Cause and manner of death among users of anabolic androgenic steroids

Medicolegally investigated deaths among 34 male users of anabolic androgeni c steroids (AAS) are described. Nine persons were victims of homicide, II h ad committed suicide, 12 deaths were judged as accidental and 2 as indeterm inate. In two cases of accidental poisoning, the levels of pharmaceuticals and ill icit: drugs were considered too low to be the sole cause of death and AAS w as considered part of the lethal polypharmacia. Chronic cardiac changes were observed in 12 cases. In two cases of accident al poisonous deaths, these changes were regarded as contributory cause of d eath. Homicides, suicides, and poisonings determined accidental or indeterminate in manner were related to impulsive, disinhibited behavior characterized by violent rages, mood swings, and/or uncontrolled drug intake. The observations in the present study indicate an increased risk of violent death from impulsive, aggressive behavior, or depressive symptoms associat ed with use of AAS. There are also data to support earlier reports of possi ble lethal cardiovascular complications from use of AAS, Furthermore, a con tributing role of AAS in lethal polypharmacia is suggested. Finally, the ob servations indicate that use: of AAS may be the gateway of approach to abus e of other psychotropic drugs.