Introduction
Method
Search strategy and inclusion criteria
Data extraction and synthesis
First author, year, reference
|
Country
|
Study type
|
AAS users
|
Recruitment site/mode
|
Non-AAS substances ever used
|
---|---|---|---|---|---|
Ahlgrim 2009 [9] | USA | Case study | 41-year-old male former bodybuilder | Hospital | Captopril, carvedilol, digoxin, furosemide, growth hormone, hydrochlorothiazide, spironolactone, torsemide, |
Angoorani 2009 [10] | Iran | Interview | 843 bodybuilders aged 16 to 40 years | Gymnasium | Amphetamine |
Bilard 2011 [11] | France | Interview | 203 bodybuilders | Voluntary | Beta-2-agonists, cannabinoids, glucocorticosteroids, peptide hormones |
Chandler 2014 [12] | UK | Interview | 8 persons | Online forums, syringe exchange center | Aromatase inhibitors, clenbuterol, 2,4-dinitrophenol, clomiphene, diuretics, ephedrine, growth hormone releasing peptide, growth hormone, human chorionic gonadotropin (hCG), insulin-like growth factor 1, insulin, mechano growth factor, melanotan, mephedrone, tamoxifen, thyroid hormones, viagra®/cialis® |
Cornford 2014 [13] | England | Interview and focus group | 30 males aged 20 to 40 years | Syringe exchange center | Heroin |
Davies 2011 [14] | England | Interview and questionnaire†
| 9 male bodybuilders | Gymnasium | Creatine, dietary supplements |
Dunn 2010 [15] | Australia | Interview and questionnaire†
| 70 persons | Community | Alcohol, cannabis, cocaine, ecstasy, gamma hydroxybutyrate, hallucinogens, inhalants, ketamine, amphetamine |
Filiault 2010 [16] | Australia, Canada, USA | Interview and questionnaire†
| 16 gay male athletes aged 18 to 52 years | Gay sporting groups | Creatine, dietary supplements, growth hormone, recovery drinks |
Fudala 2003 [17] | USA | Interview | 7 males aged 22 to 33 years | Gymnasium and community | Alcohol, analgesics, cannabis, cocaine, stimulants, growth hormone, human chorionic gonadotropin (hCG), insulin-like growth factor 1 |
Gårevik 2010 [18] | Sweden | Interview | 45 offenders; mean age 30 years | Police station | Amphetamine, anti-oestrogens, benzodiazepines, cannabis, clenbuterol, cocaine, diazepam, ephedra, ephedrine, growth hormone, human chorionic gonadotropin (hCG), heroin, insulin, sildenafil |
Goldfield 2009 [19] | Canada | Interview and questionnaire†
| 8 female bodybuilders | Gymnasium | Diuretics, laxatives |
Gruber 1998 [20] | USA | Interview | 19 female weightlifters | Gymnasium | Clenbuterol, ephedrine, narcotics/other drugs |
Gruber 1999 [21] | USA | Interview | 5 female bodybuilders | Gymnasium | Alcohol, cannabis, cocaine, clenbuterol, dietary supplements, other drugs, other performance-enhancing drugs |
Gruber 2000 [22] | USA | Interview | 25 female weightlifters; mean age 31 years | Gymnasium | Aminogluthemide, amphetamine, caffeine, clenbuterol, diuretics, ephedrine, hydroxyl butyrate, human chorionic gonadotropin (hCG), growth hormone, laxatives, nalbuphine, other opioids, tamoxifen, thyroid hormones, yohimbine |
Hegazy 2013 [23] | USA | Case study | 28-year-old male | Clinic | Alcohol, amphetamine, opioids |
Hoff 2012 [24] | Sweden | Interview | 11 male (10 powerlifters, 1 weightlifter) | Swedish Sports Confederation | Alcohol, amphetamine, cocaine, narcotics, others |
Hope 2013 [25] | England and Wales | Interview and questionnaire†
