Superheroes - Image and performance enhancing drug (IPED) use within the UK, social media and gym culture.

Anabolic androgenic steroids (AAS) are the drug of choice in many cultures of the UK. Whilst there is an abundance of evidence relating to the physiological and psychological effects of steroid abuse on the individual, surprisingly there is a paucity of information relating to the perspectives of steroid users regarding the social impact of steroid use on self and society. The lack of data from steroid users has implications for forensic and legal medicine. Specifically, evidence is limited in terms of the user's voice. This is a crucial omission; the unheard voices of steroid users have much to offer into future research. 24 IPED using participants (using substituted names to protect anonymity), engaged in semi structured interviews to discuss their own personal usage, culture issues, social media and more.

The Availability and Acquisition of Illicit Anabolic Androgenic Steroids and Testosterone Preparations on the Internet.

The lifetime prevalence of anabolic androgenic steroids (AAS) use in the United States is over 1%. Recent reports have suggested AAS can easily be obtained over the Internet without a prescription, but this has been poorly studied. This study focused on determining the availability and ease of purchase for AAS, testosterone, and other non-AAS therapies on the Internet from the perspective of a typical consumer. A Google search was performed and the top-ranking sites offering AAS for sale were individually evaluated for selection of AAS offered, the purchasing process, and additional consumer information to support AAS use. The current results revealed that 87% of sites offered commonly used forms of AAS, injectable testosterone, and non-AAS hormone therapies. Seventy-five percent offered at least one postcycle recovery agent and 62% offered at least one erectile dysfunction medication. No site required a prescription for purchase of any substance, 75% accepted common forms of payment including credit card, and all sites were supplied by unregulated international pharmacies providing shipment to home addresses with disclaimers that consumers are liable to local laws. Seventy-five percent of sites provided specific cycle and stacking recommendations, 62% provided postcycle recovery information, but only one site offered information on non-AAS alternatives. In conclusion, AAS, injectable testosterone, and other non-AAS therapies are readily available and remarkably easy to purchase on the Internet without a prescription. It is of paramount importance that clinicians are aware of this considerable public health problem given the detrimental physiologic effects including infertility and sexual dysfunction.

Falsificação de medicamentos no Brasil / Counterfeiting of drugs in Brazil / Falsificación de medicamentos en Brasil

OBJETIVO: Identificar os principais medicamentos falsificados apreendidos pela Polícia Federal brasileira e os estados em que houve a apreensão. MÉTODOS: Estudo retrospectivo descritivo dos laudos periciais elaborados por Peritos Criminais da Polícia Federal sobre medicamentos contrafeitos entre janeiro de 2007 e setembro de 2010. RESULTADOS: Os medicamentos com maior número de apreensões foram inibidores seletivos da fosfodiesterase 5, utilizados para tratar a disfunção erétil masculina (Cialis® e Viagra®, em média 66 por cento), seguidos por esteróides anabolizantes (Durateston® e Hemogenin®, 8,9 por cento e 5,7 por cento, respectivamente). A maior parte dos medicamentos falsos foi apreendida nos estados do Paraná, São Paulo e Santa Catarina, com incremento superior a 200 por cento no número de medicamentos inautênticos encaminhados à perícia no período. Houve aumento nas apreensões de medicamentos contrabandeados arrecadados em conjunto com os falsos; 67 por cento das apreensões incluíram no mínimo um medicamento contrabandeado. CONCLUSÕES: A falsificação de medicamentos é um grave problema de saúde pública. A identificação das classes de medicamentos falsos no País e os principais estados brasileiros com essa problemática podem facilitar ações futuras de prevenção e repressão pelos órgãos brasileiros responsáveis.

OBJECTIVE: To identify the main counterfeit drugs seized by the Brazilian Federal Police and the states where seizures have been made. METHODS: A retrospective descriptive study on expert reports produced by criminal investigators of the Federal Police between January 2007 and September 2010, in relation to counterfeit drugs, was carried out. RESULTS: The drugs with greatest numbers of seizures were selective phosphodiesterase-5 inhibitors that are used for treating male erectile dysfunction (Cialis® and Viagra®, mean = 66 percent ), followed by anabolic steroids (Durateston® and Hemogenin®: 8.9 percent and 5.7 percent, respectively). The greatest proportions of the counterfeit drugs were seized in the states of Paraná, Santa Catarina (both Southeastern Brazil) and São Paulo (Southeastern), and the number of non-authentic drugs sent for investigation increased by more than 200 percent over the study period. There were increases in seizures of smuggled drugs found together with counterfeit drugs: 67 percent of the seizures included at least one smuggled drug. CONCLUSIONS: Counterfeiting of drugs is a severe public health problem. Identification of the classes of counterfeit drugs present in Brazil and the main Brazilian states with this problem may facilitate future preventive and suppressive actions by the Brazilian bodies responsible for such actions.

