{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:31:00Z","timestamp":1792103460722,"version":"4.4.0"},"reference-count":16,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use & Addiction Journal"],"published-print":{"date-parts":[[2026,1]]},"abstract":"\n Background:<\/jats:title>\n Misuse of anabolic-androgenic steroids (AAS), especially through \u201cstacking\u201d multiple substances, poses significant health risks. This study leverages data from the FDA\u2019s Adverse Event Reporting System (FAERS) to assess these risks and identify factors predicting severe outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We analyzed 286 FAERS reports of intentional AAS misuse. After removing duplicates, the final dataset included 218 unique cases involving men, 7 involving women, and 14 cases with unspecified sex. Drugs, adverse drug reactions (ADRs), and demographic data were categorized. Statistical analyses, including logistic regression, evaluated associations between substance combinations and serious outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Serious cases constituted 46.8% of the total among men, with cardiovascular, endocrine, and psychological ADRs being most frequent. Stacking other drugs on top of AAS was highly associated with serious outcomes (\n P<\/jats:italic>\n \u2009<\u2009.001). Stacking central nervous system (CNS) depressants (\n P<\/jats:italic>\n \u2009=\u20093.50\u2009\u00d7\u200910\n \u22128<\/jats:sup>\n ), fat-burning agents (\n P<\/jats:italic>\n \u2009=\u20091.51\u2009\u00d7\u200910\n \u221210<\/jats:sup>\n ), endocrine modulators (\n P<\/jats:italic>\n \u2009=\u20096.26\u2009\u00d7\u200910\n \u22126<\/jats:sup>\n ), and other CNS-active substances (\n P<\/jats:italic>\n \u2009=\u20093.34\u2009\u00d7\u200910\n \u22125<\/jats:sup>\n ) were strongly associated with serious outcomes. Logistic regression revealed younger age (\n P<\/jats:italic>\n \u2009=\u2009.0188, negative coefficient \u22120.117) and higher drug count (\n P<\/jats:italic>\n \u2009=\u2009.0458, positive coefficient 0.991) and recent report year (\n P<\/jats:italic>\n \u2009=\u2009.0006, negative coefficient \u22120.467) as significant predictors of life-threatening events.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n AAS misuse, especially through high-risk stacking, significantly elevates the risk of serious health outcomes, particularly in younger individuals. Public health interventions\u2014including targeted outreach, harm reduction, and enhanced healthcare provider awareness training\u2014are necessary to educate on and mitigate these risks.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/29767342251360872","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T11:41:01Z","timestamp":1757072461000},"page":"159-166","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Stacking the Risks: Fatal Consequences of Anabolic Steroid Misuse and Stacked Substance Use in FAERS Data"],"prefix":"10.1177","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2809-8547","authenticated-orcid":false,"given":"Ji Won","family":"Heo","sequence":"first","affiliation":[{"name":"Brain Boutique, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Doo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Cell Biology, Sungkyunkwan University Graduate School of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1153-1934","authenticated-orcid":false,"given":"Sun Kyoung","family":"Yum","sequence":"additional","affiliation":[{"name":"Brain Boutique, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Min","family":"Joo","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Cell Biology, Sungkyunkwan University School of Medicine, Suwon, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2620-6448","authenticated-orcid":false,"given":"Sun Young","family":"Yum","sequence":"additional","affiliation":[{"name":"Brain Boutique, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2008.12.042"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13011-015-0006-5"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circheartfailure.109.931063"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2003.000199"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.05.013"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004140050165"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182192281"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.02338"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/1752-1947-2-340"},{"key":"e_1_3_2_11_2","unstructured":"FDA. FDA Adverse Event Reporting System (FAERS) public dashboard. 2024. Last accessed September 30 2024. https:\/\/www.fda.gov\/drugs\/questions-and-answers-fdas-adverse-event-reporting-system-faers\/fda-adverse-event-reporting-system-faers-public-dashboard; https:\/\/www.ema.europa.eu\/en\/human-regulatory-overview\/post-authorisation\/pharmacovigilance-post-authorisation\/good-pharmacovigilance-practices-gvp"},{"key":"e_1_3_2_12_2","unstructured":"European Medicines Agency (EMA). Guideline on good pharmacovigilance practices (GVP) module VI\u2014collection management and submission of reports of suspected adverse reactions to medicinal products (Rev 2). 2017. Last Accessed March 26 2025. https:\/\/www.ema.europa.eu\/en\/human-regulatory-overview\/post-authorisation\/pharmacovigilance-post-authorisation\/good-pharmacovigilance-practices-gvp"},{"key":"e_1_3_2_13_2","unstructured":"National Institute of Diabetes and Digestive and Kidney Diseases. Ephedra. LiverTox: clinical and research information on drug-induced liver injury. 2012. Last Accessed March 26 2024. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK548711\/"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.3389\/ftox.2024.1379272"},{"key":"e_1_3_2_15_2","unstructured":"National Institute on Drug Abuse (NIDA). Anabolic steroids and other appearance and performance enhancing drugs (APEDs). 2023. Last accessed March 19 2025. https:\/\/nida.nih.gov\/research-topics\/anabolic-steroids"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1080\/09687637.2024.2373056"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2014.930372"}],"container-title":["Substance Use & Addiction Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29767342251360872","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/29767342251360872","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29767342251360872","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:51:52Z","timestamp":1777600312000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/29767342251360872"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,5]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/29767342251360872"],"URL":"https:\/\/doi.org\/10.1177\/29767342251360872","relation":{},"ISSN":["2976-7342","2976-7350"],"issn-type":[{"value":"2976-7342","type":"print"},{"value":"2976-7350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,5]]}}}