| 340 injecting drug users | Syringe exchange center | 2,4-dinitrophenol, alcohol, amphetamine, anti-oestrogens, clenbuterol, cocaine, ephedrine, erythropoietin, growth hormone, human chorionic gonadotropin (hCG), insulin, melanotan II, nalbuphine, thyroid hormones, diuretics, PDE5i, viagra®/cialis® |
Kanayama 2003 [26] | USA | Interview and questionnaire†
| 48 male weightlifters; mean age 29 years | Gymnasium and sports supplement store | Alcohol, cannabis, cocaine, opioids, other narcotics/illicit drugs |
Kanayama 2003 [27] | USA | Interview | 24 male drug users; mean age 32 years | Clinic | Alcohol, cocaine, heroin, nalbuphine, opioids, oxycodone |
Kanayama 2009 [28] | USA | Interview | 62 male weightlifters | Gymnasium and sports supplement store | Alcohol, cannabis, cocaine, opioids, other performance-enhancing drugs, other drugs |
Katz 1990 [29] | USA | Case study | 23-year-old male bodybuilder | Gymnasium | Alcohol, cocaine |
Kimergård 2014 [30] | England and Wales | Interview | 24 males aged 21 to 61 years; mean age 34 years | Gymnasium, prison, steroid clinic and charity, syringe exchange centre | Amphetamine, clenbuterol, growth hormone, ephedrine, human chorionic gonadotropin (hCG), insulin, melanotan II, sildenafil, tamoxifen |
Klötz 2010 [31] | Sweden | Interview | 33 male prisoners aged 21 to 52 years | Prison | Antidepressants, anti-oestrogen, aspirin®, benzodiazepines, caffeine, cannabis, central stimulating drugs, clenbuterol, creatine, diuretics, ephedrine, Gamma hydroxybutyrate, insulin-like growth factor 1, insulin, genotropine, muscle relaxing drugs, myoblast, opiates, other drugs, potency increasing drugs, somatotropine, testicular function recovering hormones |
Korkia 1993 [32] | England, Scotland, and Wales | Interview | 110 persons (13 female) aged 16 to 63 years | Clinic, gymnasium, syringe exchange centre | Antibiotics, corticosteroids, dietary supplements, diuretics, esiclene, human chorionic gonadotropin (hCG), oestrogen-antagonist drug, growth hormone, thiomucase, thyroxine |
Korkia 1996 [33] | England | Interview and questionnaire†
| 15 females; mean age 28 years | Not specified | Clenbuterol, growth hormone, nolvadex, nubain®, thiomucase, triacana |
Kusserow 1990 [34] | USA | Interview | 72 (6 female) persons (mostly adolescents); 14 to 25 years; mean age 20 years | Not specified | Alcohol, blood pressure regulators, ‘downers’, estrogen inhibitors, growth hormone, cannabis, Recreational substances/drugs, ‘uppers’ |
Larance 2008 [35] | Australia | Interview | 60 males aged 17 to 59 years | Gymnasium, internet forums, supplement shops | Anti-oestrogenic agents, aspirin®, benzodiazepines, caffeine, cannabis, cocaine, clenbuterol dehydroepiandrosterone (DHEA), diuretics, ecstasy, hallucinogens, heroin, human chorionic gonadotrophin (hCG), ephedrine, growth hormone, inhalants, insulin-like growth factors, insulin, meth/amphetamine, thyroxine |
Lenehan 1996 [36] | England | Interview | 386 persons aged 17 to 56 years; mean age 28 years | Gymnasium | Clenbuterol, corticosteroids, diuretics, growth hormone, human chorionic gonadotropin (hCG), thyroxine, insulin-like growth factor 1, nubain®, tamoxifen |
Lundholm 2010 [37] | Sweden | Interview | 924 (20 female) persons | Prison | Benzodiazepines, cannabis, cocaine, meth/amphetamine, opiates |
