Young steroid users at increased risk of heart disease

Men in their late 20s and early 30s who abuse steroids are dying from serious heart disease, according to an Australian study of deaths involving the drugs.

Researchers at the National Drug and Alcohol Research Centre (NDARC) at UNSW and the New South Wales Department of Forensic Medicine say increasing numbers of steroid users in Australia are oblivious to the health risks linked to performance-enhancing drugs, including cardiovascular disease, reproductive failure, liver damage and high levels of aggression.

The researchers examined all 24 steroid-related deaths, involving men aged between 22 and 48 years, in NSW between 1996 and 2012. Extensive heart disease, including left ventricular hypertrophy and thickening of the arteries, was present in half the cases.

Although all the cases showed evidence of steroid use, these were not the direct cause of death. All but one of the sample were polydrug users and accidental drug toxicity accounted for two thirds of the deaths, either alone or in combination with heart disease. Violent deaths either suicide or homicide accounted for a quarter of cases.

Lead researcher Professor Shane Darke of NDARC said the findings added to emerging evidence that steroid users are often polydrug users, and that steroid and psychostimulant use may damage the heart.

Professor Darke explained "nearly all of the 24 deceased men that we examined in this study showed the classic signs of steroid abuse, such as overdeveloped muscles and testicular atrophy (shrunken, scarred testicles).

"We also found that nearly all of the individuals who had been using steroids together with psychostimulants had a lot of damage to their cardiovascular system. It appears that combined stimulant and steroid use increases a person's risk of developing cardiovascular disease.

"Ironically many steroid users are also keen health and fitness enthusiasts and this is borne out by our sample, which included personal trainers, body builders and security guards.

"But the vast majority of users are unaware of the health dangers of their lifestyle.

"Cardiovascular disease, particularly in such young people, signifies the very opposite of good health."

He added that many young male users are in danger of reproductive health issues attributable to testicular atrophy.

Among the psychoactive drugs detected were psychostimulants (present in 66.7% of cases), followed by benzodiazapines (45.8%), opioids (37.5%) and alcohol (25%). Psychostimulant toxicity was the direct cause of death in eight of the 24 deaths and opioid overdose was the direct cause in seven. Over half of the cases (54%) showed evidence of recent injecting drug use.

Toxicology results showed testosterone was the most commonly used steroid among the 24 men. Two thirds of the men were employed at their time of death.

The study 'Sudden or unnatural deaths involving anabolic androgenic steroids' has been published online in the Journal of Forensic Science.

Professor Darke told the Sydney Morning Herald that the study provided a glimpse into the "hidden" world of steroid use.

The National Drug and Alcohol Research Centre at UNSW is supported by funding from the Australian Government under the Substance Misuse Prevention and Service Improvements Grants Fund.

Sydney newspaper The Daily Telegraph recently reported that steroid use in Australian gyms has become so established that some fitness clubs are installing needle­disposal bins to cater for members who inject muscle-building drugs before they work out.

The report also suggest that steroid users have now overtaken heroin addicts as the main clientele at some needle-exchange sites in NSW and Queensland.