Counterfeiting in performance‐ and image‐enhancing drugs

Abstract

The current drastic escalation in obesity may be contributing to the exponential rise in drugs used for image enhancement. Drugs such as anabolic-androgenic steroids (AAS) are perceived as a viable method of achieving a perfect physique. They are also the most widely abused drugs in sport. The Internet has encouraged the abuse of expensive drugs, particularly human growth hormone (hGH), resulting in increased importation for personal use. The substantial increase in this market has opened up avenues for counterfeiting, estimated as a multi-million pound business. The acute adverse effects from contaminated vials may result in a variety of pathologies including communicable diseases. In 2007, in the UK, a series of intramuscular abscesses, requiring surgical treatment, led us to study samples obtained from the underground market. The analysis of 38 parenteral samples and 19 oral samples of tablets was performed by a World Anti-Doping Agency (WADA) accredited laboratory, in an attempt to establish the extent of available counterfeit products. Fifty-three per cent (20) of the injectable AAS esters and 21% (4) of the oral tablets were counterfeit. Culture and sensitivity revealed the presence of skin commensal organisms, which may have contributed to the development of the abscesses. Users of AAS and hGH for sport, including bodybuilding, are currently risking their health because of counterfeit and poorly controlled products.

Stable carbon isotope ratio profiling of illicit testosterone preparations – domestic and international seizures

“…One aqueous suspension of testosterone was analyzed which was highly contaminated with androstenedione. [23] A further 47 samples (16.6 %) recorded δ 13 C values in the range À25.9 ‰ to À27.0 ‰, which is a larger proportion than previously reported. [22] The δ 13 C values for the illicit testosterone sample population (n = 283) displayed a normal distribution (D'Agostino & Pearson omnibus normality test) with mean and median of À28.6 ‰, minimum of 32.9 ‰ and maximum of À23.4 ‰.…”

Self-Perceived Weight and Anabolic Steroid Misuse Among US Adolescent Boys

“…Other adverse psychiatric effects, including aggression, violence, and hypomania, have also been documented, although recent studies to substantiate these effects are lacking [2]. In addition, AAS sold over the Internet or on the street are often fake, contaminated, or counterfeit, potentially exposing the purchaser to dangerous substances [9]. Although adolescents may constitute a minority of AAS users [10], they also are a particularly important group to study given that they biologically may be more vulnerable to the effects of AAS, due to their still developing brain and body [11].…”

Anabolic–Androgenic Steroids and Adolescents

“…Although Hazelton may have used his own syringes, those who share needles for administering AAS risk not only injecting toxic substances but also possibly contracting HIV, hepatitis B, or hepatitis C (Aitken, Delalande, & Stanton, 2002;Evans, 2004). As with the purchase of narcotics, adolescents who purchase AAS from an Internet source or from someone at a gym basically take their chances with content and administration (Cordaro, Lombardo, & Cosentino, 2011;Graham et al, 2009;U.S. Drug Enforcement Administration, 2009a).…”