Malone 1995 [38] | USA | Interview | 77 (6 female) powerlifters and bodybuilders | Gymnasium | Alcohol, cocaine, hallucinogen, opioids, sedatives, stimulants, tetrahydrocannabinol, tobacco |
McBride 1996 [39] | Wales | Case study | 3 males: 1 AAS dealer and roofer aged 27 years, 1 bodybuilder aged 22 years, and 1 gym owner aged 26 years) | Not specified | Amphetamine, cannabis, clenbuterol, human chorionic gonadotropin (hCG), nalbuphine, tamoxifen, temazepam |
McKillop 1987 [40] | Scotland | Interview | 8 male bodybuilders aged 17 to 32 years | Gymnasium | Furosemide, thiazides, thyroxine, human chorionic gonadotropin (hCG) |
Moss 1992 [41] | USA | Interview | 50 male bodybuilders | Gymnasium | Clomiphene citrate, human chorionic gonadotropin (hCG) |
Moss 1993 [42] | USA | Interview | 30 male bodybuilders | Gymnasium | Clomiphene citrate, human chorionic gonadotropin (hCG) |
Pappa 2012 [43] | Europe | Interview | 9 athletes aged 19 to 26 years | Community via snowball sampling | Analgesics, amphetamine, caffeine, cannabis, dietary supplements, diuretics, erythropoietin. |
Perry 1990 [44] | USA | Interview and questionnaire†
| 20 male weightlifters aged 18 to 28 years | Gymnasium | Human chorionic gonadotropin (hCG) |
Perry 2003 [45] | USA | Interview | 10 male weightlifters aged 21 to 40 years | Gymnasium | Aspirin®, caffeine, clomiphene, creatine, dietary supplement, ephedrine, glutamine, liothyronine, protein powder, yohimbine |
Peters 1997 [46] | Australia | Interview and questionnaire†
| 100 persons (6 female) aged 18 to 50 years | Advertisements, gymnasium, interviews, radio, sports shops and associations, syringe exchange centre | Alcohol, aminogluthimide, amphetamine, antibiotics, beta blockers, caffeine, cannabis, chromium picolinate, clenbuterol, cocaine, daonil®, dietary supplement, diuretics, ecstasy, ephedrine, growth hormone, human chorionic gonadotropin (hCG), hydroxocobal amin, insulin-like growth factor 1, insulin, oestrogen antagonist, pregnyl®, proviron®, teroxin (T3), thyroxine |
Pope 1988 [47] | USA | Interview | 41 male bodybuilders and footballers | Gymnasium | Alcohol, cannabis, cigarettes, cocaine, human chorionic gonadotropin (hCG) |
Pope 1994 [48] | USA | Interview | 88 athletes; mean age 26 years | Gymnasium | Alcohol, cannabis, tobacco |
Rashid 2000 [49] | USA | Case study | 40-year-old male | Clinic | Cocaine, cannabis, ‘uppers’, ‘downers’, lysergic acid diethylamide (LSD) |
Schäfer 2011 [50] | Denmark | Case study | 26-year-old male bodybuilder | Clinic | Erythropoietin |
Silvester 1995 [51] | USA | Interview | 22 former athletes aged 36 to 66 years | Not specified | Growth hormone |
Skårberg 2007 [52] | Sweden | Interview and questionnaire†
| 18 male drug users; mean age 35 years | Clinic | Alcohol, narcotics/other drugs |
Skårberg 2008 [53] | Sweden | Interview | 6 drug users (2 female) | Clinic | Alcohol, amphetamine, analgesics, anti-catabolics, anti-oestrogens, aspirin®, benzodiazepines, bronchodilators, buprenorphine, caffeine, cannabis, cocaine, codeine, conjugated linoleic acid, creatine, dietary supplements, ecstasy, ephedra, ephedrine, growth hormone, Herbal products, insulin growth factor 1, insulin, protein powder, testosterone releasers |
Skårberg 2009 [54] | Sweden | Interview and questionnaire†
