Cause and Manner of Death Among Users of Anabolic Androgenic Steroids

Thiblin, Ingemar; Lindquist, Olle; Rajs, Jovan

doi:10.1520/jfs14635j

Cited by 139 publications

(91 citation statements)

References 42 publications

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“…In particular, nalbuphine hydrochloride (Nubain) is popular among bodybuilders [183], and is associated with other substance misuse. In the clinical literature, naloxone has been used to treat AAS withdrawal in a bodybuilder [169], and AAS appear to interact with heroin in accidental drug overdose [172]. …”

Section: Opioidsmentioning

confidence: 99%

“…There is also a precedent for an interaction of androgens and opioids in humans [9,169,172]. In 2002, Arvary and Pope suggested that AAS could act as a gateway drug to opioid dependence [9].…”

Section: Opioidsmentioning

confidence: 99%

“…Similar findings have been reported for rhesus monkeys treated with naloxone following testosterone propionate [117]. Thus, it may be that testosterone serves as a partial opioid agonist and/or may act through non-opioid systems.There is precedent for an interaction of androgens and opioids in the brain in animal studies [73,[82][83][84] There is also a precedent for an interaction of androgens and opioids in humans [9,169,172]. In 2002, Arvary and Pope suggested that AAS could act as a gateway drug to opioid dependence [9].…”

mentioning

confidence: 99%

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Anabolic–androgenic steroid dependence? Insights from animals and humans

Wood

2008

Frontiers in Neuroendocrinology

136

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Anabolic-androgenic steroids (AAS) are drugs of abuse. They are taken in large quantities by athletes and others to increase performance, with negative health consequences. As a result, in 1991 testosterone and related AAS were declared controlled substances. However, the relative abuse and dependence liability of AAS have not been fully characterized. In humans, it is difficult to separate the direct psychoactive effects of AAS from reinforcement due to their systemic anabolic effects. However, using conditioned place preference and self-administration, studies in animals have demonstrated that AAS are reinforcing in a context where athletic performance is irrelevant. Furthermore, AAS share brain sites of action and neurotransmitter systems in common with other drugs of abuse. In particular, recent evidence links AAS with opioids. In humans, AAS abuse is associated with prescription opioid use. In animals, AAS overdose produces symptoms resembling opioid overdose, and AAS modify the activity of the endogenous opioid system. KeywordsAnabolic agents; Testosterone; self-administration; hamsters; drug dependence • Breakfast of champions: Recent history and prevalence of AAS useAnabolic-androgenic steroids (AAS) are a hot topic. A search of the Google news archive in March 2007 reveals 47,500 news stories on "steroids" in 2006, a 400% increase since their debut in the archive in 2002. In 2006, "steroids" even surpassed trend-setters such as "Paris Hilton" (38,500 stories) or "spinach" (42,700 stories). Current media attention on AAS abuse has been driven by accusations of steroid use among professional athletes in baseball, track, and cycling. However, public recognition of AAS use in sports dates back nearly 20 years, when Ben Johnson tested positive for stanozolol at the Seoul Olympics in 1988 [77]. Eastern Block athletes had been using steroids since the 1950's, and the International Olympic Committee banned steroid use from Olympic competition in 1976. However, the ability to reliably detect androgen metabolites in urine samples was limited until the advent of gas chromatography-mass spectroscopy [89]. Johnson's drug test spurred the United States Congress to pass the Anabolic Steroid Control Act of 1991 which declared steroids as Address all reprint requests and correspondence to Ruth I. Wood, Department of Cell and Neurobiology, Keck School of Medicine at the University of Southern California, 1333 San Pablo St., BMT 401, Los Angeles, CA 90033. Telephone (323) 442-1980, Fax: (323) 442-3466, e-mail: riw@usc.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain....

