Evaluation of projects and general experience

It is well known that doping-designated substances cause a risk to health. Little was previously known, however, about the quality of illegal doping products. This was researched in 2005 (De Hon & Van Kleij, 2005).

In addition to a study of literature, 336 product packs were analysed for the presence of doping-designated substances. In addition, 38 interviews were conducted with users and other informed persons and 14 discussion forums were visited on the Internet during a period of 16 months.

The results showed that the quality of illegally obtained doping-designated substances is poor. At least 50–60% of the products do not deliver what is declared on the packaging.

There are all types of counterfeits: either they contain other, similar substances or they contain too little or even too much of the active substance. In 7% of cases, the product contained no active substance whatsoever.

Except in a few obvious cases, there is no good practical way of determining whether the substance concerned is counterfeit or not. A laboratory analysis is the most suitable method, but fitness centre members do not have access to this in practice.

Therefore, in practice a trial-and-error approach tends to be used in which the extent of muscle development and/or increase in strength serves as evidence that the product is not counterfeit. But even using this method, reassured users run risks: the quality of the counterfeit products varies considerably, and a product which appears uniform on the outside, including having the same batch number and the same shelf life date, can contain very different doses.

The user market

The research results indicate that the use of doping-designated substances, whether of illegal origin or not, can be associated with a greatly concealed health problem. The risks to health are not only concealed in the side-effects which users of the sub-stances themselves can suffer from, but also in the way in which these substances are used in various combinations with often very high (declared) dosages. Furthermore, the use of counter-feit doping substances also carries additional risks. The dosages are completely unpredictable, which means that the side-effects encountered are also unpredictable. Sometimes, the unhygienic conditions in which the counterfeits are manufactured can also create a health risk.

At the same time, there are many users who declare that they do not give any thought to the risk to health. These users have a great deal of contact with one another and mutually reinforce

their own ideas about “safe” use. The research and case studies available in medical literature regarding increased or reduced health damage due to doping use are played down by this group, perhaps because they are not personally confronted by them.

Alternative approaches, such as creating the opportunity to test illegally manufactured doping-designated substances in a labo-ratory prior to proceeding to use them or the introduction of medical counters for doping-related health questions, have the disadvantage that they could implicitly stimulate their use.

Trafficking via the Internet

In 2010, a study was carried out by the Doping Authority into the illegal doping trade via the Internet (Wassink et al., 2010).

The aim of this research was to obtain a better picture of the Internet trafficking of doping-designated substances and the health risk and other risks associated with it. For this purpose, a summary was compiled of all of the research undertaken in the Netherlands into illegal doping trafficking via the Internet. In addition, during the period November 2009 to February 2010, websites offering AAS and growth hormones were viewed. A selection and qualitative analysis was thus made of all of the (extra) health risks on the basis of the information and recom-mendations on the websites concerned.

It can be concluded on the basis of the research summary that trafficking in illegal doping-designated substances via the Internet is on the increase. There are some indications that these substances are more frequently counterfeited than in the

“regular” doping trade. The most recent estimate states that 30% of users purchase doping-designated substances via the In-ternet. The Internet plays an unmistakable role in the provision of information and the search for purchasing opportunities. In addition to health risks, there are also financial and legal risks associated with purchasing via the Internet.

The analysis of websites offering illegal doping reveals various risks. It is known that the use of doping already creates health risks and that 50–60% of the illegal substances are counterfeit, but, in addition to this, users incur extra risks as a result of the recommendations given. Strong initial doses are recommended, use is made easy, and there is evidence of the provision of bi-ased information (risks are played down; high-risk groups such as minors and women are not specifically warned). The findings of this research are used in the Doping Authority’s prevention activities aimed primarily at sports people and fitness instruc-tors in fitness centres. In order to be able to map trends better, future prevalence studies will need to incorporate this aspect.

It is a known fact that the quality of everyday medicines sold on the Internet can vary greatly. It must therefore be

recom-mended that the quality and risks of the illegal doping trade on the Internet must (continue to) be monitored.

Common contribution Summary of Chapter 7

The collection of data from contributing countries shows that the customs authorities are aware of the issue with the traffick-ing of AAS, etc. However, at present, the countries generally do not focus on or have special procedures for tackling the traffick-ing of doptraffick-ing substances. In the Netherlands, illegal medicine is a focus area, and in some cases doping substances are therefore included in this group. In Sweden, on the other hand, the cus-toms authorities and the police focus on doping substances as part of their work with criminal networks and financial crime.

In Denmark, the Tax and Customs Administration, SKAT, in-creased its fight against doping substances in 2010. As a result, and partially thanks to collaboration with Anti Doping Den-mark, SKAT has increased its general knowledge about doping and the distribution of doping substances and is therefore able to combat trafficking more effectively.

The contributing countries have different procedures for recording doping seizures. As a result, it is difficult to compare the amount and nature of the substances seized. There is there-fore a need to standardise records across the countries in order to improve transparency and knowledge in this area.

The AAS and doping market in general largely consists of counterfeit products that can be difficult to identify and are not subject to any form of government control. They can therefore potentially be extremely hazardous to health.

Endeavours to stop cross-border distribution create opportuni-ties for improving collaboration between relevant organisations such as the customs authorities, the police, and organisations within the pharmaceutical industry. Networks of relevant organisations already exist in this area, but prioritisation of the fight against steroid abuse and other forms of doping in these networks remains a challenge, and it is difficult to ensure that the networks have the necessary expertise and knowledge.