| 32 male drug users | Clinic | Alcohol, amphetamine, anti-oestrogen (clomid), analgesics, anti-acne drug, anti-catabolics, anti-depressants, anti-hypertensive drugs, anti-oestrogens, benzodiazepines, bronchodilators, cannabis, cocaine, creatine, dietary supplements, diuretics, ephedrine, fat-loss agents, gamma hydroxybutyrate, growth hormone, heroin, insulin, insulin-like growth factor 1, levodopa, muscle oil (synthol), non-steroidal anti-inflammatory drugs, opioid, plant steroid compounds, protein powder, stimulants, testosterone boosters, thyroid hormone |
Strauss 1985 [55] | USA | Interview | 10 weight-trained female athletes; mean age 33 years | Personal contact | Acetaminophen, aspirin®, benoxaprofen, Ben-Gay®, caffeine, calcium, choline and inositol, dietary supplements, dimethyl sulfoxide, codeine, electrolyte solution, epinephrine, furosemide, growth hormone, levodopa, lidocaine, naproxen, oxycodone hydrochloride, phenylbutazone, piroxicam, potassium, suntan pills, thyroglobulin, vitamins |
Tallon 2007 [56] | Scotland | Interview and questionnaire†
| 30 males aged 18 to 43 years; mean age 27 years | Gymnasium | Alcohol, cannabis, cocaine, clenbuterol, dietary supplements, diuretics, ecstasy, growth hormone, insulin, tamoxifen |
Wilson-Fearon 1999 [57] | England | Case study | 29-year-old bodybuilder | Not specified | Clenbuterol, dietary supplements, diuretics, growth hormone, human chorionic gonadotropin (hCG), thiomucase |
Wines 1999 [58] | USA | Interview | 11 weightlifters (5 female) aged 19 to 42 years | Gymnasium | Alcohol, buprenorphine, heroin, hydrocodone, nalbuphine, other drugs |
Classification of substances
Results and discussion
Description of studies and inter-reviewer reliability
Substances used prior to AAS initiation
Substance
|
Reason(s) for use
|
Studies (First author, reference)
|
---|---|---|
Alcohol | Better sleep and relaxation | |
Amphetamine | Boosting training, alertness, psychological wellbeing | |
Analgesics/opioids†
| Pain relief | Kanayama [26] |
Cannabis | NS | |
Cocaine | NS | |
Creatine | Boosting training | Skårberg [53] |
Dietary/nutritional supplements†
| Boosting training, energy | Skårberg [53] |
Heroin | NS | Cornford [13] |
Protein powder | Boosting training | Skårberg [53] |
Stimulants†
| NS | Kusserow [34] |
Other IPEDs, licit and illicit substances | NS |
[AAS] users displayed much higher rates of other illicit drug use, abuse, or dependence than non-users, with use of other illicit substances almost always preceding first use of AAS (p. 77).
A quick way to make yourself look healthy, isn’t it, without being embarrassed about being on heroin [is to use AAS], do you know what I mean. It [heroin] does take a lot of your confidence away don’t it and like I say, especially, I lose weight pretty fast when I’m on heroin, do you know what I mean. It [AAS use] is a quick way to just make yourself look healthy again, isn’t it (p. 2).
Respondent 8 reported using narcotics after he had started using AAS. In this case, alcohol and drug abuse cannot explain why he started doping [using AAS]. However, AAS use seems to have led him into drug use and criminality in order to finance his extensive AAS use and investment in elite powerlifting. This respondent became aggressive and violent when he combined AAS and alcohol. Due to these side effects he changed from alcohol to cocaine as his primary social drug when he was on AAS (p. 63).