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Section: Opioidsmentioning

confidence: 99%

Section: Opioidsmentioning

confidence: 99%

mentioning

confidence: 99%

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Anabolic–androgenic steroid dependence? Insights from animals and humans

Wood

2008

Frontiers in Neuroendocrinology

136

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“…These episodes can escalate to extreme violence, including murder attempts (7). AAS abuse may lead to dependence, and drug discontinuation can cause severe withdrawal symptoms that may lead to suicide attempts (12,13).…”

Section: Submicromolar Doses Of S-norfluoxetine (S-nflx) That Are Insmentioning

confidence: 99%

Changes in brain testosterone and allopregnanolone biosynthesis elicit aggressive behavior

Pinna

Costa

Guidotti

2005

Proc. Natl. Acad. Sci. U.S.A.

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“…However, when low doses of AS are used (l10-550mg per week), no increase in hostility could be detected [85]. At least 8 welldocumented cases of suicide have been linked to withdrawal from AS abuse [73], while analysis of CSF testosterone levels in 46 Swedish suicide attempters found lower Testosterone levels than in aggressive / violent patients in other studies [30]. AS abuse also appears to increase the risk of experiencing physical violence, including murder [54].…”

Section: Effects On Mental Statementioning

confidence: 99%

The actions and side effects of Anabolic Steroids in sport and social abuse

George

2003

Androl.

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Anabolic steroids (AS) derived from testosterone have both anabolic (muscle and strength enhancing) and a n d r o g e n i c (primary and s e c o n d a r y sexual) effects. Efforts to limit the androgenic while enhancing the anabolic effects have not been successful. Alterations to the structure of testosterone, so as to improve the pharmacokinetics of AS, have resulted in drugs, which are orally active, have a longer plasma half life and may be administered as depot injections. Therapeutic doses of AS produce statistically significant effects on strength and athletic performance in well-controlled scientific and clinical trials. At low, therapeutic doses, diet and an intensive training regime are equally important in producing a statistically significant increase in strength. Higher doses 6-7000mg per week are regularly administered in sport and produce the greatest increases in muscle strength erythropoiesis and lean body mass. Patterns of steroid abuse can be complex, reflecting a desire to minimise side effects, and avoid detection. AS side effects are of many types. AS increase salt and water retention leading to an expansion of the blood volume, but effects of steroids on blood pressure are equivocal and most cardiovascular side effects appear to be reversible.Abuse of AS causes an increase in blood triglyceride and cholesterol levels and this is associated with a decline in High Density Lipoproteins (HDLs) and an increase in the Low Density (LDL) type. Though these effects are reversible they are associated with an increased risk of both acute and c h r o n i c c a r d i o v a s c u l a r p a t h o l o g y . The m o s t serious irreversible anabolic steroid side effects are associated with carcinomas -mainly of the liver, prostate and kidney. Hepatic carcinomas are strongly associated with abuse of the orally active 17alpha methyl substituted steroids, which also produce a reversible jaundice. In males, anabolic steroid abuse causes suppression of LH and FSH release leading to inhibition of testosterone production often accompanied by testicular atrophy, and azoospermia. High, chronic doses of the drugs may also cause moderate to severe feminising effects in the form of gynaecomastia. Male secondary sexual characteristics are a side effect of AS abuse in women. Increased insulin resistance and elevated fasting blood glucose levels are the commonest non-gonadal endocrine side effects of AS.AS abuse leads to contradictory, complex, behavioural, and psychiatric changes. Increased frequency of mental illness, in anabolic steroid abusers including paranoid schizophrenia, mania and d e p r e s s i o n has been r e p o r t e d . P h y s i c a l and psychological dependency occur amongst some anabolic steroid abusers and severe psychiatric disorders can appear upon withdrawal, leading in a few cases to criminality and even suicide. We need more studies on the long-term effects of AS. The implications of the past 50 years of AS abuse will be discussed in the review.

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Cause and Manner of Death Among Users of Anabolic Androgenic Steroids

Cited by 139 publications

References 42 publications

Anabolic–androgenic steroid dependence? Insights from animals and humans

Anabolic–androgenic steroid dependence? Insights from animals and humans

Changes in brain testosterone and allopregnanolone biosynthesis elicit aggressive behavior

The actions and side effects of Anabolic Steroids in sport and social abuse

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