Throughout 2014–2023, over 20,000 AAS analyses have been conducted at the drug of abuse laboratory, Karolinska University Hospital. Approximately 20% and 2% of the samples have been positive for AAS, with no trends of increase or decrease. Around 50% of the AAS-positive samples were also positive for narcotics (year 2022–2023), with gender differences; cocaine and cannabis being more frequent in AAS-positive male and female samples, respectively.

ABSTRACT

It is of interest to investigate trends in AAS usage profile. Here we aimed to retrospectively study the prevalence of AAS-positive samples based on 21,172 consecutive analyses from routine AAS testing 2014–2023. Moreover, 310 urine samples from 2022 to 2023 were reanalyzed for a broader AAS panel as well as for the presence of narcotics. Between 2014 and 2023, the frequency of reported AAS-positive samples varied between 6% and 11%, with no trend discerned. The prevalence of samples containing several AAS also shows a similar distribution. The most common AAS detected were consistently testosterone, nandrolone, and drostanolone. Of the 310 urine samples reanalyzed, 80 male and 6 female samples were positive for AAS. Thirteen of the samples showed T/E 4–10, indicative of testosterone use, with no other AAS. Consequently, 4% of the samples might have been reported as false negatives. Of the AAS-positive samples, amphetamine was found in 10% and 0% of the male and female samples, respectively. Cannabis was more often detected in AAS-positive female samples (50%) than in male samples (25%), whereas cocaine was more commonly detected in male than in female samples (33 versus 17%). The prevalence of cannabis and amphetamine was like previous AAS studies conducted in Sweden, whereas the presence of cocaine in male samples was substantially higher. Co-use of AAS and narcotics is a well-known problem and highlights the importance of preventive actions and education/awareness of AAS.