Use of supplementary/ancillary substances
Current polypharmacy (Combined with AAS)
|
Lifetime polypharmacy (Ever use)
| ||||
---|---|---|---|---|---|
Substance
|
Reason(s) for use
|
Studies (First author, reference)
|
Reason(s) for use
|
Studies (First author, reference)
|
Number of studies
|
2,4-dinitrophenol | NS | Chandler [12] | NS | 4 | |
Acetaminophen | NS | Strauss [55] | NS | Strauss [55] | 1 |
Alcohol | Better sleep and relaxation | Better sleep and relaxation | 23 | ||
Aminogluthimide | Reducing receptors’ attraction to cortisol | Peters [46] | Reducing receptors’ attraction to cortisol | 2 | |
Amyl nitrate | NS | Chandler [12] | NS | Chandler [12] | 1 |
Analgesics/opioids†
| Pain relief | Pain relief | 14 | ||
Anti-acne drugs†
| – | – | Combating acne | Skårberg [54] | 1 |
Antibiotics†
| Combating acne | Peters [46] | Combating acne | 2 | |
Anti-catabolics†
| NS | Skårberg [53] | Facilitating synthesis of hepatic protein and nitrogen economy | 2 | |
Anti-depressants†
| Combating side effects | Klötz [31] | Combating side effects, depression relief, boosting levels of serotonin and noradrenaline | 2 | |
Anti-oestrogens†
| Burning fat, combating gynecomastia, reducing effects on oestrogen | Combating gynecomastia, burning fat, reducing effects on oestrogen | 9 | ||
Aromatase inhibitors†
| NS | Chandler [12] | NS | Chandler [12] | 1 |
Aspirin® | NS | NS | 5 | ||
Ben-Gay® | NS | Strauss [55] | NS | Strauss [55] | 1 |
Benoxaprofen | NS | Strauss [55] | NS | Strauss [55] | 1 |
Benzodiazepines†
| Better sleep, combating side effects, relaxation | Combating side effects, enhancing sleep and relaxation, self-control, sedation | 8 | ||
Beta blockers†
| Burning fat | Peters [46] | Burning fat | Peters [46] | 1 |
Beta-2-agonists†
| – | – | NS | Bilard [11] | 1 |
Blood pressure regulators†
| NS | Kusserow [34] | Lower blood pressure | 2 | |
Bronchodilators†
| Energy and boosting training | Skårberg [53] | Burning fat, energy and boosting training, increasing strength | 2 | |
Buprenorphine | NS | Skårberg [53] | NS | 2 | |
Caffeine | Burning fat | Burning fat | 8 | ||
Calcium | – | – | NS | Strauss [55] | 1 |
Cannabis/cannabinoids | Enhancing sleep, relaxation | Enhancing sleep, relaxation | 21 | ||
Captopril | NS | Ahlgrim [9] | NS | Ahlgrim [9] | 1 |
Carvedilol | NS | Ahlgrim [9] | NS | Ahlgrim [9] | 1 |
Choline and inositol | NS | Strauss [55] | NS | Strauss [55] | 1 |
Chromium picolinate | Reducing body weight | Peters [46] | Reducing body weight | Peters [46] | 1 |
Clenbuterol | Anabolic effects, burning fat, removing skin fluid, weight loss | Anabolic effects, burning fat, removing skin fluid, weight loss | 14 | ||
Clomiphene citrate | NS | NS | 4 | ||
Cocaine | Boosting training, burning fat, increasing strength | Boosting training, burning fat, increasing strength | 19 | ||
Codeine | Boosting training | Boosting training | 2 | ||
Conjugated linoleic acid | Burning fat | Skårberg [53] | Burning fat | Skårberg [53] | 1 |
Corticosteroids†
| NS | Lenehan [36] | NS | 3 | |
Creatine | Enhancing the effects of training | Anabolic effects, endurance booster, enhancing the effects of training, recovery aid | 7 | ||
Daonil® | Increasing insulin release | Peters [46] | Increasing insulin release | Peters [46] | 1 |
