Fake anabolic androgenic steroids on the black market – Study protocol for a systematic review and meta-analysis on qualitative and quantitative analytical results found within the published literature

Magnolini, Raphael; Falcato, Luis; Cremonesi, Alessio; Schori, Dominique; Bruggmann, Philip

doi:10.37766/inplasy2021.11.0042

Cited by 3 publications

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“…A perfect foundation has been laid to sell fake drugs since acquiring PEDs online appears to be extremely easy (McBride et al, 2018). Typically, counterfeit drugs contain either a completely different active ingredient than listed, smaller amounts than listed or no active ingredient (ARUD Center for Addiction Medicine, Zürich, Switzerland et al, 2021; Coopman & Cordonnier, 2012; Hullstein et al, 2015; Krug et al, 2014). In this case, they will have adulterants, or what is known as cutting agents, that resemble the drug to increase bulk and maximize profit margins (Broséus et al, 2016; Cho et al, 2015; Cole et al, 2011).…”

Section: The Rise Of Anabolic Steroidsmentioning

confidence: 99%

“…Many can go online in groups and forums, remain anonymous and discuss the topic while amassing pertinent information (Tighe et al, 2017). Unfortunately, the information on anabolic steroids is typically found through non-medical or science backgrounds, but rather from misleading sources such as bodybuilders, athletes and drug dealers (ARUD Center for Addiction Medicine, Zürich, Switzerland et al, 2021).…”

Section: Social Media Influencementioning

confidence: 99%

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The dichotomy between health and drug abuse in bodybuilding

Horn

2023

Nordic Studies on Alcohol and Drugs

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Aim: The aim of the present study was to investigate the expansion and prevalence of anabolic steroid use by examining the divergent effects between health and drug abuse and to create more awareness around the harmful consequences of these drugs when administered at abusive levels. Methods: A focused and concise literature search was conducted, and 101 high-quality articles were included in the review. Results: The findings underscore the adverse health risks of steroid abuse, emphasizing the stark contrast between health and drug abuse. Conclusions: While steroids and other performance-enhancing drugs can yield muscle growth, strength and even fat loss, abusing these substances can lead to adverse health outcomes. Furthermore, within the fitness subculture, particularly in the realm of bodybuilding, steroid abuse fosters an atmosphere of cheating and deception, frequently downplaying or ignoring the negative and sometimes deadly consequences it brings.

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Section: The Rise Of Anabolic Steroidsmentioning

confidence: 99%

Section: Social Media Influencementioning

confidence: 99%

The dichotomy between health and drug abuse in bodybuilding

Horn

2023

Nordic Studies on Alcohol and Drugs

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Fake anabolic androgenic steroids on the black market – a systematic review and meta-analysis on qualitative and quantitative analytical results found within the literature

et al. 2022

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Objective Supraphysiologic doses of anabolic androgenic steroids (AAS) are widely used to improve body image and sport performance goals. These substances can easily be acquired over the internet, leading to a substantial black market. We reviewed literature that assessed the quality and quantity of AAS found on the black market. Methods We searched PubMed/Medline, Embase and Google Scholar for articles published before March 2022. Additional hand searches were conducted to obtain studies not found in the primary literature search. Studies were included if they report on qualitative and/or quantitative analytical findings of AAS from the black market. Primary outcomes were proportions of counterfeit or substandard AAS. Eligible articles were extracted; quality appraisal was done using the ToxRTool for in-vitro studies. We used random-effects models to calculate the overall mean estimates for outcomes. The review protocol has been published and registered in INPLASY. Results Overall, 19 studies, which in total comprised 5,413 anabolic samples, met the inclusion criteria, and passed the quality appraisal from two WHO world regions that reported findings, the Americas and Europe. Most studies were nonclinical laboratory studies (95%) and provided samples seized by authorities (74%). In 18 articles, proportions of counterfeit substances and in eight articles, proportions of substandard substances were presented. The overall mean estimate for counterfeit anabolic steroids found on the black market was 36% (95% CI = 29, 43). An additional 37% (95% CI = 17, 63) were of substandard quality. We also demonstrate that these drugs could contain no active ingredient, or in another amount than that labeled, a wrong active ingredient, as well as not all or more active ingredients than were labeled. High heterogeneity among all analyses and significant differences between geographical subgroups were found. Conclusion With this systematic review and meta-analysis, we demonstrate that substantial mean proportions of black-market AAS are counterfeit and of substandard quality. These products pose a considerable individual and public health threat, and the very wide range in proportions of fake black-market AAS puts the user in a situation of unpredictable uncertainty. There is a great need for future prevention and harm-reduction programs to protect users from these substances.

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Evidence of use and users of image- and performance-enhancing drugs in sports in Switzerland: a scoping literature review and implications for Swiss drug policy

Kruijver,

Bruggmann,

Magnolini

2023

Swiss Med Wkly

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BACKGROUND: “Image- and performance-enhancing drugs” are widely used in sports worldwide to improve body image and performance goals. In view of the growing research interest and use of these substances, and the paucity of data on the situation in Switzerland, we conducted a scoping literature review on evidence of the use and users of these substances in Switzerland. METHODS: A scoping review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) statement. We searched PubMed/Medline, Embase and Google Scholar for articles published before August 2022. Primary outcomes were evidence of the use and users of image- and performance enhancing drugs in Switzerland. We used a narrative synthesis approach for data analysis. RESULTS: Overall, 18 studies were reviewed, which in total comprised 11,401 survey participants, 140 interviews and 1368 toxicologically analysed substances. Articles were mostly peer-reviewed (83%) and mostly included evidence from professional athletes (43%). The mean publication year was 2011. In most articles both outcomes (78%) were evaluated simultaneously. We demonstrate that image- and performance-enhancing drugs appear to be prevalent among athletes and non-athletes in Switzerland. A wide variety of substances exist, and the type of substances used varied by age, motivation, sex and sports discipline. The main motivations for using these substances were, among others, image- and performance enhancement. The main route of acquisition of these substances was the Internet. Furthermore, we demonstrated that substantial proportions of these substances, as well as supplements, may be counterfeit. Information on image- and performance-enhancing drug use was acquired from different sources. CONCLUSIONS: Although evidence of image- and performance-enhancing drug use and its users in Switzerland is scarce and there are major gaps, we demonstrate that these substances are also prevalent among athletes and non-athletes in Switzerland. Furthermore, high proportions of substances acquired from unregulated drug markets are counterfeit, which puts users in a situation of unpredictable risk when consuming them. Overall, the use of these substances may pose a substantial risk to individual and public health in this possibly growing and often insufficiently informed and medically neglected user community in Switzerland. There is a great need for future research, as well as prevention, harm-reduction and treatment programmes for this hard-to-reach user community. Doping policies in Switzerland should be critically reviewed as simple medical care and evidence-based treatment for non-athlete image- and performance-enhancing drug users is excessively criminalized under the current legislature, leaving possibly over 200,000 image- and performance-enhancing drug users in Switzerland with inadequate medical care.

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Fake anabolic androgenic steroids on the black market – Study protocol for a systematic review and meta-analysis on qualitative and quantitative analytical results found within the published literature

Cited by 3 publications

References 0 publications

The dichotomy between health and drug abuse in bodybuilding

The dichotomy between health and drug abuse in bodybuilding

Fake anabolic androgenic steroids on the black market – a systematic review and meta-analysis on qualitative and quantitative analytical results found within the literature

Evidence of use and users of image- and performance-enhancing drugs in sports in Switzerland: a scoping literature review and implications for Swiss drug policy

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