title: 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.
authors.affiliation: The Newman Centre for Sport and Exercise Research, Newman University College, Birmingham, UK. drgraham.ac.uk@live.co.uk
authors.forename: Michael R
authors.initials: MR
authors.lastname: Graham
authors.forename: Paul
authors.initials: P
authors.lastname: Ryan
authors.forename: Julien S
authors.initials: JS
authors.lastname: Baker
authors.forename: Bruce
authors.initials: B
authors.lastname: Davies
authors.forename: Non-Eleri
authors.initials: NE
authors.lastname: Thomas
authors.forename: Stephen-Mark
authors.initials: SM
authors.lastname: Cooper
authors.forename: Peter
authors.initials: P
authors.lastname: Evans
authors.forename: Sue
authors.initials: S
authors.lastname: Easmon
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Walker
authors.forename: David
authors.initials: D
authors.lastname: Cowan
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Kicman
mesh_terms: D045930:Anabolic Agents / Q000009:adverse effects / Q000032:analysis; D002626:Chemistry, Pharmaceutical / Q000379:methods*; D004300:Doping in Sports / Q000331:legislation & jurisprudence; D004340:Drug Contamination / Q000331:legislation & jurisprudence; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D005607:Fraud / Q000331:legislation & jurisprudence; D019382:Human Growth Hormone / Q000009:adverse effects / Q000032:analysis; D006801:Humans; D007880:Legislation, Drug; D004364:Pharmaceutical Preparations / Q000032:analysis*; D013207:Staphylococcal Skin Infections / Q000139:chemically induced / Q000382:microbiology
chemical_list: D045930:Anabolic Agents; D004364:Pharmaceutical Preparations; D019382:Human Growth Hormone