Dehydroepiandrosterone (DHEA) | – | – | NS | Larance [35] | 1 |
Diazepam | – | – | NS | Gårevik [18] | 1 |
Dietary/nutritional supplements†
| Energy and boosting training, nutrition | Energy and boosting training, anabolic effects, endurance booster, nutrition, recovery aid | 12 | ||
Digoxin | NS | Ahlgrim [9] | NS | Ahlgrim [9] | 1 |
Dimethyl sulfoxide | NS | Strauss [55] | NS | Strauss [55] | 1 |
Diuretics†
| Combating side effects, masking doping drugs, reducing fluid levels | Combating side effects, masking doping drugs, reducing fluid levels | 12 | ||
Electrolyte solution | NS | Strauss [55] | NS | Strauss [55] | 1 |
Ephedra/Ephedrine | Energy and boosting training, enhancing weight loss | Energy and boosting training, burning fat, enhancing weight loss, increasing strength | 14 | ||
Epinephrine | NS | Strauss [55] | NS | Strauss [55] | 1 |
Erythropoietin (EPO) | NS | NS | 3 | ||
Esiclene | – | – | NS | Korkia [32] | 1 |
Fat-loss agents†
| – | – | Burning fat | Skårberg [54] | 1 |
Furosemide | Weight loss | Weight loss | 3 | ||
Gamma hydroxybutyrate (GHB) | Enhancing sleep | Enhancing sleep | 5 | ||
Genotropine | NS | Klötz [31] | NS | Klötz [31] | 1 |
Glutamine | NS | Perry [45] | NS | Perry [45] | 1 |
Growth hormone | Anabolic effects and strength, burning fat, weight loss | Anabolic effects, burning fat, endurance booster, recovery aid, weight loss | 18 | ||
Growth hormone releasing peptides†
| NS | Chandler [12] | NS | Chandler [12] | 1 |
Hallucinogens†
| NS | NS | 3 | ||
Herbal products†
| NS | Skårberg [53] | Increasing strength | ||
Heroin | Enhancing sleep, pain relief | Enhancing sleep, pain relief | 6 | ||
Human chorionic gonadotropin (hCG) | Minimizing depressive symptoms upon AAS cessation/withdrawal, improving testosterone production, preventing weight loss, stopping testicular atrophy, increasing strength | Anabolic effects, increasing testosterone production, minimizing depressive symptoms upon AAS cessation/withdrawal, preventing weight loss, stopping testicular atrophy, increasing strength | 17 | ||
Hydrochlorothiazide | Weight loss | Ahlgrim [9] | Weight loss | Ahlgrim [62] | 1 |
Hydrocodone | – | – | NS | Wines [58] | 1 |
Hydroxocobal amin | Weight gain | Peters [46] | Weight gain | Peters [46] | 1 |
Inhalants†
| NS | Larance [35] | NS | 2 | |
Insulin | Anabolic effects and strength, burning fat, weight loss | Anabolic effects and strength, burning fat, weight loss | 10 | ||
Insulin-like growth factor 1 (IGF-1) | Anabolic effects and strength, burning fat | Anabolic effects and strength, burning fat | 8 | ||
Ketamine | NS | Chandler [12] | NS | 2 | |
Laxative | – | – | NS | Goldfield [19] | 2 |
Levodopa | NS | Strauss [55] | Increasing growth hormone | 2 | |
Lidocaine | NS | Strauss [55] | NS | Strauss [55] | 2 |
Liothyronine | NS | Perry [45] | NS | Perry [45] | 1 |
Lysergic acid diethylamide (LSD) | NS | Skårberg [54] | NS | 2 | |
Mechano growth factor | NS | Chandler [12] | NS | Chandler [12] | 1 |
Melanotan | Boosting training, skin tanning | Boosting training, skin tanning | 3 | ||
Mephedrone | NS | Chandler [12] | NS | Chandler [12] | 1 |
Meth/amphetamine | Alertness, boosting training, burning fat, increasing aggression during exercise, increasing strength, psychological wellbeing | Alertness, boosting training, burning fat, increasing aggression during exercise, increasing strength, psychological wellbeing | 15 | ||