OBJETIVO: Identificar los principales medicamentos falsificados incautados por la Policía Federal Brasileña y los estados donde hubo incautación. MÉTODOS: Estudio retrospectivo descriptivo de los laudos periciales elaborados por Peritos Criminales de la Policía Federal brasileña sobre medicamentos falsos entre enero de 2007 y septiembre de 2010. RESULTADOS: Los medicamentos con mayor número de incautaciones fueron los inhibidores selectivos de la fosfodiesterasa 5, utilizados para tratar la disfunción eréctil masculina (Ciallis® y Viagra®, en medio 66 por ciento), seguidos por esteroides anabolizantes (Durateston® y Hemogenin®, 8,9 por ciento y 5,7 por ciento, respectivamente). La mayor parte de los medicamentos falsos fue incautada en los estados Paraná, Sao Paulo y Santa Catarina, con incremento superior a 200 por ciento en el número de medicamentos inauténticos encaminados a la pericia en el período. Hubo aumento en las incautaciones de medicamentos contrabandeados arrecadados en conjunto con los falsos, 67 por ciento de las incautaciones incluyeron al menos un medicamento contrabandeado. CONCLUSIONES: La falsificación de medicamentos es un grave problema de salud pública. La identificación de las clases de medicamentos falsos en Brasil y los principales estados brasileños con esta problemática pueden facilitar acciones futuras de prevención y represión por los órganos brasileños responsables.

Counterfeiting of drugs in Brazil.

OBJECTIVE: To identify the main counterfeit drugs seized by the Brazilian Federal Police and the states where seizures have been made. METHODS: A retrospective descriptive study on expert reports produced by criminal investigators of the Federal Police between January 2007 and September 2010, in relation to counterfeit drugs, was carried out. RESULTS: The drugs with greatest numbers of seizures were selective phosphodiesterase-5 inhibitors that are used for treating male erectile dysfunction (Cialis® and Viagra®, mean = 66% ), followed by anabolic steroids (Durateston® and Hemogenin®: 8.9% and 5.7%, respectively). The greatest proportions of the counterfeit drugs were seized in the states of Paraná, Santa Catarina (both Southeastern Brazil) and São Paulo (Southeastern), and the number of non-authentic drugs sent for investigation increased by more than 200% over the study period. There were increases in seizures of smuggled drugs found together with counterfeit drugs: 67% of the seizures included at least one smuggled drug. CONCLUSIONS: Counterfeiting of drugs is a severe public health problem. Identification of the classes of counterfeit drugs present in Brazil and the main Brazilian states with this problem may facilitate future preventive and suppressive actions by the Brazilian bodies responsible for such actions.

Nonprescription steroids on the Internet.

This study evaluated the degree to which anabolic-androgenic steroids are proffered for sale over the Internet and how they are characterized on popular Web sites. Searches for specific steroid product labels (e.g., Dianabol) between March 2006 and June 2006 revealed that approximately half of the Web sites advocated their "safe" use, and roughly one third offered to sell them without prescriptions. The Web sites frequently presented misinformation about steroids and minimized their dangers. Less than 5% of the Web sites presented accurate health risk information about steroids or provided information to abusers seeking to discontinue their steroid use. Implications for education, prevention, treatment, and policy are discussed.

Selling androgenic anabolic steroids by the pound: identification and analysis of popular websites on the Internet.

Internet websites offering androgenic anabolic steroids (AAS) were identified and available products were examined. Keywords for the website search were: "anabolic steroids," "anabolic steroids buy," "anabolic steroid purchase." The first 10 websites offering AAS in the first 10 pages of results were considered. At least two AAS-containing products per website were selected. Thirty AAS-selling websites were identified, mainly located in the United States (46.7%) and Europe (30%). Most websites sold other anabolic/ergogenic products (clenbuterol, 76.7%; GH/IGF, 60.0%; thyroid hormones, 46.7%; erythropoietin, 30.0%; insulin, 20.0%) or products for AAS-related adverse effects (mainly: estrogen antagonists, 63.3%; products for erectile dysfunction, 56.7%; 5α-reductase inhibitors, 33.3%; anti-acne products, 33.3%). AAS were sold as medicines (69.6%) or as dietary supplements (30.4%). AAS in medicines were mainly: nandronole (20.4%), methandrostenolone (18.4%), and testosterone (12.2%). Dietary supplements contained mainly DHEA and included several fake compounds. Manufacturers were declared for 97.9% of medicines and 66.7% of dietary supplements; however, several manufacturers were not found on the Internet. Described benefits were usually few adverse effects and no estrogenicity. Toxicity was seldom reported and presented as mild. Recommended doses were two-fourfold higher than current medical recommendations. In conclusion, misleading information and deceiving practices were common findings on AAS-selling websites, indicating their deleterious potential for public health.

Performance-enhancing drugs in sport.

This discussion reviews the concept and history of ergogenic aides, the penetration of use in society, some benefit/risk information, drug sources in our society, detection and regulation of these agents, and provides a look to the future. It also examines the role of the clinician/endocrinologist for these patients and uses some cases as examples of drug use among adolescents/teens.

