Coordination in treatments for people who use anabolic androgenic steroid (AAS) - Experiences of professionals.

Abstract

Aims: Research has identified the use of anabolic-androgenic steroids (AAS) as a gap between treatment needs and available facilities for substance use disorder (SUD) treatment in Norway. State policy emphasizes the need for measures to ensure coordinated treatment services. This study aims to explore whether clinical pathways of mental health and substance abuse and team-based organisation function as intended in the treatment of patients with AAS use. Design: A qualitative research design was used. Individual semi-structured in-depth interviews were conducted with eight professionals who we assumed had experience with this patient group. The participants were asked about the clarification process regarding assessment and treatment for AAS and internal and external cooperation. Everyday work, roles and task distribution, structure and routines, and knowledge of AAS were topics that were addressed. We analysed by interpreting the data considering relevant theoretical perspectives of organisational- and sociology of profession perspective. Results: We found that it was arbitrary whether AAS use was discovered, which may indicate a lack of attention to this form of abuse. Organisation in teams seems to as an adequate horizontal coordination mechanism within SUD treatment. However, the teams lacked both knowledge of AAS as well medical expertise, which may lead to a lack of a treatment programme that is in line with the patient's needs. Conclusion: There still seems to be a need for increased awareness of AAS among the professionals and organisations involved. Team-based organisation within SUD seemed to function well, however loss of coordination between SUD and local services may indicate that the clinical pathway for mental health and substance abuse do not function as intended.