Muscle oil (synthol) | – | – | Anabolic effect | Skårberg [54] | 1 |
Muscle relaxing drugs†
| Combating side effects | Klötz [31] | Combating side effects | Klötz [31] | 1 |
Myoblast | NS | Klötz [31] | NS | Klötz [31] | 1 |
Nalbuphine/nubain® | NS | Treating pain from weightlifting injuries, “anti-catabolic”, mental high | 8 | ||
Naproxen | NS | Strauss [55] | NS | Strauss [55] | 1 |
Non-steroidal anti-inflammatory drugs (NSAIDs) †
| – | – | Inflammation, pain, and fever relief | Skårberg [54] | 1 |
Oxycodone | NS | Strauss [55] | NS | 2 | |
Peptide hormones†
| – | – | NS | Bilard [11] | 1 |
Phenylbutazone | NS | Strauss [55] | NS | Strauss [55] | 1 |
Phosphodiesterase-5 inhibitors (PDE5i) †
| – | – | NS | Hope [25] | 1 |
Piroxicam | NS | Strauss [55] | NS | Strauss [55] | 1 |
Potassium | NS | Strauss [55] | NS | Strauss [55] | 1 |
Potency/testicular increasing drugs†
| Combating side effects | Klötz [31] | Combating side effects | Klötz [31] | 1 |
Pregnyl® | Improved testosterone production | Peters [46] | Improved testosterone production | Peters [46] | 1 |
Protein powder | Enhancing effects of training, increasing protein synthesis | Enhancing effects of training, increasing protein synthesis | 3 | ||
Proviron® | Hardiness, improved testosterone production | Peters [46] | Hardiness, improved testosterone production | Peters [46] | 1 |
Recovery drinks†
| – | – | Endurance booster, recovery aid | Filiault [16] | 1 |
Sedatives†
| NS | Malone [38] | NS | Malone [38] | 1 |
Sildenafil/viagra®/cialis | Enhanced sexual functioning | Enhanced sexual functioning | 4 | ||
Somatotropine | NS | Klötz [31] | NS | Klötz [31] | 1 |
Spironolactone | Weight loss | Ahlgrim [9] | Weight loss | Ahlgrim [9] | 1 |
Stimulants†
| NS | Increasing strength, burning fat | 6 | ||
Suntan pills†
| NS | Strauss [55] | NS | Strauss [55] | 1 |
Tamoxifen | Combating side effects | Combating side effects | 7 | ||
Teroxin (T3) | Preventing weight gain | Peters [46] | Preventing weight gain | Peters [46] | 1 |
Testosterone releasers/boosters†
| Combating side effects, increasing hormone production | Skårberg [53] | Combating side effects, increasing blood serum levels of testosterone or hormone production | 2 | |
Thiazides†
| – | – | NS | McKillop [40] | 1 |
Thiomucase | NS | Wilson-Fearon [57] | Burning fat | 3 | |
Thyroxine | Burning fat, increasing metabolism | Burning fat, increasing metabolism | 10 | ||
Tobacco | NS | NS | 3 | ||
Torsemide | NS | Ahlgrim [9] | NS | Ahlgrim [9] | 1 |
Triacana | – | – | NS | Korkia [33] | 1 |
Yohimbine | NS | Perry [45] | NS | 3 | |
Other IPEDs, licit and illicit substances | NS | NS |
Lifetime polypharmacy
Groups of non-AAS substances used by AAS users
Group
|
Examples
|
Purpose(s)
|
---|---|---|
Analgesics/non-steroidal anti-inflammatory drugs/opioids | Acetaminophen, aspirin®, Ben-Gay®, benoxaprofen, buprenorphine, codeine, corticosteroids†, heroin, hydrocodone, lidocaine, muscle oil (synthol) and muscle relaxing drugs†, nalbuphine/nubain®, naproxen, oxycodone, phenylbutazone, piroxicam | Relieving inflammation, pain, and fever |
