{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:33:54Z","timestamp":1790670834363,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["2041822"],"award-info":[{"award-number":["2041822"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Trenbolone is a high\u2010risk anabolic\u2010androgenic steroid (AAS), yet quantitative evidence describing its psychosocial and physical harm profile remains limited. This study compared self\u2010reported concerns among men who used trenbolone in the past 12\u2009months (trenbolone group) with those who used other AAS but not trenbolone (non\u2010trenbolone group).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data were drawn from male respondents to the Global Drug Survey 2024 who reported past\u2010year AAS consumption (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20091146;\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      \u2009=\u200931.46,\n                      <jats:italic>SD<\/jats:italic>\n                      \u2009=\u20099.93). Participants were categorised as the trenbolone group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009237) or non\u2010trenbolone group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009909) based on past\u201012\u2010month injectable trenbolone use. Chi\u2010squared tests examined between\u2010group differences in psychosocial and physical concerns. Multiple\u2010response frequencies and UpSet plots were used to assess number and co\u2010occurrence of reported harms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Chi\u2010square analyses indicated that psychosocial concerns, including mood instability, irritability and depressive symptoms, were significantly more common among the trenbolone group (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with small\u2010to\u2010moderate effect sizes (\n                      <jats:italic>\u03d5<\/jats:italic>\n                      \u2009=\u20090.13 to 0.20). Physical concerns, particularly cardiovascular and hepatic effects, were also significantly more prevalent among the trenbolone group (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001;\n                      <jats:italic>\u03d5<\/jats:italic>\n                      \u2009=\u20090.18 to 0.20). UpSet plot visualisations showed denser clustering of harms among the trenbolone group compared with the non\u2010trenbolone group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>Trenbolone use is associated with a higher prevalence and co\u2010occurrence of psychosocial and physical concerns relative to other AAS use. These harms suggest trenbolone use is reflective of severe risk profiles within the AAS\u2010using communities. Targeted harm\u2010reduction messaging and clinical screening strategies may be warranted for this subgroup.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70162","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T07:33:59Z","timestamp":1777275239000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Trenbolo(g)ne Sandwich: An International Study Comparing Health Harms Among Men Who Use Anabolic\u2010Androgenic Steroids With and Without Trenbolone"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-8759-2101","authenticated-orcid":false,"given":"Benjamin","family":"Bonenti","sequence":"first","affiliation":[{"name":"School of Public Health, Faculty of Health, Medicine and Behavioural Sciences The University of Queensland  Brisbane Australia"},{"name":"School of Applied Psychology and Griffith Centre for Mental Health Griffith University  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahareh","family":"Ahmadinejad","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Health, Medicine and Behavioural Sciences The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3658-9772","authenticated-orcid":false,"given":"Cheneal","family":"Puljevi\u0107","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Health, Medicine and Behavioural Sciences The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7474-0173","authenticated-orcid":false,"given":"Jason","family":"Ferris","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Health, Medicine and Behavioural Sciences The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Winstock","sequence":"additional","affiliation":[{"name":"University College London  London UK"},{"name":"Global Drug Survey  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle T.","family":"Ganson","sequence":"additional","affiliation":[{"name":"Factor\u2010Inwentash Faculty of Social Work University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M.","family":"Nagata","sequence":"additional","affiliation":[{"name":"Division of Adolescent and Young Adult Medicine, Department of Pediatrics University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Health, Medicine and Behavioural Sciences The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Piatkowski","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Health, Medicine and Behavioural Sciences The University of Queensland  Brisbane Australia"},{"name":"Queensland Injectors Voice for Advocacy and Action  Sunshine Coast Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.15187"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12850"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2014.01.009"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16643"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2024.2337717"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2024.104636"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2022.09.023"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwad362"},{"key":"e_1_2_11_10_1","volume-title":"Healthcare","author":"Albano G. 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