Sudden or unnatural deaths involving anabolic-androgenic steroids

J Forensic Sci. 2014 Jul;59(4):1025-8. doi: 10.1111/1556-4029.12424. Epub 2014 Feb 19.

Abstract

Anabolic-androgenic steroids (AASs) are frequently misused. 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 by metabolites of nandrolone (58.3%), stanozolol (33.3%), and methandienone (20.8%). In 23 of 24 cases, substances other than steroids were detected, most commonly psychostimulants (66.7%). In nearly half, testicular atrophy was noted, as was testicular fibrosis and arrested spermatogenesis. Left ventricular hypertrophy was noted in 30.4%, and moderate to severe narrowing of the coronary arteries in 26.1%. To summarize, the typical case was a male polydrug user aged in their thirties, with death due to drug toxicity. Extensive cardiovascular disease was particularly notable.

Keywords: cardiovascular disease; demographics; forensic science; psychostimulants; steroids; toxicology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anabolic Agents / adverse effects*
  • Anabolic Agents / blood
  • Anabolic Agents / urine
  • Androgens / adverse effects*
  • Androgens / blood
  • Androgens / urine
  • Atrophy
  • Coronary Stenosis / pathology
  • Epitestosterone / blood
  • Epitestosterone / urine
  • Homicide*
  • Humans
  • Hypertrophy, Left Ventricular / pathology
  • Male
  • Methandrostenolone / blood
  • Methandrostenolone / urine
  • Middle Aged
  • Nandrolone / blood
  • Nandrolone / urine
  • New South Wales / epidemiology
  • Stanozolol / blood
  • Stanozolol / urine
  • Substance-Related Disorders / blood
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / urine
  • Suicide*
  • Testis / pathology
  • Testosterone / blood
  • Testosterone / urine
  • Young Adult

Substances

  • Anabolic Agents
  • Androgens
  • Testosterone
  • Epitestosterone
  • Stanozolol
  • Nandrolone
  • Methandrostenolone