Prevalence of AAS‐Positive Samples at Drug Abuse Laboratory Sweden Between 2014 and 2023 and Sub‐Study of Dual Use of AAS and Narcotics

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.