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In recent years there have been increasing calls for the use of anabolic androgenic steroids (AAS) and associated drugs to be recognized as a public health issue. In the domain of the competitive athlete and professional bodybuilder, recent decades have seen the diffusion of AAS from the hardcore gyms of the 1980s and 1990s to the mainstream exercise and fitness environments of the twenty-first century. Alongside the apparent increases in the use of these drugs, there is a growing evidence base in relation to harms – physical, psychological and (to some extent) social. But is this form of drug use a public health issue? What criteria should we use to make this judgement? What is the available evidence and has our understanding of the issue improved? By drawing on the authors' research in the United Kingdom and the wider international literature this chapter will explore these issues and attempt to answer the fundamental question – is the use of anabolic steroids a public health issue?

With digital spaces an increasing feature of our everyday lives, and the internet now a primary means of sourcing IPEDs and information regarding their use, this chapter seeks to understand how digital fitness forum communities shape the dissemination of culturally embedded harm reduction advice. Findings are drawn from two netnographic studies of fitness forums, which identify several key areas in which community norms and structures served to inform harm reduction behaviours. This included embedded forum reputation systems and the ways in which these shaped IPED access, including through elevating ‘expert’ users and encouraging informed discussion regarding product quality, to the emergence of steroid testing services from forums as a community harm reduction tool. Second, forums were observed to often encourage users to conduct research and inform themselves regarding safe use, though limitations to this norm were also documented in relation to poor-quality medical advice, highlighting the issues with IPED users' reliance on anecdotal advice in the contexts of prohibition. Finally, the role of digital fitness forums as ‘digital backstage’ is considered, examining both how this can be harmful to IPED users from excluded or ‘otherised’ groups, but simultaneously offers cultural participants the opportunity for airing vulnerabilities in a space where their masculine identity is not threatened in doing so, thus facilitating harm reduction among cultural ‘insiders’.

This chapter takes the ‘wakefulness promoting’ drug modafinil as an exemplarity case in the sociology of pharmaceutical enhancement. The chapter draws on empirical data collected through 25 interviews with prospective users of modafinil, focusing on two of the ways in which prospective users of modafinil imagined how the drug might be used in their specific social domains: the use of modafinil as a safety tool in the workplace and its use as a study aid by university students. The data presented in this chapter suggests that although a therapy-enhancement dichotomy is a useful heuristic; it could also be limiting to uphold as it may direct attention away from other ways in which uses for new technologies can be positioned, negotiated, realised and resisted by (potential) users in the context of their daily lives.

Previous research has found that people who use anabolic androgenic steroids (hereafter ‘steroids’) typically describe these drugs as safe. However, research exploring the inside perspective on steroid risk has focussed on steroids in general, and failed to examine how particular steroids are viewed and experienced. During my online ethnographic research in bodybuilding communities, I found discussion of one particular steroid said to cause significant physical, psychological, social and sexual harm: trenbolone. Trenbolone is a veterinary drug used to increase muscle in beef cattle that has been found to have neurodegenerative and genotoxic effects on animals. It has been used by bodybuilders since the 1980s, and recent research has found it to be one of the most popular steroids used by bodybuilders. If trenbolone is described by bodybuilders as causing significant harm, why do so many bodybuilders use it? This chapter attempts to answer this question through a description of bodybuilder folk models of trenbolone risk. Using a social life of drugs approach it describes: (1) the effects of trenbolone; (2) how these effects are given meaning as either harms or benefits, and then weighed against each other; (3) how the risks of trenbolone are reduced through harm reduction strategies and (4) the role of online communities in negotiations of trenbolone risk. Trenbolone was found to occupy a mythical status in bodybuilding communities, in part because of the conflicted relationship bodybuilders have with the drug. This conflicted relationship illustrates the inherent ambivalence of drugs, which are always both remedy and poison.