Anti-oestrogens | Aminogluthimide, aromatase inhibitors†, clomiphene/clomid, proviron®, tamoxifen | Improved testosterone production, burning body fat, reducing the effects of AAS on oestrogens, and dealing with gynecomastia |
Cardiovascular drugs | Beta-2-agonists†, beta-blockers†, captopril, carvedilol, digoxin, thiazides†
| Lowering blood pressure, reducing risk of infarction, and burning body fat |
CNS depressants | Alcohol, benzodiazepines†, buprenorphine, cannabis/cannabinoids, diazepam, gamma hydroxybutyrate (GHB), heroin, hydrocodone, ketamine, oxycodone | Improving sleep, relaxation, and dealing with side effects of AAS use such as gynecomastia |
CNS stimulants | Amyl nitrate, caffeine, cocaine, ephedrine, epinephrine, mephedrone, meth/amphetamine, yohimbine | Alertness, boosting training, burning body fat, increased aggression and strength, and psychological wellbeing |
Cosmetic drugs | Anti-acne drugs†, esiclene, melanotan I, suntan pills, thiomucase | Curing acne, skin tanning, and enhancing physical appearance |
Dietary/nutritional supplements | Calcium, choline and inositol, chromium picolinate, conjugated linoleic acid, creatine, electrolyte solution, glutamine, hydroxocobal amin, piroxicam, potassium, protein powder | For essential nutrients to supplement the diet and combat the risk of illness |
Diuretics | Furosemide, hydrochlorothiazide, spironolactone, torsemide | Increasing strength, masking AAS and other doping drugs, burning body fat, and reducing levels of body fluid |
Fat burning/weight loss drugs | 2,4-dinitrophenol (DNP), anti-oestrogens†, beta blockers†, bronchodilators†, caffeine, chromium picolinate, clenbuterol, cocaine, conjugated linoleic acid, ephedrine, hydrochlorothiazide, insulin**, laxatives††, liothyronine, melanotan II, meth/amphetamine, spironolactone, teroxin (T3), thiomucase, thyroxine, triacana, yohimbine | Suppression of appetite, increased metabolism, and reduced absorption of body fat |
Muscle/strength-enhancement drugs (non-hormone) | Amphetamine/meth, anti-catabolics†, glutamine, bronchodilators, chromium picolinate, clenbuterol, creatine, ephedrine, herbal products††, hydroxocobal amin (B12), myoblast, muscle oil (synthol), protein powder, recovery drinks†
| Enhancing the size and structure of muscles as well as boosting strength |
Muscle/strength-enhancement hormones††
| Dehydroepiandrosterone (DHEA), erythropoietin (EPO), genotropine, growth hormone, growth hormone releasing peptide (GHRP), human chorionic gonadotropin (hCG), insulin-like growth factor 1 (IGF-1), insulin, levodopa, mechano growth factor, pregnyl®, prohormones†, proviron®, somatotropine | Enhancing the size and structure of muscles as well as boosting strength |
Recreational substances/drugs | Alcohol, buprenorphine, cannabis/cannabinoids, cigarettes/tobacco methamphetamine, blood pressure regulators†, caffeine, cocaine, ecstasy, hallucinogens†, heroin, hydrocodone, ketamine, lysergic acid diethylamide (LSD), sedatives†, tetrahydrocannabinol | Enhancing sleep, relaxation, and psychological wellbeing |
Sexual enhancement drugs | Anti-oestrogens†, human chorionic gonadotropin (hCG), melanotan II, phosphodiesterase-5 inhibitors (PDE5i), sildenafil/cialis®, yohimbine | Dealing with testicular atrophy, improved sexual desire or arousal and boosting erectile functioning |