Culture, Psychosomatics and Substance Abuse: The Example of Body Image Drugs

Patterns of illicit drug use vary widely around the world. For example, one recent survey [1] found lifetime cannabis use among 41.9% of respondents in New Zealand, but only 6.6% of respondents in Italy and 1.5% in Japan. Cocaine was reported by 16.2% of respondents in the USA, versus 4.1% in Spain and 0.0% in the People's Republic of China. Favored drugs of abuse may also rank differently within different countries. Japan, for instance, has experienced three major epidemics of methamphetamine abuse over the last 50 years [2, 3], but shows a low prevalence of many other forms of drug abuse that are widespread elsewhere [4]. Clearly, factors such as drug availability, government enforcement policies and national healthcare systems contribute to these figures, but one must also acknowledge the critical role of culture [5]. Culture influences not only attitudes towards illicit drug use in general, but also which particular drugs people choose to use; a drug effect sought by one population might have little appeal for another. As one example of this little-studied issue, we explore here a form of drug abuse that is strikingly asymmetric across cultures: the use of ‘body image drugs’ such as anabolic-androgenic steroids (AAS).