Exploring the experiences of general practitioners working with patients who use performance and image enhancing drugs

Objective: Medical practitioners such as general practitioners (GPs) may have an underutilized role when it comes to addressing the associated harms among people who use performance and image enhancing drugs (PIEDs) such as anabolic androgenic steroids (AAS). However, consumers report not accessing this group due to the perception they lack knowledge, and medical practitioners often report having a negative view of this group. The aim of this study was to investigate the experiences of Australian GPs with patients who use PIEDs such as AAS Method: A purposive sample of participants was recruited via research contacts and strategic announcements through GP groups and medical boards. Participants were also recruited through snowball sampling. Interviews were conducted online. A semi-structured interview schedule was utilised. The data were analysed thematically using an inductive approach. Findings: Six participants were recruited. Three themes emerged; these were: (1) Knowledge, support and training, challenges: “Better prepared than what I am”; (2) Ethical conflicts: “The difficulty lies in the conflict”; and (3) Poly drug use: “It's a bit intersectoral”. Conclusions: GPs feel inadequately prepared to provide services to this unique cohort of substance consumers and suggest there are specific challenges which intersect with ethics and legality, which make this an even more complex cohort. PIED consumers which access GPs may also be engaging in polysubstance use, although the temporal order of this relationship is still unclear.