Sudden or Unnatural Deaths Involving Anabolic‐androgenic Steroids

@article{Darke2014SuddenOU,
  title={Sudden or Unnatural Deaths Involving Anabolic‐androgenic Steroids},
  author={Shane Darke and Michelle Torok and Johan Duflou},
  journal={Journal of Forensic Sciences},
  year={2014},
  volume={59}
}
Anabolic-androgenic steroids (AASs) are frequently misused. [] Key Method To determine causes of death, characteristics, toxicology, and pathology of AAS positive cases, all cases (n = 24) presenting to the New South Wales Department of Forensic Medicine (1995-2012) were retrieved. All were male, and the mean age was 31.7 years. Deaths were mainly due to accidental drug toxicity (62.5%), then suicide (16.7%) and homicide (12.5%). Abnormal testosterone/epitestosterone ratios were reported in 62.5%, followed…
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References

SHOWING 1-10 OF 28 REFERENCES
Cause and manner of death among users of anabolic androgenic steroids.
TLDR
The observations indicate an increased risk of violent death from impulsive, aggressive behavior, or depressive symptoms associated with use of anabolic androgenic steroids and that use of AAS may be the gateway of approach to abuse of other psychotropic drugs.
Toxicological findings and manner of death in autopsied users of anabolic androgenic steroids.
Sudden anabolic steroid abuse-related death in athletes.
Anabolic steroid abuse and cardiac sudden death: a pathologic study.
TLDR
The histologic findings in these 2 cases and in the few others reported in medical literature are nonspecific and do not prove the cardiac toxicity of AAS, but a better understanding of Aas action on the neurogenic control of the cardiac function in relation to regional myocardial contraction and vascular regulation is required.
Anabolic-androgenic steroid dependence: an emerging disorder.
TLDR
The accumulating human and animal evidence showing that AAS may cause a distinct dependence syndrome is reviewed, and standard diagnostic criteria for substance dependence must be adapted slightly for cumulatively acting drugs such as AAS.
Treatment of anabolic-androgenic steroid dependence: Emerging evidence and its implications.
Multisubstance Use as a Feature of Addiction to Anabolic-Androgenic Steroids
TLDR
Most of the current AAS users who have been admitted to a treatment programme are multiple drug users with polysubstance dependence, and the most common reason given for taking AAS and other hormones was to increase muscle mass and strength, but some participants also used insulin as a means of losing fat.
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