The Market for Image and Performance Enhancing Drugs (IPEDs)

"The market for image and performance enhancing drugs has undergone seismic changes in the last two decades and, as has been alluded to above, its partial digitisation has created something of a dual space of commerce (Gibbs, Forthcoming). Before presenting an overview of the supply-side of the market however, it is worth considering the production of IPEDs. According to Turnock (2020), most anabolics steroids in the UK are produced in domestic ‘underground labs’ (UGLs) (Coomber et al. 2015), with raw powders imported from ‘producer’ countries like China, Egypt, Greece, Thailand, Turkey, and India (Antonopoulos and Hall 2016; Brennan et al. 2018; Llewellyn and Tober 2010; Denham 2019). Underground labs can be defined as illicit operations where IPEDs, most commonly anabolics androgenic steroids, are produced from these imported powders outside of registered pharmaceutical manufacture. These operations vary in scale from minor set-ups with minimal expertise, to large-scale production staffed by highly specialised (but illicitly operating) staff capable of producing a wide range of enhancement drugs beyond just AAS (see Gibbs Forthcoming, for an overview of the UK UGL market). The public health challenges of such production are widely reported, encompassing product dosing, hygiene, and contamination (Llewellyn and Tober 2010; Coomber et al. 2015). Analogous substances like post-cycle therapy drugs and human growth hormone, on the other hand, are generally produced in licit pharmaceutical laboratories in jurisdictions with more lax regulations and subsequently imported or removed from domestic pharmaceutical supply chains by illicit actors (Fink et al. 2019).

"As has been alluded to above, empirical evidence indicates that the bulk of IPED transactions occur between peers operating within sporting or fitness-related contexts (van de Ven and Mulrooney 2017; Sagoe et al. 2014), and can broadly be characterised as social supply (Coomber et al. 2014; Begley et al. 2017). Accordingly, literature around IPED supply tends to ascribe a pivotal role to one’s social network or community (Bates et al. 2017; Greenway and Price 2018). Coomber et al. (2014) note that their participants overwhelmingly sourced IPEDs from ‘connected friends’, whilst Fincoeur et al. (2015: 241) suggest that some suppliers are subject to a process of normalisation due to their IPED-using peers, and thus do not view themselves as ‘real dealers’. In this sense, they conceptualise the suppliers in their sample as ‘cultural products’ who engage in a process of ‘cultural reciprocity’ in consumer-supplier interactions, whereby financial gain is less important than other benefits (e.g., respect, reputation, or acknowledgement of expertise) within an ‘enduring relationship’ between the two parties (Fincoeur et al. 2015: 242; van de Ven and Mulrooney 2017). In practice, Antonopoulos and Hall (2016: 707) note that social supply tends to occur in ‘discreet places’ in gyms, such as toilets and changing rooms, and sellers rarely approach prospective customers, relying instead on their personal network of trusted users. However, Coomber and Moyle (2014) critique the concept of social supply on account of its dismissal of the fundamentally economic nature of drug transactions. Addressing this, they coined the term ‘minimally commercial supply’ to acknowledge the inevitable economic exchange taking place.

"Crucially, access to this ‘partial’ offline market (Fincoeur et al. 2015) is guarded by symbolic barriers, meaning that those without the prerequisite cultural or bodily capital cannot gain access (Maycock and Howat 2005; Coomber and Turnbull 2007; Antonopoulos and Hall 2016). However, whereas these cultural battlements have traditionally limited the consumer base to community embedded ‘expert’ users (Christiansen 2020), discernible shifts have occurred that have ushered in a new wave of prospective buyers. Firstly, a raft of literature points to a professionalisation of the IPED market. Fincoeur et al. (2015), drawing upon the axes of commercialisation and cultural embeddedness, contend that IPED supply has become more professionalised and profit driven. This is supported by Salinas et al. (2019), who found that their sample’s consumption ‘transcended IPEDs to encompass a much broader cocktail of substances’ (Salinas et al. 2019: 49) including recreational drugs like cannabis and cocaine (see also Turnock 2021b). As such, this polydrug use is facilitated by increasingly ‘market-oriented dealers’ (Fincoeur et al. 2015: 244), with fewer ties to the fitness community and, crucially, with no qualms about selling to non-culturally embedded customers. Secondly, changes in the global accessibility of IPEDs have occurred due to the rise of online selling. Hall and Antonopoulos (2016: 64) note that the market ‘has in some respects moved online’, and therefore customers who lack cultural and bodily capital can circumnavigate traditional barriers to supply. Such customers, termed ‘occasional users’ (Antonopoulos and Hall 2016: 702), are the principal target for online sellers, who can offer a ‘virtual relationship’, mimicking that of the gym community. As a result, the authors describe the online IPED market as ‘decentralized, highly flexible with no hierarchies, and open to anyone’ (Antonopoulos and Hall 2016: 708). Finally, recent scholarship has examined changes in the motivation to use IPEDs and the impact of a focus on medicalised ‘wellbeing’ rather than conventional sporting consumption (Underwood et al. 2021). This includes users sourcing products online as self-prescribed testosterone replacement therapy (TRT) (Dunn et al. 2021; Harvey et al. 2021; Turnock 2022) as part of a wider pharmaceuticalisation of health (Williams et al. 2011; Nettleton 2013; Morrison 2015)."