Social capital: implications from an investigation of illegal anabolic steroid networks.

Numerous studies have linked the constructs of social capital with behaviours that are health enhancing. The factors of social trust, social cohesion, sense of belonging, civic involvement, volunteer activity, social engagement and social reciprocity are all associated with social capital and their existence is often linked with communities or settings where health enhancement is high. Utilizing an interpretive perspective, this paper demonstrates how the existence of social capital may enhance the transition into drug use, the experience of using an illegal drug and decrease the risk of detection. It highlights how social capital may contribute to behaviours which are not health enhancing. Using a variety of data, including participant observation of 147 male anabolic steroid users and 98 semi-structured in-depth interviews with male anabolic steroid users, dealers and distributors it was found that social capital facilitated the operation of the illegal anabolic steroid distribution network. The subcultural norms and social trust that existed within the network allowed anabolic steroid dealers to sell the drug to others with reduced risk of detection. It is argued that social capital facilitates the distribution of illegal anabolic steroids and that social capital is a non-discriminatory concept, that may enhance both negative and positive health-related behaviours.

Anabolic ergogenic substance users in fitness-sports: a distinct group supported by the health care system.

BACKGROUND: Anabolic ergogenic substance use, in particular the use of anabolic androgenic steroids, is a serious problem in general. Nevertheless, it is subject to debate whether ergogenic substance users exhibit similar features as multiple substance users or whether they constitute a discrete group. METHODS: One thousand eight hundred and two standardized, anonymous questionnaires were distributed among visitors of 113 fitness centers. Questions were asked concerning biometric parameters, social indicators, physical fitness, use of natural stimulants, general illicit drugs and ergogenic substances. With logistic regression analysis, multivariate odds ratios were estimated to investigate the association of anabolic ergogenic substance or general illicit drug use with other parameters. RESULTS: 13.5% of all participants confessed to having used anabolic ergogenic substances at some point in time. Anabolic ergogenic substance use was positively related with cocaine use, training years, training frequency, negatively related to the level of education, alcohol intake and less frequently used by Germans than by non-Germans. General illicit drug use, however, was positively related with alcohol intake, smoking and a university degree and negatively with having children. In addition, anabolic ergogenic substance use was significantly related with the use of general illicit drugs based on the strong relation with the use of cocaine, which is an ergogenic substance itself. The health care system supplies 48.1% of the anaolic ergogenic substance users with their substances and 32.1% are even monitored by a physician. CONCLUSIONS: The results of this study strengthen the notion that anabolic ergogenic substance users constitute a specific body-oriented substance user group. Uncommon for general illicit drug use, the health care system is a major sponsor of anabolic ergogenic substance users. These findings suggest the need for alternative approaches for successful prevention and intervention programs.

[Doping: epidemiological studies]. / Le dopage: données épidémiologiques.

PREVALENCE: Whatever method is used (observation, interviews, questionnaire, laboratory tests), it is difficult to collect epidemiological data on doping. Particularly difficult problems are related to the definitions of sports players and the drugs involved as well as the often illicit nature of drug use. RESULTS: The prevalence of doping in children and adolescents participating in sports is estimated at 3% to 5% with higher percentages in boys, older adolescents and those playing at a competition level. Use of anabolic steroids, as early as 8 years of age, has increased since 1990, especially in girls. All studies have emphasized how easy it is for adolescents to procure any prohibited drug. In adults participating in amateur sports, the prevalence of doping would be 5% to 15%. All sports are involved with higher prevalence in men, age ranges 20-25 years and 35-39 years, and competitive level players. The main drugs used are stimulants, narcotics, corticosteroids and anabolic steroids. Combination of at least 2 drugs is frequent with an increase of mean daily dose over the last 15 years. According to users, the drugs are obtained with a medical prescription, on the underground market, or from other participants. Few data are available on doping outside sports activities. In the French department Meurthe-et-Moselle, 15% of the inhabitants use drugs to improve their occupational performance. CONCLUSIONS: Doping is more widespread than would be expected from antidoping control data. Other studies are needed to acquire more precise epidemiological data.

Building your body to survive: the use of anabolic steroids for HIV therapy.

AIDS: The loss of lean body mass (LBM) that is commonly associated with wasting syndrome has been linked to death in HIV disease. Bioelectrical Impedance Analysis (BIA) is a simple, inexpensive and painless technique used to assess body composition. The test gives a good reading of body cell mass, fat mass, and body water, and can be used to detect loss of LBM when it first occurs. BIA is a useful tool in managing and preventing wasting. Other factors that influence LBM include testosterone levels and anabolic steroids. Anabolic steroids, synthetic analogs of testosterone, are a Class III regulated drug. The use of anabolic steroids is controversial, and abuse by athletes led to the drugs being banned for many uses. A list of approved steroids, their actions, and potential problems associated with their use is included. Another table rates the major steroids for their effectiveness in AIDS therapy.^ieng