“Pharmacies are less confronting than a medical practitioner”: A qualitative exploration of community pharmacy as an environment for reducing harms related to anabolic-androgenic steroid use

Abstract Background While community pharmacies have been successful in providing harm reduction support for illicit substance consumers, little research has explored their role in addressing the needs of anabolic-androgenic steroid (AAS) consumers. Objective This study aims to understand the attitudes and experiences of AAS users in relation to community pharmacies, with the goal of identifying opportunities for harm reduction interventions and creating safer-use environments. Methods Semi-structured interviews were conducted with eight AAS consumers living in Australia between December 2022 and April 2023. Interview data were analysed using reflexive thematic analysis. Results Participants discussed accessing AAS equipment and overcoming challenges, such as limited access in rural areas. They highlighted the disparity between the availability and accessibility of equipment from pharmacies and needle and syringe programs. Participants expressed a preference for community pharmacies, perceiving them as less confronting and a feasible avenue for accessing professional advice, highlighting the potential role of pharmacists in nurturing therapeutic alliances with users of AAS. Overall consumers supported the idea of AAS safe-injecting kits being available in pharmacies and they were receptive to pharmacies as potential sources of information and support. Conclusions The findings suggest that community pharmacies can further contribute to promoting safer AAS use and providing support for consumers. However, further research is needed to address knowledge gaps and training needs for pharmacy staff, with the aim of creating a safer environment for AAS consumers.