While steroid use in the sports context has already been extensively studied by academic researchers, its patterns and implications in the prison context have received scant attention. Why do inmates use androgenic–anabolic steroids (AAS)? How does this use relate to sports activities, in particular fitness training, and what does it mean vis-à-vis the body image that is promoted in this environment? Does it even relate to fitness or sport? How do prison authorities regulate or prevent prisoners' AAS use? This empirical study is based on 28 interviews with 19 inmates and nine staff members (guards, managers) of four Belgian prisons. We showed that steroid use is largely connected with fitness activities and that it has an instrumental, goal-oriented dimension. AAS are used for athletic/performance purposes, e.g. increasing muscular strength. They also help gain or maintain a satisfactory body (self-)image, which has implications on the own identity, prestige and power relations within the prison community. In jail, the body is a major type of symbolic capital that is intended to reinforce status and cope with the difficulties and actual conditions of incarceration. We also observed differences in the perceived legitimacy of the various drugs that are used in prison. While guards are more tolerant towards AAS than other drugs, prisoners are less prone to openly confess to using AAS. Admitting to using AAS would damage the inmate's reputation, the legitimacy of his muscled body, and the subsequent goals of individual power and prestige.

This chapter introduces the main aims and ambition with the anthology, which is to bring together research from diverse perspectives on doping and Image and Performance Enhancing Drug (IPED) use. The chapter highlights existing but often backgrounded links between sport and fitness doping research and present a re-reading of the cultural history of doping through which simplistic divisions, such as that between sport and fitness, are deconstructed. Further, by unbinding the hegemonic divide between sports doping and fitness doping, new insights (and themes) concerning anti-doping, health and risk, new emerging doping spaces and the gendering of this field of research are brought to the fore. These themes are then used as point of departure when introducing the different chapters and scholars that contribute to the volume at hand.

This chapter examines representations of gender in online modafinil markets. While gender has often been absent from scholarship on online drug markets, our analysis demonstrates the ubiquity of gender in representations of modafinil users and sellers. The analysis draws on visual images, blogs, and marketing emails relating to three websites selling modafinil, discussed pseudonymously. We describe the range of ways that notions of gender are represented in advertising. Although women represent around 40% of that buying modafinil online, websites and communications tended not to feature women. Although sexist stereotypes of women were rarely present (in contrast to direct-to-consumer pharmaceutical advertising), the ways that modafinil was imagined tended to focus narrowly on corporate spheres of work and productivity. We contrast this narrow imaginary with female journalists’ own accounts of using modafinil to manage illness and enhance creativity. Thus, we conclude that the ways that modafinil has been imagined reflects working assumptions as to who is considered the ‘normal’ participant in online modafinil markets.

This chapter presents an auto-ethnographic journey into the world of women's bodybuilding and the role performance-enhancing drugs play in the pursuit of muscularity in this growing, but hard-to-reach, subculture. The research addresses a paucity in the literature and paves the way for further research to inform public health initiatives for this population. Synthesizing journal entries, field observations and informal conversations recorded over the course of 18 months, this chapter provides insight into the rituals and practices present in bodybuilding culture. This embodied narrative explores the decision-making process surrounding anabolic androgenic steroid use in the context of competitive endeavour, including the impact that cultural norms, peer influence and personal narrative have on their uptake. It also sheds light on the experiences of being a woman in a man's world and the additional stigma women face when attempting to increase their muscularity. It also highlights the personal and professional challenges involved in auto-ethnographic endeavour.

This study aims to increase understanding of the factors that affect retail pharmacy performance. This paper investigates how various product-, store-, customer- and competitor characteristics affect over-the-counter (OTC) drug sales and thus store performance.

This paper specifies and estimates a hierarchical model comprising scanner-based information, as well as individual-level data from a customer survey.

Results indicate that the drivers of retail pharmacy performance in OTC categories are different from those identified in traditional retailing research.

This is the first study that determines which factors impact the sales of OTC drugs in pharmacies.

The coronavirus (COVID-19) is the worst pandemic in recent memory in terms of its economic and social impacts. Deadly second wave of COVID-19 in India shook the country and reshaped the ways organizations functions and societies behave. Medical infrastructure was unaffordable and unsupportive which created high distress in the Indian society, especially for poor. At this juncture, some pharmaceutical firms made a unique social investment when they reduced price of drugs used to treat COVID-19 patients. This study aims to examine how the market and the society respond to the price reduction announcement during the psychological distress of COVID-19.

Market reactions have been analyzed by conducting an event study on stock market data and visual analytics-based sentiment analysis on Twitter data.

Overall, this study finds positive abnormal returns on the day and around the day of event. Interestingly, this study finds that returns during the time of high distress are significantly higher. Sentiment analysis conveys that net sentiment is favorable to the pharmaceutical firms around the day of event and it sustains more during the time of high distress.

This study is unique in contributing to the business and industrial management literature by highlighting market reactions to social responsibility of business during the time of psychological distress in emerging economies.