bouncer aged 23)

The fact that the doorman was aware of the cameras and tried to take steps to remove the evidence by moving the person he was bashing into the female toilets demonstrates some awareness of his environment and potential future consequences. The following quote is from a body builder who was adamant that roid rages did not exist and that they were used as excuses by violent people. Even after this event he still held that belief. "I used to think raid rages were a crock of shit... lt was three weeks out from a competition ... it was hot. I am· turning into the car park and some fool cut me off. I toot... he sticks the finger up, and bang I am gone for all money. I am out the window, I am swearing at him. I stop the car throw open the door and I am chasing his car down the street. He drives through a red light with me running after him. I have a dozen cars behind me, he is pulling away and I remember thinking I am not going to catch him. I stop and am standing in the middle of the street, everyone looking and I think, oh shit what has happened. It wasn't me, there was no control during the rage. I didn't have the feeling of control until afterwards. It is the only time in my life I haven't been in con-

trol. It was lucky he got away, I had

a picture in my head of dragging him through the window, he was gone." (Body builder, aged 40)

In both of these quotes the individuals identified a number of factors which they believed contributed to their response. These included the other person provoked them by being arrogant, and escalating the incident through their response, environmental factors, (it was hot) and intra personal factors (they were tired and dieting). These two reports were presented as they were both reported to the researcher as being roid induced rages. However, while anabolic androgenic steroid consumption may have contributed to the violent responses other factors were also involved. This research has described and illustrated some of the other contributing variables. It is worth noting that while anabolic androgenic steroid users use themselves as guinea pigs for determining the effects of dose and drug type they often report implement strategies to minimise the potential for violence. These included not drinking when on a cycle, never drinking while on a shift, not using amphetamines when on a cycle, appointing minders to monitor them let them know if they were becoming belligerent. They reported actively avoiding individuals who made them hostile, they avoided public places where they may be ridiculed and they would attempt to dress down in such a way as to conceal their size.

CONCLUSION

In 1995, 28 000 Australians identified themselves as consumers of anabolic androgenic steroids for non-medical purposes (Drugs of Dependence Branch 1996), however only a very small number of violent incidents are ever reported. Users who report increased feeling of aggression often initiate harm minimisation strategies to minimise the chance of violence.


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The lack of violence by the vast majority of anabolic androgenic steroid users is not reported in the media. From a media and policy perspective it is easier to claim that the violence was due to anabolic androgenic steroids rather than investigating other factors. This paper has suggested a number of factors that could contribute to the anabolic steroid violence relationship. It should be evident that further research is required to explore the nature of these factors. It is possible that some anabolic androgenic steroids produce greater effects in some individuals and that a combination of factors can produce uncontrollable rages. It is entirely plausible that due to social desirability and the potential to claim diminished responsibility claims of roid rages may be exaggerated. It is also highly likely that the reason an individual initiates use and the socialisation that goes on in some sub groups contributes significantly to the potential for a violent response. Those seeking to place the blame for violent responses on anabolic androgenic steroid consumption need to consider the potential consequences of these other factors. ACKNOWLEDGMENTS School of Public Health, Curtin University of Technology, Perth, Western Australia, (This research was partially funded by the Commonwealth Department of Health & Family Services, National Drug Strategy Research Scholarship) REFERENCES Bahrke, M. S., Wright, J. E., Strauss, R. H., Catlin, D. H. 1992, 'Psychological moods and subjectively perceived behavioural and somatic changes accompanying anabolic-androgenic steroid use', American Journal of Sports Medicine, val. 20, no.6, pp. 717724.


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