Blood work: Exploring direct to consumer health monitoring and performance enhancement
Needle and syringe exchange programmes were developed as part of harm reduction policies in the mid-1980s. While this was largely as a response to public fears about the threat of HIV/AIDS, they also acted to provide users with various support mechanisms, targeted education, signpost treatments and medical screening (Berridge, 1996; Rhodes and Hedrich, 2010).
Despite originally being aimed at users of psychoactive drugs, evidence has demonstrated that such programmes are increasingly used by anabolic steroid users (Iverson, et al., 2012; McVeigh, Beynon, and Bellis, 2003). This has resulted in ‘steroid clinics’ being set up which provide a service geared directly towards the specific needs of such users (National Treatment Agency for Substance Misuse, 1993). And with evidence that steroid and performance enhancing drug usage is still rising (Advisory Council on the Misuse of Drugs, 2010; McVeigh, Beynon, and Bellis, 2003) it would be fair to conclude that the importance of such programmes will continue to increase. This led Kimergard and McVeigh (2014) to call for research to help shed light on those who use such clinics as a means of managing the impending public health issues which are associated with steroid abuse.
The recent rise of companies that specialise in direct to consumer health monitoring, testing and screening, adds a new level of complexity to attempts to research harm reduction programmes. These companies have led the development of products that circumvent clinicians as well as medical programmes and health promoting initiatives. Such direct access to medical testing aligns with the increases in individual health consciousness and are promoted as providing a personalised, pre-emptive, private and convenient means of enhancing and maintaining health. While the nuances of the American health system means this might be seen in a somewhat positive light (Pitkin, et al., 2017), a recent comment article for the BMJ highlights the potential cost of such testing to the NHS (McCartney, 2018).
More specifically in the UK companies offering ‘blood work’, a term with its origins in America, which describes various blood testing protocols, are targeting online bodybuilding communities (both ‘natural’ and enhanced) with a variety of products. Here, MediChecks, Youth Revisited and Transform Now, are three examples of companies using ‘fitness influencers’ social media reach to market themselves to young, usually male, audiences. A variety of tests are advertised offering users the ability to discover their hormonal levels, nutrient deficiencies, markers of heart, liver and kidney health and various other options. It appears that those taking steroids and other performance enhancing drugs are using such services to monitor both the effectiveness of their ‘stack’ (the combination of drugs being injected and taken orally) and apparent markers of health/ill-health. There is a complete lack of knowledge around this relatively new phenomena. As such, this study is proposed in order to address the following questions:
Who uses direct to consumer ‘blood work’ and why?
What do consumers do with the information they receive from these tests?
Are ‘online coaches’ specialising in helping people interpret results from ‘blood work’ and, if so, what are their qualifications and what type of advice do they dispense?
How do users modify potentially damaging behaviours after getting ‘blood work’ done?
Is there evidence of an extra burden being placed on the NHS due to such tests?
References
Advisory Council on the Misuse of Drugs (2010) Consideration of the Anabolic Steroids. London, Home Office.
Berridge, V. (1996) AIDS in the UK – Making of Policy, 1981-1994. Oxford, Oxford University Press.
Iverson, J., Topp, L., Wand, H. and Maher, L. (2012) Are People Who Inject Performance and Image-Enhancing Drugs an Increasing Population of Needle and Syringe Programme Attendees? Drug and Alcohol Review, 32, 205-207.
McCartney, M. (2018) How Private Screening Costs the NHS. The BMJ, 360: k598.
McVeigh, J., Beynon, C. and Bellis M.A. (2003) New Challenges for Agency Based Syringe Exchange Schemes: Analysis of 11 Years of Data (1991-2001) in Merseyside and Cheshire, United Kingdom. International Journal of Drug Policy, 14, 399-405.
National Treatment Agency for Substance Misuse (1993) Good Practice in Harm Reduction. London, NTA.
Pitkin, F., Watson, L., Foster, R. Poorman, T. and Martin, A. (2017) Direct to Consumer Laboratory Testing: A Review. Annals of Clinical and Laboratory Research, 5(2), 164-166.
Rhodes, T. and Hedrich, D. (2010) Harm Reduction and the Mainstream. In T. Rhodes, and D. Hedrich (Eds.) Harm Reduction – Evidence, Impacts and Challenges. Lisbon, EMCDDA, 19-33.