Laws and Penalties: Concerns over growing illegal AAS abuse by teenagers, and many of the just discussed long-term effects, led Congress in 1991 to place the whole AAS class of drugs into Schedule III of the Controlled Substances Act (CSA). Under this legislation, AAS are defined as any drug or hormonal substance, chemically and pharmacologically related to T (other than estrogens, progestins, and corticosteroids) that promotes muscle growth. The possession or sale of AAS without a valid prescription is illegal. Since 1991, simple possession of illegally obtained AAS carry a maximum penalty of one year in prison and a minimum $1,000 fine if this is an individual’s first drug offense. The maximum penalty for trafficking (selling or possessing enough to be suspected of selling) is five years in prison and a fine of $250,000 if this is the individual’s first felony drug offense. If this is the second felony drug offense, the maximum period of imprisonment and the maximum fine both double. While the above listed penalties are for federal offenses, individual states have also implemented fines and penalties for illegal use of AAS. State executive offices have also recognized the seriousness of AAS abuse and other drugs of abuse in schools. For example, the State of Virginia enacted a law that will allow student drug testing as a legitimate school drug prevention program (48, 49).
In addition to the mentioned side effects several others have been reported. In both males and females acne are frequently reported, as well as hypertrophy of sebaceous glands, increased tallow excretion, hair loss, and alopecia. There is some evidence that anabolic steroid abuse may affect the immune system, leading to a decreased effectiveness of the defense system. Steroid use decreases the glucose tolerance, while there is an increase in insulin resistance. These changes mimic Type II diabetes. These changes seem to be reversible after abstention from the drugs.
Drug compounding centers are not regulated by the high standards that drug producers must meet. Most compounding centers are regulated by state agencies and not by the stricter FDA rules that are applied to drug producers. This current outbreak of fungal meningitis, joint infections, and other infections such as epidural abscesses related to products used to treat patients is likely to change this "oversight or regulation" situation. Currently, several high-ranking politicians are demanding stricter regulations be set up for drug-compounding companies. The FDA commissioner, the NECC cofounder, and the director of the Massachusetts Board of Registration in Pharmacy are scheduled to meet with a congressional panel on Nov. 14, 2012. Confidence in compounded drugs can be brought back to the many doctors and patients who need to use them only if such incidences of contaminated drugs from compounding centers are substantially reduced or eliminated.