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Fake anabolic androgenic steroids on the black market a systematic review and meta-analysis on qualitative and quantitative analytical results found within the literature.-.md Normal file

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Recreational drug testing services became available in the 1990s . Another strategy could entail the introduction of specialized drug checking services for this user community. In the opioid field, one of the most effective harm reduction measures is the medical prescription of opioids (opioid agonist therapy), together with psychosocial, interdisciplinary care . Different harm reduction strategies could be employed to limit this user community from either getting in contact with fake AAS from the black market or to promote safer use and informed decision making. Therefore, it is of great importance that clinicians, politicians and law-makers are aware of this considerable individual and public health threat, given the significant negative long-term health impact of AAS misuse and exposure to fake AAS. Information about the use of AAS is commonly acquired from non-medical sources, such as word of mouth propaganda from athletes, dealers and bodybuilders , as there is major [khmerhd.tv](https://khmerhd.tv/@shanaleitch67?page=about) distrust and lack of confidence by AAS users towards medical doctors 4, 9, 14. Furthermore, due to punitive laws, stigma, and inexperience of health care professionals, this user population is widely unaccessed.
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Ukraine has historically had one of the largest black markets for arms in Europe, with around 300,000 small arms and light weapons reported lost or stolen during the Russian invasion of Crimea between 2013 and 2015. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. All authors contributed to refinement of the literature review and approved the final manuscript.
We used a subclassification of "counterfeit" substances to comprise "adulterated", "substituted" and "inert"; and "substandard" substances to comprise "over- and under- concentrated" (Table 3). Eligible articles were extracted; quality appraisal was done using the ToxRTool for in-vitro studies. We reviewed literature that assessed the quality and quantity of AAS found on the black market.
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