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Table 1 Characteristics of qualitative/descriptive studies presenting data on polypharmacy in AAS users

From: Polypharmacy among anabolic-androgenic steroid users: a descriptive metasynthesis

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
  1. We relied on the qualitative results generated from the interview.