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Injectable Steroid Contaminants

Underground injectable steroids in Australia are not made in professional pharmaceutical manufacturing plants with enforced standards and quality control systems – the “raws” (powdered/liquid steroid concentrates) used are usually sourced from China with no knowledge of the conditions or methods of manufacture, and then made up into oils in a kitchen of a local supplier within Australia. 

Contamination within injectable steroids has not been researched anywhere near as thoroughly as contaminants within narcotics, and finding statistics on it is difficult. Most steroids seized by law enforcement are only analysed for steroid type, if at all. 

It can be expected that there will be a very high risk of various forms of contamination. The main types are: 

  1. microbial contamination 
  2. steroid contamination 
  3. chemical contamination 
  4. particulate contamination 

 

1. MICROBIAL CONTAMINATION  

Multi-use vials (a vial containing more than one dose of a medication, where numerous needles will puncture the stopper over a period of time) are at risk of microbial contamination. 

Once a needle punctures a stopper for the first time, a multi-use vial has a 28 day expiry – after this date it is no longer safe and the risk of infection goes up.  

FYI – the date printed on the side of vials is how long they can be stored BEFORE being used. 

Microbial contamination can be introduced during the manufacture of raws overseas, during the process of bottling oils in Australia, or by the user through poor storage, hygiene or injection practices.  

EVEN THE EXPERTS GET IT WRONG 

Studies have shown that even in clinical settings where all staff are educated on storage and handling of multiuse vials, microbial contamination still happens. Paper 1 (Van Den Heever, A.; 2016) details how 6.4% of vials of phenylephrine used in one hospital were found to be contaminated over a 3-month period in 2016.  

In a German hospital in 2001, two patients died of meningitis after being injected with a contaminated contrast media, so a prevalence study was done on all multi-use vials in use in a single day (Paper 2 – Mattner, F.; 2004). 227 open vials were collected from wards and tested. 0.9% were contaminated with Staphylococcus, only 50% had been labelled with the date first used, and 13% of those labelled had expired. It may sound low to have 0.9% contaminated – but in a hospital that size it equates to an infection per day. 

If the experts can accidentally cause vials to be contaminated in clinical settings, how likely is it that you could get an infection from a vial that has been in your humid bathroom cupboard for months, or in your sweaty gym bag? Highly likely. 

One of the most common ways steroid users can contaminate vials is by loading a syringe with multiple medications – changing the needle on the syringe is not enough to prevent cross-contamination. Loading multiple medications into the one syringe is a very common, high-risk behaviour. 

If you do suspect that you have an infection, get medical attention as soon as possible, and do not use the same vial again. 

TIPS FOR PREVENTING INFECTION 

Wash your hands, use alcohol wipes, don’t rest needles on dirty benchtops etc. 

Don’t carry vials around in cars, gym bags, etc. Don’t store steroids in humid bathrooms or in sunlight. Keep them in a cool, dark, clean place. 

Don’t load needles from multiple vials at the same time. 

Don’t preload syringes and store them. 

Throw out vials 28 days after they are first punctured. 

Check the stopper is firmly attached – if it wiggles or comes off, that vial is either already contaminated or soon will be. Do not use if the rubber is perished, crumbling or damaged. 

NEVER reuse needles. 

NEVER share vials. 

NEVER use a vial that has cloudy/dirty glass on the inside. 

 

2. STERIOD CONTAMINATION 

Never forget that you are using a substandard product made in substandard conditions. No matter how fancy the packaging is, any underground medication is an inferior product. 

It is quite common for underground steroids to be contaminated with other steroids not listed on the label. 

This can be done in several ways: 

  1. Deliberate contamination – suppliers swapping or adding products in an effort to fool/scam the customer. 
  2. Unintentional contamination – raws can be contaminated during manufacture, or the supplier in Australia can contaminate one steroid with another if they aren’t maintaining a clean/sterile environment. 

Analysis labs have reported that it is quite normal to see traces of other steroids in underground products when they are analysed, and they will often not report this contamination to the customer if it is “low level”. 

Unfortunately, there is not a lot of literature available on the contamination of steroids – most research is looking for steroids contaminating other products. 

When testing steroids with kits, contamination with other steroids can create an inconclusive result. PEDTest products are very sensitive, and will show the trace of a steroid that is too low to register on HPLC analysis (<5%). 

Steroid contamination can affect kit results by mixing colours. If you are ever unsure of a result, send the photos of the kit result to us and we will do our best to help you interpret the result. 

 

3. CHEMICAL CONTAMINATION 

Chemical contamination in illicit drugs has mainly focussed on narcotics, there has been minimal (if any) research on similar contamination in steroids. There is a lack of information on what is used to cut raws, for example. 

Chemical contaminants can come from a wide variety of sources – from chemicals used during the manufacture process, to metals leaching out of equipment, to random dirt and environmental contaminants from poor hygiene during any part of the process (Paper 3 – Bentil, E.: 2019). 

It also includes chemicals produced by the breakdown of the product itself over time – some of which can be quite toxic. 

Chemical contamination won’t be identified with the usual HPLC and other analysis methods until it is over 5% of the sample, and in some cases still cant be detected (i.e. volatile compounds etc). 

PED Test Australia have found a proportion of steroid brands have products that form a precipitate (a solid substance is created) when tested – this never happens with legal pharmaceutical products. 

Our research so far has proven that it is not due to oils, preservatives or solvents used – it is something in the raws themselves. Whatever this chemical is that causes the precipitate, it is not supposed to be in there. Unfortunately we have been unable to identify it with the analysis methods available to us and are collaborating with researchers in Australia to see if more advanced analysis methods can be used.  

Research is ongoing, and we will keep you up to date on the findings via our Instagram account. 

 

4. PARTICULATE CONTAMINATION 

Particulate contamination is anything solid floating in the steroid, and can be particles too small to see with the naked eye. 

Particles can come from poor manufacturing and transport, dirty equipment, or poor filtering. 

Another source are the stoppers on the top of vials. If vials are stored too long (or are of poor quality) the stopper can perish and become brittle. Then it doesn’t take much for small particles of plastic to drop into the oil.  

Don’t use a vial if: 

  • The oil is cloudy, 
  • There is sediment at the bottom of the vial, 
  • The glass looks dirty inside the vial, or 
  • The stopper has holes in it and is no longer sealing properly. 

Remember the rule: IF IN DOUBT, THROW IT OUT. 

PED Test Australia and NARCO Test Australia provide at-home testing kits for a range of substances. 

Our aim is to improve safety, education, and minimise harm for those who choose to use illegal substances. 

Our kits help users make informed decisions about the risks they are exposed to. Contact us to find out more. 

Paper 1: Van Den Heever, A.; 2016; Microbial contamination and labelling of self-prepared, multi-dose phenylephrine solutions used at a teaching hospital; Southern African Journal of Anaesthesia and Analgesia 22(6):175-179  

 

Paper 2: Mattner, F.; 2004; Bacterial contamination of multi-dose vials: A prevalence study; American Journal of Infection Control 32(1):12-6 

 

Paper 3: Bentil, E.: 2019; Statistical analysis of trace metals content of cocaine using inductively coupled plasma-mass spectrometry calibrations; Cogent Chemistry 5(1)