Insulin is the hormone diabetics inject to control their blood sugar. Insulin stimulates the uptake of numerous nutrients into metabolically active tissue and fat cells, including Amino Acids. When injected immediately after an intense training session, insulin can greatly increase the anabolic response to a workout, making it very popular among athletes and bodybuilders.25 Unfortunately, when insulin is dosed incorrectly, it causes hypoglycemia (low blood sugar) and can even plunge a person into a coma quite rapidly. If the blood sugar level isn’t quickly corrected, brain death can occur within a matter of minutes to hours.26 Insulin has even been used as a murder weapon.27
    The list of potential risks associated with the number and doses of drugs used to build muscle or reduce body fat go on (Cytomel, clenbuterol, etc.) Sadly, many bodybuilders also suffer from recreational drug use not related to muscle building/fat loss.

Pushing the Limits of Human Experience
    Bodybuilding is primarily a sport of young adults who are competitive and driven. In some cases, this drive is based on irrational goals or leads to stress that exceeds the coping skills of the individual.28 In other cases, bodybuilding is just another high-risk pursuit followed by manic individuals seeking to constantly push the limits of human experience.29 In yet other cases, bodybuilding may be an ineffective coping mechanism used to deal with an earlier trauma, possibly explaining the high incidence of weight training among female rape victims noted in one study.30 Then there are the people who just enjoy improving on their physique and health/performance (didn’t you start to wonder it there were any normal people left?).

    Combine these groups with the forced exposure to black market, street drug dealers and the fall into addictive drug use is nearly inevitable— assuming recreational drug use didn’t predate AAS use, which happens in many cases.31 Many bodybuilders became addicted to the painkiller Nubain during its heyday; OxyContin use and heroin addiction aren’t uncommon.32 In fact, former bodybuilding sensation Paul “Quadzilla” DeMayo died at the age of 37 of a heroin overdose, among others.33

    Painkillers, stimulants such as “meth” (methamphetamine), hallucinogenics and other drugs are harmful enough on their own. In an AAS user, these drugs may be even more dangerous as AAS affect certain receptors and pathways in the brain, making it difficult to predict how an individual may respond to psychoactive drugs.34-3

    Even over-the-counter drugs like ibuprofen (Advil, etc.) are associated with kidney damage. Ibuprofen doesn’t provide a high; it mitigates the chronic tendon and joint inflammation brought on by near-daily weight training. Several bodybuilders are dialysis-dependent or have impaired kidney function, quite probably caused to some degree by the overuse of nonsteroidal painkillers.37

    Given the record of early deaths, damaged health, shattered lives and ended careers that have resulted from drug use by bodybuilders, how can anyone possibly justify performance drug use? This is a very complex question and goes into much greater depth than a single article can address. Many of the tragedies that occur within the culture of bodybuilding aren’t related to performance enhancement. Recreational drug use is just as harmful and deadly among the strong and buff as it is among the homeless and destitute. It’s possible that some people pursue AAS (and other performance drug use) as a consequence of the same psychoses, genetic predisposition or personality disorder that leads them to choose other high-risk behaviors.38 Individual performance drugs all have therapeutic windows and dose ranges in which their use is effective, but also safe. Unfortunately, the “more is better” mantra is still practiced by many bodybuilders, and the degree of excess among young, inexperienced users is much higher today than it was 20 years ago.

    While it’s relatively easy to predict the effects— positive and negative— of single drugs, bodybuilders have expanded the concept of stacking beyond the boundaries of reason. It’s not just the professionals who are using a dozen or more drugs, but amateurs and even noncompetitive “gym rats.” With the advent of selective drugs that counter many of the side effects seen with more traditional performance drugs, bodybuilders are now able to push the envelope even further.

Hearing the Tree Fall
    Clearly, not even a Nobel Prize winner could tell a person on stacks like Munzer’s, or in the case of GH-associated diabetes, what’s happening in his or her body or the likelihood of suffering a negative side effect, now or in the future. When people use drugs with limited or no knowledge of the risks and benefits— they’re doing so without making an informed consent. An informed consent is making a choice knowing the possible outcomes.

    One entity that certainly deserves some measure of blame in this catastrophe is the government. Against the initial advice of nearly all health care professional societies and law enforcement agencies, AAS and other performance drugs have been classified as controlled substances and physicians are prohibited from prescribing these drugs for cosmetic or performance purposes. This has driven the bodybuilder out of the clinic and into the street to acquire his drugs, exposing him/her to drugs of questionable quality purchased from career criminals with no formal training or education. Not only has this placed the bodybuilder/athlete at risk, it has broadened the market for the drugs to include adolescents and sociopaths, encouraged criminal distribution, created a loss of revenue for the drug companies, pharmacies and physicians as well as erased any tax revenue that might have been generated. In addition, adverse events are not tracked, as they are with other prescribed drugs. The outcome of this culture of performance drug prohibition is the same as experienced with alcohol (the 18th Amendment to the U.S. Constitution)— failure. The 18th Amendment was repealed by Congress with the ratification of the 21st Amendment less than five years later. Perhaps there’s a lesson to be learned from history.